|
HC ENDO SM INT ILEUM DIAG
|
Facility
|
IP
|
$9,129.00
|
|
|
Service Code
|
CPT 44376
|
| Hospital Charge Code |
906744376
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,825.80 |
| Max. Negotiated Rate |
$8,216.10 |
| Rate for Payer: Cash Price |
$4,108.05
|
| Rate for Payer: Central Health Plan Commercial |
$7,303.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,651.60
|
| Rate for Payer: Galaxy Health WC |
$7,759.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,477.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,216.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,089.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,478.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,825.80
|
| Rate for Payer: Multiplan Commercial |
$6,846.75
|
| Rate for Payer: Networks By Design Commercial |
$5,933.85
|
| Rate for Payer: Prime Health Services Commercial |
$7,759.65
|
|
|
HC ENDO SM INT ILEUM DIAG
|
Facility
|
OP
|
$4,745.00
|
|
|
Service Code
|
CPT 44376
|
| Hospital Charge Code |
906744376
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$479.60 |
| 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 |
$2,847.00
|
| 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: Caremore Medicare Advantage |
$2,377.45
|
| Rate for Payer: Cash Price |
$2,135.25
|
| Rate for Payer: Cash Price |
$2,135.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,796.00
|
| Rate for Payer: Cigna of CA PPO |
$3,511.30
|
| 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 |
$4,033.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,847.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,270.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,558.75
|
| 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 |
$3,164.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$479.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$949.00
|
| 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 |
$3,558.75
|
| Rate for Payer: Networks By Design Commercial |
$3,084.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,033.25
|
| 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 |
$2,847.00
|
| 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 ILEUM W BX
|
Facility
|
IP
|
$5,936.00
|
|
|
Service Code
|
CPT 44377
|
| Hospital Charge Code |
906744377
|
|
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 INT ILEUM W BX
|
Facility
|
OP
|
$2,622.00
|
|
|
Service Code
|
CPT 44377
|
| Hospital Charge Code |
906744377
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$507.19 |
| 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 |
$507.19
|
| 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 ILEUM W CNTRL BLEEDING
|
Facility
|
OP
|
$2,622.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
906744378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$524.40 |
| 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 |
$661.39
|
| 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 ILEUM W CNTRL BLEEDING
|
Facility
|
IP
|
$5,936.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
906744378
|
|
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 INT ILEUM W STNT PLCMNT
|
Facility
|
IP
|
$13,027.00
|
|
|
Service Code
|
CPT 44379
|
| Hospital Charge Code |
906744379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,605.40 |
| Max. Negotiated Rate |
$11,724.30 |
| Rate for Payer: Cash Price |
$5,862.15
|
| Rate for Payer: Central Health Plan Commercial |
$10,421.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,210.80
|
| Rate for Payer: Galaxy Health WC |
$11,072.95
|
| Rate for Payer: Global Benefits Group Commercial |
$7,816.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,724.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,689.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,963.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,605.40
|
| Rate for Payer: Multiplan Commercial |
$9,770.25
|
| Rate for Payer: Networks By Design Commercial |
$8,467.55
|
| Rate for Payer: Prime Health Services Commercial |
$11,072.95
|
|
|
HC ENDO SM INT ILEUM W STNT PLCMNT
|
Facility
|
OP
|
$7,192.00
|
|
|
Service Code
|
CPT 44379
|
| Hospital Charge Code |
906744379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$611.17 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,120.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,120.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,315.20
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$7,120.83
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,753.60
|
| Rate for Payer: Cigna of CA PPO |
$5,322.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Dignity Health Media |
$7,120.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,832.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,613.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,120.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,120.83
|
| Rate for Payer: Galaxy Health WC |
$6,113.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,315.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,472.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,394.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,678.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,749.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,120.83
|
| Rate for Payer: InnovAge PACE Commercial |
$10,681.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,797.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$611.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,120.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,541.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,541.91
|
| Rate for Payer: Multiplan Commercial |
$5,394.00
|
| Rate for Payer: Networks By Design Commercial |
$4,674.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,113.20
|
| Rate for Payer: Prime Health Services Medicare |
$7,548.08
|
| Rate for Payer: Riverside University Health System MISP |
$7,832.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,315.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,545.00
|
| 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 |
$10,681.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: Vantage Medical Group Senior |
$7,120.83
|
|
|
HC ENDO SM INT W/ABLATION
|
Facility
|
OP
|
$2,622.00
|
|
|
Service Code
|
CPT 44369
|
| Hospital Charge Code |
906744369
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$500.82 |
| 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 |
$500.82
|
| 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 W/ABLATION
|
Facility
|
IP
|
$4,750.00
|
|
|
Service Code
