|
HC ENDOLUMINAL BX BILIARY TREE
|
Facility
|
OP
|
$1,263.00
|
|
|
Service Code
|
CPT 47543
|
| Hospital Charge Code |
909047543
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$252.60 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,073.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$694.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$694.65
|
| 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 |
$757.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Cash Price |
$568.35
|
| Rate for Payer: Cash Price |
$568.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,010.40
|
| Rate for Payer: Cigna of CA PPO |
$934.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,073.55
|
| Rate for Payer: Dignity Health Media |
$1,073.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,073.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$505.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada (Sierra) Other |
$947.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$442.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$842.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,325.12
|
| 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
|
| Rate for Payer: Riverside University Health System MISP |
$505.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$757.80
|
| 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 |
$1,073.55
|
| Rate for Payer: Vantage Medical Group Senior |
$1,073.55
|
|
|
HC ENDOMETRIAL BIOPSY
|
Facility
|
IP
|
$684.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
900501615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$136.80 |
| Max. Negotiated Rate |
$615.60 |
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Central Health Plan Commercial |
$547.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.60
|
| Rate for Payer: Galaxy Health WC |
$581.40
|
| Rate for Payer: Global Benefits Group Commercial |
$410.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$615.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$456.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$260.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.80
|
| Rate for Payer: Multiplan Commercial |
$513.00
|
| Rate for Payer: Networks By Design Commercial |
$444.60
|
| Rate for Payer: Prime Health Services Commercial |
$581.40
|
|
|
HC ENDOMETRIAL BIOPSY
|
Facility
|
IP
|
$684.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
900501615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$136.80 |
| Max. Negotiated Rate |
$615.60 |
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Central Health Plan Commercial |
$547.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.60
|
| Rate for Payer: Galaxy Health WC |
$581.40
|
| Rate for Payer: Global Benefits Group Commercial |
$410.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$615.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$456.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$260.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.80
|
| Rate for Payer: Multiplan Commercial |
$513.00
|
| Rate for Payer: Networks By Design Commercial |
$444.60
|
| Rate for Payer: Prime Health Services Commercial |
$581.40
|
|
|
HC ENDOMETRIAL BIOPSY
|
Facility
|
OP
|
$684.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
900501615
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$77.98 |
| 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 |
$373.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$273.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$248.97
|
| 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 |
$410.40
|
| Rate for Payer: Caremore Medicare Advantage |
$248.97
|
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Central Health Plan Commercial |
$547.20
|
| Rate for Payer: Cigna of CA PPO |
$506.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$373.46
|
| Rate for Payer: Dignity Health Media |
$248.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$273.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$336.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$248.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$248.97
|
| Rate for Payer: Galaxy Health WC |
$581.40
|
| Rate for Payer: Global Benefits Group Commercial |
$410.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$615.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$513.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$408.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$248.97
|
| Rate for Payer: InnovAge PACE Commercial |
$373.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$456.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$248.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$333.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$333.62
|
| Rate for Payer: Multiplan Commercial |
$513.00
|
| Rate for Payer: Networks By Design Commercial |
$444.60
|
| Rate for Payer: Prime Health Services Commercial |
$581.40
|
| Rate for Payer: Prime Health Services Medicare |
$263.91
|
| Rate for Payer: Riverside University Health System MISP |
$273.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$410.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$342.00
|
| Rate for Payer: United Healthcare All Other HMO |
$342.00
|
| Rate for Payer: United Healthcare HMO Rider |
$342.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$342.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$373.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$273.87
|
| Rate for Payer: Vantage Medical Group Senior |
$248.97
|
|
|
HC ENDOMETRIAL BIOPSY
|
Facility
|
OP
|
$684.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
900501615
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$77.98 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$248.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$373.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$273.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$248.97
|
| 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 |
$410.40
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$248.97
|
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Cash Price |
$307.80
|
| Rate for Payer: Central Health Plan Commercial |
$547.20
|
| Rate for Payer: Cigna of CA PPO |
$506.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$373.46
|
| Rate for Payer: Dignity Health Media |
$248.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$273.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$336.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$248.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$248.97
|
| Rate for Payer: Galaxy Health WC |
$581.40
|
| Rate for Payer: Global Benefits Group Commercial |
$410.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$615.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$513.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$408.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$410.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$248.97
|
| Rate for Payer: InnovAge PACE Commercial |
