|
BICTEGRAVIR 50 MG-EMTRICITABINE 200 MG-TENOFOVIR ALAFENAM 25 MG TABLET [221141]
|
Facility
OP
|
$151.81
|
|
|
Service Code
|
NDC 61958-2501-1
|
| Hospital Charge Code |
ERX221141
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$30.36 |
| Max. Negotiated Rate |
$136.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$92.19
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$129.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$83.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$83.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$73.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.69
|
| Rate for Payer: BCBS Transplant Transplant |
$91.09
|
| Rate for Payer: Blue Shield of California Commercial |
$95.49
|
| Rate for Payer: Blue Shield of California EPN |
$74.24
|
| Rate for Payer: Cash Price |
$68.31
|
| Rate for Payer: Central Health Plan Commercial |
$121.45
|
| Rate for Payer: Cigna of CA HMO |
$106.27
|
| Rate for Payer: Cigna of CA PPO |
$106.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$129.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$60.72
|
| Rate for Payer: Galaxy Health WC |
$129.04
|
| Rate for Payer: Global Benefits Group Commercial |
$91.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$136.63
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$113.86
|
| Rate for Payer: IEHP medi-cal |
$53.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$101.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.36
|
| Rate for Payer: Multiplan Commercial |
$113.86
|
| Rate for Payer: Networks By Design Commercial |
$98.68
|
| Rate for Payer: Prime Health Services Commercial |
$129.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$91.09
|
| Rate for Payer: Riverside University Health MISP |
$60.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$75.90
|
| Rate for Payer: United Healthcare All Other HMO |
$75.90
|
| Rate for Payer: United Healthcare HMO Rider |
$75.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$75.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$129.04
|
| Rate for Payer: Vantage Medical Group Senior |
$129.04
|
|
|
BIMATOPROST 0.01 % EYE DROPS [105410]
|
Facility
OP
|
$114.92
|
|
|
Service Code
|
NDC 0023-3205-03
|
| Hospital Charge Code |
NDG105410
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$22.98 |
| Max. Negotiated Rate |
$103.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$69.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$97.68
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$63.21
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$63.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$55.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.89
|
| Rate for Payer: BCBS Transplant Transplant |
$68.95
|
| Rate for Payer: Blue Shield of California Commercial |
$72.28
|
| Rate for Payer: Blue Shield of California EPN |
$56.20
|
| Rate for Payer: Cash Price |
$51.71
|
| Rate for Payer: Central Health Plan Commercial |
$91.94
|
| Rate for Payer: Cigna of CA HMO |
$80.44
|
| Rate for Payer: Cigna of CA PPO |
$80.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$97.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$45.97
|
| Rate for Payer: Galaxy Health WC |
$97.68
|
| Rate for Payer: Global Benefits Group Commercial |
$68.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.43
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$86.19
|
| Rate for Payer: IEHP medi-cal |
$40.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.98
|
| Rate for Payer: Multiplan Commercial |
$86.19
|
| Rate for Payer: Networks By Design Commercial |
$74.70
|
| Rate for Payer: Prime Health Services Commercial |
$97.68
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$68.95
|
| Rate for Payer: Riverside University Health MISP |
$45.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$68.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$68.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.46
|
| Rate for Payer: United Healthcare All Other HMO |
$57.46
|
| Rate for Payer: United Healthcare HMO Rider |
$57.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$57.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$97.68
|
| Rate for Payer: Vantage Medical Group Senior |
$97.68
|
|
|
BIMATOPROST 0.01 % EYE DROPS [105410]
|
Facility
IP
|
$114.92
|
|
|
Service Code
|
NDC 0023-3205-03
|
| Hospital Charge Code |
NDG105410
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$22.98 |
| Max. Negotiated Rate |
$103.43 |
| Rate for Payer: Blue Shield of California Commercial |
$86.19
|
| Rate for Payer: Blue Shield of California EPN |
$61.37
|
| Rate for Payer: Cash Price |
$51.71
|
| Rate for Payer: Central Health Plan Commercial |
$91.94
|
| Rate for Payer: Cigna of CA HMO |
$80.44
|
| Rate for Payer: Cigna of CA PPO |
$80.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.97
|
| Rate for Payer: Galaxy Health WC |
$97.68
|
| Rate for Payer: Global Benefits Group Commercial |
$68.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$76.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.98
|
| Rate for Payer: Multiplan Commercial |
$86.19
|
| Rate for Payer: Networks By Design Commercial |
$74.70
|
| Rate for Payer: Prime Health Services Commercial |
$97.68
|
|
|
Biopsy, bone, open; deep (eg, humeral shaft, ischium, femoral shaft)
|
Facility
OP
|
$15,354.00
|
|
|
Service Code
|
CPT 20245
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,383.18 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,325.39
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,905.29
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
| 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 Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
| Rate for Payer: IEHP medi-cal |
$5,857.93
|
| Rate for Payer: IEHP Medicare Advantage |
$3,550.26
|
| Rate for Payer: Innovage PACE Commercial |
$5,325.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
| Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
| Rate for Payer: Riverside University Health MISP |
$3,905.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
| Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
|
Biopsy, bone, open; superficial (eg, sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)
|
Facility
OP
|
$15,354.00
|
|
|
Service Code
|
CPT 20240
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,325.39
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,905.29
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
| 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 Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
| Rate for Payer: IEHP medi-cal |
$5,857.93
|
| Rate for Payer: IEHP Medicare Advantage |
$3,550.26
|
| Rate for Payer: Innovage PACE Commercial |
$5,325.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
| Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
| Rate for Payer: Riverside University Health MISP |
$3,905.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
| Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
|
Biopsy of anorectal wall, anal approach (eg, congenital megacolon)
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 45100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,212.08 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,508.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,262.22
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,508.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| 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 |
$3,508.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,262.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,736.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,508.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,508.15
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,753.37
|
| Rate for Payer: IEHP medi-cal |
$5,788.45
|
| Rate for Payer: IEHP Medicare Advantage |
$3,508.15
|
| Rate for Payer: Innovage PACE Commercial |
$5,262.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,508.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,700.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,700.92
|
| Rate for Payer: Prime Health Services Medicare |
$3,718.64
|
| Rate for Payer: Riverside University Health MISP |
$3,858.96
|
| 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 |
$5,262.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,508.15
|
|
|
Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 57500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,004.43 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,004.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,004.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,004.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,506.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,004.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,004.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,647.27
|
| Rate for Payer: IEHP medi-cal |
$1,657.31
|
| Rate for Payer: IEHP Medicare Advantage |
$1,004.43
|
| Rate for Payer: Innovage PACE Commercial |
$1,506.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,004.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,345.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.94
|
| Rate for Payer: Prime Health Services Medicare |
$1,064.70
|
| Rate for Payer: Riverside University Health MISP |
$1,104.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Vantage Medical Group Senior |
$1,004.43
|
|
|
Biopsy of lacrimal gland
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 68510
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,212.08 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,919.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,919.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| 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 |
$2,919.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,379.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,941.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,919.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,919.67
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,788.26
|
| Rate for Payer: IEHP medi-cal |
$4,817.46
|
| Rate for Payer: IEHP Medicare Advantage |
$2,919.67
|
| Rate for Payer: Innovage PACE Commercial |
$4,379.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,919.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,912.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,912.36
|
| Rate for Payer: Prime Health Services Medicare |
$3,094.85
|
| Rate for Payer: Riverside University Health MISP |
$3,211.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,919.67
|
|
|
Biopsy of liver, needle; percutaneous
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 47000
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,025.69 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| 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 |
$2,025.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
| Rate for Payer: IEHP medi-cal |
$3,342.39
|
| Rate for Payer: IEHP Medicare Advantage |
$2,025.69
|
| Rate for Payer: Innovage PACE Commercial |
$3,038.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
| Rate for Payer: Riverside University Health MISP |
$2,228.26
|
| 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 |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
Biopsy of nerve
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 64795
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,412.38 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,412.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,618.57
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,653.62
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,412.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| 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 |
$2,412.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,618.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,256.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,412.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,412.38
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,956.30
|
| Rate for Payer: IEHP medi-cal |
$3,980.43
|
| Rate for Payer: IEHP Medicare Advantage |