|
CPT 44369
|
| Hospital Charge Code |
906744369
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$950.00 |
| Max. Negotiated Rate |
$4,275.00 |
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,800.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,900.00
|
| Rate for Payer: Galaxy Health WC |
$4,037.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,850.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,275.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,168.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,809.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.00
|
| Rate for Payer: Multiplan Commercial |
$3,562.50
|
| Rate for Payer: Networks By Design Commercial |
$3,087.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,037.50
|
|
|
HC ENDO SM INT W/ CONVERSION
|
Facility
|
OP
|
$4,551.00
|
|
|
Service Code
|
CPT 44373
|
| Hospital Charge Code |
906744373
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$402.50 |
| 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 |
$2,730.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$2,377.45
|
| Rate for Payer: Cash Price |
$2,047.95
|
| Rate for Payer: Cash Price |
$2,047.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,640.80
|
| Rate for Payer: Cigna of CA PPO |
$3,367.74
|
| 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 |
$3,868.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,730.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,095.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,413.25
|
| 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 |
$3,035.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$402.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$910.20
|
| 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 |
$3,413.25
|
| Rate for Payer: Networks By Design Commercial |
$2,958.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,868.35
|
| 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 |
$2,730.60
|
| 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 W/ CONVERSION
|
Facility
|
IP
|
$8,244.00
|
|
|
Service Code
|
CPT 44373
|
| Hospital Charge Code |
906744373
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,648.80 |
| Max. Negotiated Rate |
$7,419.60 |
| Rate for Payer: Cash Price |
$3,709.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,595.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,297.60
|
| Rate for Payer: Galaxy Health WC |
$7,007.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,946.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,419.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,498.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,140.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,648.80
|
| Rate for Payer: Multiplan Commercial |
$6,183.00
|
| Rate for Payer: Networks By Design Commercial |
$5,358.60
|
| Rate for Payer: Prime Health Services Commercial |
$7,007.40
|
|
|
HC ENDO SM INT W/FORCEPS
|
Facility
|
OP
|
$2,622.00
|
|
|
Service Code
|
CPT 44365
|
| Hospital Charge Code |
906744365
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$493.75 |
| 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 |
$493.75
|
| 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 W/FORCEPS
|
Facility
|
IP
|
$4,750.00
|
|
|
Service Code
|
CPT 44365
|
| Hospital Charge Code |
906744365
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$950.00 |
| Max. Negotiated Rate |
$4,275.00 |
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,800.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,900.00
|
| Rate for Payer: Galaxy Health WC |
$4,037.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,850.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,275.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,168.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,809.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.00
|
| Rate for Payer: Multiplan Commercial |
$3,562.50
|
| Rate for Payer: Networks By Design Commercial |
$3,087.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,037.50
|
|
|
HC ENDO SM INT W/PLCMNT PERCUT
|
Facility
|
IP
|
$8,255.00
|
|
|
Service Code
|
CPT 44372
|
| Hospital Charge Code |
906744372
|
|
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
|
|
|
HC ENDO SM INT W/PLCMNT PERCUT
|
Facility
|
OP
|
$4,558.00
|
|
|
Service Code
|
CPT 44372
|
| Hospital Charge Code |
906744372
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$455.54 |
| 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 |
$455.54
|
| 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 INT W/RMVL FB
|
Facility
|
OP
|
$2,622.00
|
|
|
Service Code
|
CPT 44363
|
| Hospital Charge Code |
906744363
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$321.14 |
| 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 |
$321.14
|
| 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 W/RMVL FB
|
Facility
|
IP
|
$5,936.00
|
|
|
Service Code
|
CPT 44363
|
| Hospital Charge Code |
906744363
|
|
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 INT W/SNARE
|
Facility
|
OP
|
$2,622.00
|
|
|
Service Code
|
CPT 44364
|
| Hospital Charge Code |
906744364
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$385.51 |
| 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 |
$385.51
|
| 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 W/SNARE
|
Facility
|
IP
|
$4,750.00
|
|
|
Service Code
|
CPT 44364
|
| Hospital Charge Code |
906744364
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$950.00 |
| Max. Negotiated Rate |
$4,275.00 |
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,800.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,900.00
|
| Rate for Payer: Galaxy Health WC |
$4,037.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,850.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,275.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,168.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,809.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.00
|
| Rate for Payer: Multiplan Commercial |
$3,562.50
|
| Rate for Payer: Networks By Design Commercial |
$3,087.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,037.50
|
|
|
HC ENDO SM INT W STENT PLCMNT
|
Facility
|
OP
|
$7,192.00
|
|
|
Service Code
|
CPT 44370
|
| Hospital Charge Code |
906744370
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$374.91 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,120.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,071.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,120.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,315.20