$373.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$456.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$248.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$136.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$333.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$333.62
|
| Rate for Payer: Multiplan Commercial |
$513.00
|
| Rate for Payer: Networks By Design Commercial |
$444.60
|
| Rate for Payer: Prime Health Services Commercial |
$581.40
|
| Rate for Payer: Prime Health Services Medicare |
$263.91
|
| Rate for Payer: Riverside University Health System MISP |
$273.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$410.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$373.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$273.87
|
| Rate for Payer: Vantage Medical Group Senior |
$248.97
|
|
|
HC ENDOMETRIAL BX CONJUNCT W COLPOSCOPY
|
Facility
|
OP
|
$246.00
|
|
|
Service Code
|
CPT 58110
|
| Hospital Charge Code |
904000019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$209.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$135.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.30
|
| 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 |
$147.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Central Health Plan Commercial |
$196.80
|
| Rate for Payer: Cigna of CA PPO |
$182.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$209.10
|
| Rate for Payer: Dignity Health Media |
$209.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$209.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$98.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$98.40
|
| Rate for Payer: Galaxy Health WC |
$209.10
|
| Rate for Payer: Global Benefits Group Commercial |
$147.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$221.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$184.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$86.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$164.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.20
|
| Rate for Payer: Multiplan Commercial |
$184.50
|
| Rate for Payer: Networks By Design Commercial |
$159.90
|
| Rate for Payer: Prime Health Services Commercial |
$209.10
|
| Rate for Payer: Riverside University Health System MISP |
$98.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$147.60
|
| 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 |
$209.10
|
| Rate for Payer: Vantage Medical Group Senior |
$209.10
|
|
|
HC ENDOMETRIAL BX CONJUNCT W COLPOSCOPY
|
Facility
|
IP
|
$246.00
|
|
|
Service Code
|
CPT 58110
|
| Hospital Charge Code |
904000019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$221.40 |
| Rate for Payer: Cash Price |
$110.70
|
| Rate for Payer: Central Health Plan Commercial |
$196.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$98.40
|
| Rate for Payer: Galaxy Health WC |
$209.10
|
| Rate for Payer: Global Benefits Group Commercial |
$147.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$221.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$164.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$93.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.20
|
| Rate for Payer: Multiplan Commercial |
$184.50
|
| Rate for Payer: Networks By Design Commercial |
$159.90
|
| Rate for Payer: Prime Health Services Commercial |
$209.10
|
|
|
HC ENDOMYCARDIAL BIOPSY
|
Facility
|
OP
|
$5,866.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906811308
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$451.74 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,741.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| 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 |
$3,519.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$2,639.70
|
| Rate for Payer: Cash Price |
$2,639.70
|
| Rate for Payer: Cash Price |
$2,639.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,692.80
|
| Rate for Payer: Cigna of CA PPO |
$4,340.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$4,986.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,519.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,279.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,399.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,912.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$451.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,173.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$4,399.50
|
| Rate for Payer: Networks By Design Commercial |
$3,812.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,986.10
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,519.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC ENDOMYCARDIAL BIOPSY
|
Facility
|
IP
|
$5,866.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906811308
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,173.20 |
| Max. Negotiated Rate |
$5,279.40 |
| Rate for Payer: Cash Price |
$2,639.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,692.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,346.40
|
| Rate for Payer: Galaxy Health WC |
$4,986.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,519.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,279.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,912.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,234.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,173.20
|
| Rate for Payer: Multiplan Commercial |
$4,399.50
|
| Rate for Payer: Networks By Design Commercial |
$3,812.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,986.10
|
|
|
HC ENDOMYCARDIAL BIOPSY
|
Facility
|
OP
|
$5,866.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906820039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$451.74 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,741.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| 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 |
$3,519.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$2,639.70
|
| Rate for Payer: Cash Price |
$2,639.70
|
| Rate for Payer: Cash Price |
$2,639.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,692.80
|
| Rate for Payer: Cigna of CA PPO |
$4,340.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$4,986.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,519.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,279.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,399.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,912.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$451.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,173.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$4,399.50
|
| Rate for Payer: Networks By Design Commercial |
$3,812.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,986.10
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,519.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC ENDOMYCARDIAL BIOPSY
|
Facility
|
IP
|
$5,866.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906820039
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,173.20 |
| Max. Negotiated Rate |
$5,279.40 |