$2,412.38
|
| Rate for Payer: Innovage PACE Commercial |
$3,618.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,412.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,232.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,232.59
|
| Rate for Payer: Prime Health Services Medicare |
$2,557.12
|
| Rate for Payer: Riverside University Health MISP |
$2,653.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,618.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,653.62
|
| Rate for Payer: Vantage Medical Group Senior |
$2,412.38
|
|
|
Biopsy of palate, uvula
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 42100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,905.44 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,905.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,905.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,905.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,858.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,572.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,905.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,905.44
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,124.92
|
| Rate for Payer: IEHP medi-cal |
$3,143.98
|
| Rate for Payer: IEHP Medicare Advantage |
$1,905.44
|
| Rate for Payer: Innovage PACE Commercial |
$2,858.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,905.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,553.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,553.29
|
| Rate for Payer: Prime Health Services Medicare |
$2,019.77
|
| Rate for Payer: Riverside University Health MISP |
$2,095.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Vantage Medical Group Senior |
$1,905.44
|
|
|
Biopsy of tongue; anterior two-thirds
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 41100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$687.44 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$687.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,031.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$687.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| 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 |
$687.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,031.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$928.04
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$687.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$687.44
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,127.40
|
| Rate for Payer: IEHP medi-cal |
$1,134.28
|
| Rate for Payer: IEHP Medicare Advantage |
$687.44
|
| Rate for Payer: Innovage PACE Commercial |
$1,031.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$687.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$921.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$921.17
|
| Rate for Payer: Prime Health Services Medicare |
$728.69
|
| Rate for Payer: Riverside University Health MISP |
$756.18
|
| 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 |
$1,031.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$756.18
|
| Rate for Payer: Vantage Medical Group Senior |
$687.44
|
|
|
Biopsy of tongue; posterior one-third
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 41105
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,022.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,034.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,424.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,022.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| 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 |
$4,022.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,034.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,430.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,022.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,022.69
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,597.21
|
| Rate for Payer: IEHP medi-cal |
$6,637.44
|
| Rate for Payer: IEHP Medicare Advantage |
$4,022.69
|
| Rate for Payer: Innovage PACE Commercial |
$6,034.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,022.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,390.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,390.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,264.05
|
| Rate for Payer: Riverside University Health MISP |
$4,424.96
|
| 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 |
$6,034.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,424.96
|
| Rate for Payer: Vantage Medical Group Senior |
$4,022.69
|
|
|
Biopsy of vaginal mucosa; simple (separate procedure)
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 57100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,004.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,004.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| 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 |
$1,004.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,506.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,004.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,004.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,647.27
|
| Rate for Payer: IEHP medi-cal |
$1,657.31
|
| Rate for Payer: IEHP Medicare Advantage |
$1,004.43
|
| Rate for Payer: Innovage PACE Commercial |
$1,506.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,004.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,345.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.94
|
| Rate for Payer: Prime Health Services Medicare |
$1,064.70
|
| Rate for Payer: Riverside University Health MISP |
$1,104.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Vantage Medical Group Senior |
$1,004.43
|
|
|
Biopsy of vulva or perineum (separate procedure); 1 lesion
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 56605
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,004.43 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,004.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,004.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,004.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,506.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,355.98