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$7,120.83
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Cash Price |
$3,236.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,753.60
|
| Rate for Payer: Cigna of CA PPO |
$5,322.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Dignity Health Media |
$7,120.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,832.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,613.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,120.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,120.83
|
| Rate for Payer: Galaxy Health WC |
$6,113.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,315.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,472.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,394.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,678.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,749.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,120.83
|
| Rate for Payer: InnovAge PACE Commercial |
$10,681.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,797.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$374.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,120.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,438.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,541.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,541.91
|
| Rate for Payer: Multiplan Commercial |
$5,394.00
|
| Rate for Payer: Networks By Design Commercial |
$4,674.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,113.20
|
| Rate for Payer: Prime Health Services Medicare |
$7,548.08
|
| Rate for Payer: Riverside University Health System MISP |
$7,832.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,315.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,545.00
|
| 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 |
$10,681.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: Vantage Medical Group Senior |
$7,120.83
|
|
|
HC ENDO SM INT W STENT PLCMNT
|
Facility
|
IP
|
$13,027.00
|
|
|
Service Code
|
CPT 44370
|
| Hospital Charge Code |
906744370
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,605.40 |
| Max. Negotiated Rate |
$11,724.30 |
| Rate for Payer: Cash Price |
$5,862.15
|
| Rate for Payer: Central Health Plan Commercial |
$10,421.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,210.80
|
| Rate for Payer: Galaxy Health WC |
$11,072.95
|
| Rate for Payer: Global Benefits Group Commercial |
$7,816.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,724.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,689.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,963.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,605.40
|
| Rate for Payer: Multiplan Commercial |
$9,770.25
|
| Rate for Payer: Networks By Design Commercial |
$8,467.55
|
| Rate for Payer: Prime Health Services Commercial |
$11,072.95
|
|
|
HC ENDOTRACH 5.0MM W/CUFF PEDS
|
Facility
|
IP
|
$45.26
|
|
| Hospital Charge Code |
901698775
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$40.73 |
| Rate for Payer: Cash Price |
$20.37
|
| Rate for Payer: Central Health Plan Commercial |
$36.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.10
|
| Rate for Payer: Galaxy Health WC |
$38.47
|
| Rate for Payer: Global Benefits Group Commercial |
$27.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.05
|
| Rate for Payer: Multiplan Commercial |
$33.94
|
| Rate for Payer: Networks By Design Commercial |
$29.42
|
| Rate for Payer: Prime Health Services Commercial |
$38.47
|
|
|
HC ENDOTRACH 5.0MM W/CUFF PEDS
|
Facility
|
OP
|
$45.26
|
|
| Hospital Charge Code |
901698775
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$40.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.74
|
| Rate for Payer: Blue Distinction Transplant |
$27.16
|
| Rate for Payer: Blue Shield of California Commercial |
$28.47
|
| Rate for Payer: Blue Shield of California EPN |
$22.13
|
| Rate for Payer: Cash Price |
$20.37
|
| Rate for Payer: Central Health Plan Commercial |
$36.21
|
| Rate for Payer: Cigna of CA HMO |
$28.97
|
| Rate for Payer: Cigna of CA PPO |
$33.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.47
|
| Rate for Payer: Dignity Health Media |
$38.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.10
|
| Rate for Payer: Galaxy Health WC |
$38.47
|
| Rate for Payer: Global Benefits Group Commercial |
$27.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.73
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$33.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.05
|
| Rate for Payer: Multiplan Commercial |
$33.94
|
| Rate for Payer: Networks By Design Commercial |
$29.42
|
| Rate for Payer: Prime Health Services Commercial |
$38.47
|
| Rate for Payer: Riverside University Health System MISP |
$18.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.63
|
| Rate for Payer: United Healthcare All Other HMO |
$22.63
|
| Rate for Payer: United Healthcare HMO Rider |
$22.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.47
|
| Rate for Payer: Vantage Medical Group Senior |
$38.47
|
|
|
HC ENDOTRACH 5.5MM W/CUFF PEDS
|
Facility
|
OP
|
$45.26
|
|
| Hospital Charge Code |
901698774
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$40.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.74
|
| Rate for Payer: Blue Distinction Transplant |
$27.16
|
| Rate for Payer: Blue Shield of California Commercial |
$28.47
|
| Rate for Payer: Blue Shield of California EPN |
$22.13
|
| Rate for Payer: Cash Price |
$20.37
|
| Rate for Payer: Central Health Plan Commercial |
$36.21
|
| Rate for Payer: Cigna of CA HMO |
$28.97
|
| Rate for Payer: Cigna of CA PPO |
$33.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.47
|
| Rate for Payer: Dignity Health Media |
$38.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.10
|
| Rate for Payer: Galaxy Health WC |
$38.47
|
| Rate for Payer: Global Benefits Group Commercial |
$27.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.73
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$33.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.05
|
| Rate for Payer: Multiplan Commercial |
$33.94
|
| Rate for Payer: Networks By Design Commercial |
$29.42
|
| Rate for Payer: Prime Health Services Commercial |
$38.47
|
| Rate for Payer: Riverside University Health System MISP |
$18.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.63
|
| Rate for Payer: United Healthcare All Other HMO |
$22.63
|
| Rate for Payer: United Healthcare HMO Rider |
$22.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.47
|
| Rate for Payer: Vantage Medical Group Senior |
$38.47
|
|