| Rate for Payer: Cash Price |
$2,639.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,692.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,346.40
|
| Rate for Payer: Galaxy Health WC |
$4,986.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,519.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,279.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,912.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,234.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,173.20
|
| Rate for Payer: Multiplan Commercial |
$4,399.50
|
| Rate for Payer: Networks By Design Commercial |
$3,812.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,986.10
|
|
|
HC ENDOSCOPIC PANCREATOSCOPY
|
Facility
|
IP
|
$9,827.00
|
|
|
Service Code
|
CPT 43273
|
| Hospital Charge Code |
906743273
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,965.40 |
| Max. Negotiated Rate |
$8,844.30 |
| Rate for Payer: Cash Price |
$4,422.15
|
| Rate for Payer: Central Health Plan Commercial |
$7,861.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,930.80
|
| Rate for Payer: Galaxy Health WC |
$8,352.95
|
| Rate for Payer: Global Benefits Group Commercial |
$5,896.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,844.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,554.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,744.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,965.40
|
| Rate for Payer: Multiplan Commercial |
$7,370.25
|
| Rate for Payer: Networks By Design Commercial |
$6,387.55
|
| Rate for Payer: Prime Health Services Commercial |
$8,352.95
|
|
|
HC ENDOSCOPIC PANCREATOSCOPY
|
Facility
|
OP
|
$5,425.00
|
|
|
Service Code
|
CPT 43273
|
| Hospital Charge Code |
906743273
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$177.56 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,611.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,983.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,983.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,255.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Cash Price |
$2,441.25
|
| Rate for Payer: Cash Price |
$2,441.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,340.00
|
| Rate for Payer: Cigna of CA PPO |
$4,014.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,611.25
|
| Rate for Payer: Dignity Health Media |
$4,611.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,611.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,170.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,170.00
|
| Rate for Payer: Galaxy Health WC |
$4,611.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,255.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,882.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,068.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,898.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,618.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$177.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,085.00
|
| Rate for Payer: Multiplan Commercial |
$4,068.75
|
| Rate for Payer: Networks By Design Commercial |
$3,526.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,611.25
|
| Rate for Payer: Riverside University Health System MISP |
$2,170.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,255.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,255.00
|
| 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 |
$4,611.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4,611.25
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT
|
Facility
|
OP
|
$1,307.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
905601751
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$196.00 |
| Max. Negotiated Rate |
$1,176.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$391.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,110.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$718.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$718.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$784.20
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$588.15
|
| Rate for Payer: Cash Price |
$588.15
|
| Rate for Payer: Cash Price |
$588.15
|
| Rate for Payer: Cash Price |
$588.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,045.60
|
| Rate for Payer: Cigna of CA HMO |
$836.48
|
| Rate for Payer: Cigna of CA PPO |
$967.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,110.95
|
| Rate for Payer: Dignity Health Media |
$1,110.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,110.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$522.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$522.80
|
| Rate for Payer: Galaxy Health WC |
$1,110.95
|
| Rate for Payer: Global Benefits Group Commercial |
$784.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,176.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$980.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$457.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$871.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$535.87
|
| Rate for Payer: Multiplan Commercial |
$980.25
|
| Rate for Payer: Networks By Design Commercial |
$849.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,110.95
|
| Rate for Payer: Riverside University Health System MISP |
$522.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$784.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$784.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,110.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,110.95
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT
|
Facility
|
IP
|
$1,307.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
905601751
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$261.40 |
| Max. Negotiated Rate |
$1,176.30 |
| Rate for Payer: Cash Price |
$588.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,045.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$522.80
|
| Rate for Payer: Galaxy Health WC |
$1,110.95
|
| Rate for Payer: Global Benefits Group Commercial |
$784.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,176.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$871.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$497.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$261.40
|
| Rate for Payer: Multiplan Commercial |
$980.25
|
| Rate for Payer: Networks By Design Commercial |
$849.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,110.95
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT MCAL
|
Facility
|
OP
|
$1,307.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
907000015
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$196.00 |
| Max. Negotiated Rate |
$1,176.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$391.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,110.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$718.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$718.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$784.20
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$588.15
|
| Rate for Payer: Cash Price |
$588.15
|