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,004.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,004.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,647.27
|
| Rate for Payer: IEHP medi-cal |
$1,657.31
|
| Rate for Payer: IEHP Medicare Advantage |
$1,004.43
|
| Rate for Payer: Innovage PACE Commercial |
$1,506.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,004.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,345.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,345.94
|
| Rate for Payer: Prime Health Services Medicare |
$1,064.70
|
| Rate for Payer: Riverside University Health MISP |
$1,104.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,506.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,104.87
|
| Rate for Payer: Vantage Medical Group Senior |
$1,004.43
|
|
|
Biopsy of vulva or perineum (separate procedure); each separate additional lesion (List separately in addition to code for primary procedure)
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 56606
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| 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: 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
|
|
|
Biopsy or excision of lymph node(s); open, deep axillary node(s)
|
Facility
OP
|
$15,354.00
|
|
|
Service Code
|
CPT 38525
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,762.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,143.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,238.76
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,762.51
|
| 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 Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$4,762.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,143.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,429.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,762.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,762.51
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,810.52
|
| Rate for Payer: IEHP medi-cal |
$7,858.14
|
| Rate for Payer: IEHP Medicare Advantage |
$4,762.51
|
| Rate for Payer: Innovage PACE Commercial |
$7,143.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,762.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,381.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,381.76
|
| Rate for Payer: Prime Health Services Medicare |
$5,048.26
|
| Rate for Payer: Riverside University Health MISP |
$5,238.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,143.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,238.76
|
| Rate for Payer: Vantage Medical Group Senior |
$4,762.51
|
|
|
Biopsy or excision of lymph node(s); open, deep cervical node(s)
|
Facility
OP
|
$15,354.00
|
|
|
Service Code
|
CPT 38510
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,762.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,143.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,238.76
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,762.51
|
| 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 Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$4,762.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,143.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,429.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,762.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,762.51
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,810.52
|
| Rate for Payer: IEHP medi-cal |
$7,858.14
|
| Rate for Payer: IEHP Medicare Advantage |
$4,762.51
|
| Rate for Payer: Innovage PACE Commercial |
$7,143.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,762.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,381.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,381.76
|
| Rate for Payer: Prime Health Services Medicare |
$5,048.26
|
| Rate for Payer: Riverside University Health MISP |
$5,238.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,143.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,238.76
|
| Rate for Payer: Vantage Medical Group Senior |
$4,762.51
|
|
|
Biopsy or excision of lymph node(s); open, inguinofemoral node(s)
|
Facility
OP
|
$19,907.00
|
|
|
Service Code
|
CPT 38531
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,183.44 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,762.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,143.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,238.76
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,762.51
|
| 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 Shield of California Commercial |
$5,824.53
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.44
|
| Rate for Payer: Caremore Medicare Advantage |
$4,762.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,143.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,429.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,762.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,762.51
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,810.52
|
| Rate for Payer: IEHP medi-cal |
$7,858.14
|
| Rate for Payer: IEHP Medicare Advantage |
$4,762.51
|
| Rate for Payer: Innovage PACE Commercial |
$7,143.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,762.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,381.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,381.76
|
| Rate for Payer: Prime Health Services Medicare |
$5,048.26
|
| Rate for Payer: Riverside University Health MISP |
$5,238.76
|
| 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 |
$7,143.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,238.76
|
| Rate for Payer: Vantage Medical Group Senior |
$4,762.51
|
|
|
Biopsy or excision of lymph node(s); open, superficial
|
Facility
OP
|
$15,354.00
|
|
|
Service Code
|
CPT 38500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,762.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,143.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,238.76
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,762.51
|
| 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 Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$4,762.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,143.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,429.39