| Rate for Payer: Cash Price |
$588.15
|
| Rate for Payer: Cash Price |
$588.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,045.60
|
| Rate for Payer: Cigna of CA HMO |
$836.48
|
| Rate for Payer: Cigna of CA PPO |
$967.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,110.95
|
| Rate for Payer: Dignity Health Media |
$1,110.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,110.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$522.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$522.80
|
| Rate for Payer: Galaxy Health WC |
$1,110.95
|
| Rate for Payer: Global Benefits Group Commercial |
$784.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,176.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$980.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$457.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$871.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$535.87
|
| Rate for Payer: Multiplan Commercial |
$980.25
|
| Rate for Payer: Networks By Design Commercial |
$849.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,110.95
|
| Rate for Payer: Riverside University Health System MISP |
$522.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$784.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$784.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,110.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,110.95
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT MCAL
|
Facility
|
IP
|
$1,307.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
907000015
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$261.40 |
| Max. Negotiated Rate |
$1,176.30 |
| Rate for Payer: Cash Price |
$588.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,045.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$522.80
|
| Rate for Payer: Galaxy Health WC |
$1,110.95
|
| Rate for Payer: Global Benefits Group Commercial |
$784.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,176.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$871.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$497.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$261.40
|
| Rate for Payer: Multiplan Commercial |
$980.25
|
| Rate for Payer: Networks By Design Commercial |
$849.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,110.95
|
|
|
HC ENDOSCOPIC US EXAM
|
Facility
|
OP
|
$1,873.00
|
|
|
Service Code
|
CPT 43237
|
| Hospital Charge Code |
906743237
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$237.73 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,377.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,123.80
|
| 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 |
$2,377.45
|
| Rate for Payer: Cash Price |
$842.85
|
| Rate for Payer: Cash Price |
$842.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,498.40
|
| Rate for Payer: Cigna of CA PPO |
$1,386.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Dignity Health Media |
$2,377.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,615.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,209.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,377.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,377.45
|
| Rate for Payer: Galaxy Health WC |
$1,592.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,123.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,685.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,404.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,899.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,922.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,377.45
|
| Rate for Payer: InnovAge PACE Commercial |
$3,566.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,249.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$237.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$374.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,185.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,185.78
|
| Rate for Payer: Multiplan Commercial |
$1,404.75
|
| Rate for Payer: Networks By Design Commercial |
$1,217.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,592.05
|
| Rate for Payer: Prime Health Services Medicare |
$2,520.10
|
| Rate for Payer: Riverside University Health System MISP |
$2,615.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,123.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,852.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,377.45
|
|
|
HC ENDOSCOPIC US EXAM
|
Facility
|
IP
|
$3,504.00
|
|
|
Service Code
|
CPT 43237
|
| Hospital Charge Code |
906743237
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$700.80 |
| Max. Negotiated Rate |
$3,153.60 |
| Rate for Payer: Cash Price |
$1,576.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,803.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,401.60
|
| Rate for Payer: Galaxy Health WC |
$2,978.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,102.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,153.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,337.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,335.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$700.80
|
| Rate for Payer: Multiplan Commercial |
$2,628.00
|
| Rate for Payer: Networks By Design Commercial |
$2,277.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,978.40
|
|
|
HC ENDO SM INT CNTRL BLEEDING
|
Facility
|
OP
|
$2,622.00
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
906744366
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$446.35 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,377.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,573.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$2,377.45
|
| Rate for Payer: Cash Price |
$1,179.90
|
| Rate for Payer: Cash Price |
$1,179.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,097.60
|
| Rate for Payer: Cigna of CA PPO |
$1,940.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Dignity Health Media |
$2,377.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,615.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,209.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,377.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,377.45
|
| Rate for Payer: Galaxy Health WC |
$2,228.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,573.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,359.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,966.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,899.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,922.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,377.45
|
| Rate for Payer: InnovAge PACE Commercial |
$3,566.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,748.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$446.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$524.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,185.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,185.78
|
| Rate for Payer: Multiplan Commercial |
$1,966.50
|
| Rate for Payer: Networks By Design Commercial |
$1,704.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,228.70
|
| Rate for Payer: Prime Health Services Medicare |
$2,520.10
|
| Rate for Payer: Riverside University Health System MISP |
$2,615.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,573.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,852.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,377.45
|
|
|
HC ENDO SM INT CNTRL BLEEDING
|
Facility
|
IP
|
$5,936.00
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
906744366
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,187.20 |
| Max. Negotiated Rate |
$5,342.40 |
| Rate for Payer: Cash Price |
$2,671.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,748.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,374.40
|
| Rate for Payer: Galaxy Health WC |
$5,045.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,561.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,342.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,959.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,261.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,187.20
|
| Rate for Payer: Multiplan Commercial |
$4,452.00
|
| Rate for Payer: Networks By Design Commercial |
$3,858.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,045.60
|
|
|
HC ENDO SM INTEST ENDO W/BX SNGL OR MUL
|
Facility
|
OP
|
$4,558.00
|
|
|
Service Code
|
CPT 44361
|
| Hospital Charge Code |
906744361
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$339.53 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,377.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,734.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$2,377.45
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,646.40
|
| Rate for Payer: Cigna of CA PPO |
$3,372.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Dignity Health Media |
$2,377.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,615.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,209.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,377.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,377.45
|
| Rate for Payer: Galaxy Health WC |
$3,874.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,734.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,102.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,418.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,899.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,922.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,377.45
|
| Rate for Payer: InnovAge PACE Commercial |
$3,566.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,040.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$911.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,185.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,185.78
|
| Rate for Payer: Multiplan Commercial |
$3,418.50
|
| Rate for Payer: Networks By Design Commercial |
$2,962.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,874.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,520.10
|
| Rate for Payer: Riverside University Health System MISP |
$2,615.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,734.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,852.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,377.45
|
|
|
HC ENDO SM INTEST ENDO W/BX SNGL OR MUL
|
Facility
|
IP
|
$8,312.00
|
|
|
Service Code
|
CPT 44361
|
| Hospital Charge Code |
906744361
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,662.40 |
| Max. Negotiated Rate |
$7,480.80 |
| Rate for Payer: Cash Price |
$3,740.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,649.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,324.80
|
| Rate for Payer: Galaxy Health WC |
$7,065.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,987.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,480.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,544.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,166.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,662.40
|
| Rate for Payer: Multiplan Commercial |
$6,234.00
|
| Rate for Payer: Networks By Design Commercial |
$5,402.80
|
| Rate for Payer: Prime Health Services Commercial |
$7,065.20
|
|
|
HC ENDO SM INTEST W WO CO
|
Facility
|
OP
|
$4,558.00
|
|
|
Service Code
|
CPT 44360
|
| Hospital Charge Code |
906744360
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$289.31 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,377.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,734.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$2,377.45
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,646.40
|
| Rate for Payer: Cigna of CA PPO |
$3,372.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Dignity Health Media |
$2,377.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,615.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,209.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,377.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,377.45
|
| Rate for Payer: Galaxy Health WC |
$3,874.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,734.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,102.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,418.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,899.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,922.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,377.45
|
| Rate for Payer: InnovAge PACE Commercial |
$3,566.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,040.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$289.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$911.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,185.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,185.78
|
| Rate for Payer: Multiplan Commercial |
$3,418.50
|
| Rate for Payer: Networks By Design Commercial |
$2,962.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,874.30
|
| Rate for Payer: Prime Health Services Medicare |
$2,520.10
|
| Rate for Payer: Riverside University Health System MISP |
$2,615.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,734.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,852.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,377.45
|
|
|
HC ENDO SM INTEST W WO CO
|
Facility
|
IP
|
$8,255.00
|
|
|
Service Code
|
CPT 44360
|
| Hospital Charge Code |
906744360
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,651.00 |
| Max. Negotiated Rate |
$7,429.50 |
| Rate for Payer: Cash Price |
$3,714.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,604.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,302.00
|
| Rate for Payer: Galaxy Health WC |
$7,016.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,953.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,429.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,506.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,145.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,651.00
|
| Rate for Payer: Multiplan Commercial |
$6,191.25
|
| Rate for Payer: Networks By Design Commercial |
$5,365.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,016.75
|
|