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,762.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,762.51
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,810.52
|
| Rate for Payer: IEHP medi-cal |
$7,858.14
|
| Rate for Payer: IEHP Medicare Advantage |
$4,762.51
|
| Rate for Payer: Innovage PACE Commercial |
$7,143.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,762.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,381.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,381.76
|
| Rate for Payer: Prime Health Services Medicare |
$5,048.26
|
| Rate for Payer: Riverside University Health MISP |
$5,238.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,143.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,238.76
|
| Rate for Payer: Vantage Medical Group Senior |
$4,762.51
|
|
|
Biopsy, prostate; incisional, any approach
|
Facility
OP
|
$7,186.94
|
|
|
Service Code
|
CPT 55705
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$7,186.94 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,355.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,533.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,791.29
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,355.72
|
| 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 Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$4,355.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,533.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,880.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,355.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,355.72
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,143.38
|
| Rate for Payer: IEHP medi-cal |
$7,186.94
|
| Rate for Payer: IEHP Medicare Advantage |
$4,355.72
|
| Rate for Payer: Innovage PACE Commercial |
$6,533.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,355.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,836.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,836.66
|
| Rate for Payer: Prime Health Services Medicare |
$4,617.06
|
| Rate for Payer: Riverside University Health MISP |
$4,791.29
|
| 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 |
$6,533.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,791.29
|
| Rate for Payer: Vantage Medical Group Senior |
$4,355.72
|
|
|
Biopsy, prostate; needle or punch, single or multiple, any approach
|
Facility
OP
|
$7,027.00
|
|
|
Service Code
|
CPT 55700
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,544.87 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,544.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,544.87
|
| 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 Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$2,544.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,435.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,544.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,544.87
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,173.59
|
| Rate for Payer: IEHP medi-cal |
$4,199.04
|
| Rate for Payer: IEHP Medicare Advantage |
$2,544.87
|
| Rate for Payer: Innovage PACE Commercial |
$3,817.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,544.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,410.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,410.13
|
| Rate for Payer: Prime Health Services Medicare |
$2,697.56
|
| Rate for Payer: Riverside University Health MISP |
$2,799.36
|
| 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 |
$3,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Vantage Medical Group Senior |
$2,544.87
|
|
|
Biopsy thyroid, percutaneous core needle
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 60100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| 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 |
$879.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: IEHP medi-cal |
$1,450.47
|
| Rate for Payer: IEHP Medicare Advantage |
$879.07
|
| Rate for Payer: Innovage PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Riverside University Health MISP |
$966.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
Biopsy, vertebral body, open; lumbar or cervical
|
Facility
OP
|
$19,907.00
|
|
|
Service Code
|
CPT 20251
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,383.18 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,938.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$12,220.24
|
| 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: Caremore Medicare Advantage |
$8,938.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,067.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,938.53
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,659.19
|
| Rate for Payer: IEHP medi-cal |
$14,748.57
|
| Rate for Payer: IEHP Medicare Advantage |
$8,938.53
|
| Rate for Payer: Innovage PACE Commercial |
$13,407.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,977.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,977.63
|
| Rate for Payer: Multiplan WC |
$12,220.24
|
| Rate for Payer: Preferred Health Network WC |
$12,469.63
|
| Rate for Payer: Prime Health Services Medicare |
$9,474.84
|
| Rate for Payer: Prime Health Services WC |
$12,095.54
|
| Rate for Payer: Riverside University Health MISP |
$9,832.38
|
| 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 |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
|
BIOTIN 5 MG CAPSULE [9277]
|
Facility
IP
|
$0.27
|
|
|
Service Code
|
NDC 39413012
|
| Hospital Charge Code |
1712339
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.24 |
| Rate for Payer: Blue Shield of California Commercial |
$0.20
|
| Rate for Payer: Blue Shield of California EPN |
$0.14
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Central Health Plan Commercial |
$0.22
|
| Rate for Payer: Cigna of CA HMO |
$0.19
|
| Rate for Payer: Cigna of CA PPO |
$0.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.11
|
| Rate for Payer: Galaxy Health WC |
$0.23
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Networks By Design Commercial |
$0.18
|
| Rate for Payer: Prime Health Services Commercial |
$0.23
|
|
