|
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC
|
Facility
|
IP
|
$90,921.62
|
|
|
Service Code
|
MSDRG 477
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$90,921.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$90,921.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$58,731.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82,226.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$80,103.54
|
| Rate for Payer: EPIC Health Plan Senior |
$53,402.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48,547.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67,966.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$65,053.78
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$48,547.60
|
| Rate for Payer: Prime Health Services Medicare |
$51,460.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
|
IP
|
$48,924.39
|
|
|
Service Code
|
MSDRG 479
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$48,924.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,924.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,603.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,245.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,790.39
|
| Rate for Payer: EPIC Health Plan Senior |
$29,193.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,539.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37,155.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$35,563.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$26,539.63
|
| Rate for Payer: Prime Health Services Medicare |
$28,132.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
BIOPSY, BONE, OPEN; DEEP (EG, HUMERAL SHAFT, ISCHIUM, FEMORAL SHAFT)
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 20245
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$362.44 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,735.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,794.14
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$362.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,230.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,006.17
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Medicare |
$3,960.11
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,109.55
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
BIOPSY, BONE, OPEN; SUPERFICIAL (EG, STERNUM, SPINOUS PROCESS, RIB, PATELLA, OLECRANON PROCESS, CALCANEUS, TARSAL, METATARSAL, CARPAL, METACARPAL, PHALANX)
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 20240
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$217.72 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,735.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,794.14
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$217.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$240.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,230.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,006.17
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Medicare |
$3,960.11
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,109.55
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
BIOPSY, MUSCLE; DEEP
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 20205
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$187.62 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,735.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,794.14
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$187.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$207.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,230.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,006.17
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Medicare |
$3,960.11
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,109.55
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
BIOPSY OF CERVIX, SINGLE OR MULTIPLE, OR LOCAL EXCISION OF LESION, WITH OR WITHOUT FULGURATION (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 57500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$69.73 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,184.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,184.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,762.79
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,303.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,184.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.62
|
| Rate for Payer: EPIC Health Plan Senior |
$1,303.08
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,942.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$69.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$77.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,658.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,587.39
|
| Rate for Payer: Multiplan WC |
$1,762.79
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Preferred Health Network WC |
$1,798.77
|
| Rate for Payer: Prime Health Services Medicare |
$1,255.70
|
| Rate for Payer: Prime Health Services WC |
$1,744.81
|
| Rate for Payer: Riverside University Health System MISP |
$1,303.08
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,184.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,184.62
|
|
|
BIOPSY OF LIP
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 40490
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$83.25 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$304.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$470.13
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$502.64
|
| Rate for Payer: EPIC Health Plan Senior |
$335.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$499.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$83.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$91.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$426.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$408.20
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$304.63
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Medicare |
$322.91
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$335.09
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$304.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Vantage Medical Group Senior |
$304.63
|
|
|
BIOPSY OF OVARY, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 58900
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$209.17 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,163.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,163.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,436.87
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,579.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,163.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,869.74
|
| Rate for Payer: EPIC Health Plan Senior |
$4,579.83
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,828.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$209.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$231.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,828.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,579.06
|
| Rate for Payer: Multiplan WC |
$6,436.87
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Preferred Health Network WC |
$6,568.23
|
| Rate for Payer: Prime Health Services Medicare |
$4,413.29
|
| Rate for Payer: Prime Health Services WC |
$6,371.18
|
| Rate for Payer: Riverside University Health System MISP |
$4,579.83
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,163.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4,163.48
|
|
|
BIOPSY OF VAGINAL MUCOSA; SIMPLE (SEPARATE PROCEDURE)
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 57100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,184.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,184.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,762.79
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,303.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,184.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.62
|
| Rate for Payer: EPIC Health Plan Senior |
$1,303.08
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,942.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$70.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$77.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,658.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,587.39
|
| Rate for Payer: Multiplan WC |
$1,762.79
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Preferred Health Network WC |
$1,798.77
|
| Rate for Payer: Prime Health Services Medicare |
$1,255.70
|
| Rate for Payer: Prime Health Services WC |
$1,744.81
|
| Rate for Payer: Riverside University Health System MISP |
$1,303.08
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,184.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,184.62
|
|
|
BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); 1 LESION
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 56605
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$152.29 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,184.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,184.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,762.79
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,303.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,184.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,954.62
|
| Rate for Payer: EPIC Health Plan Senior |
$1,303.08
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,942.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$152.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$168.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,658.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,587.39
|
| Rate for Payer: Multiplan WC |
$1,762.79
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,184.62
|
| Rate for Payer: Preferred Health Network WC |
$1,798.77
|
| Rate for Payer: Prime Health Services Medicare |
$1,255.70
|
| Rate for Payer: Prime Health Services WC |
$1,744.81
|
| Rate for Payer: Riverside University Health System MISP |
$1,303.08
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,184.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,776.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,303.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,184.62
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP AXILLARY NODE(S)
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 38525
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$254.22 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,035.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,035.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,752.28
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,539.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,035.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,309.24
|
| Rate for Payer: EPIC Health Plan Senior |
$5,539.49
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,258.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$254.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5,035.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$280.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,050.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,748.11
|
| Rate for Payer: Multiplan WC |
$7,752.28
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5,035.90
|
| Rate for Payer: Preferred Health Network WC |
$7,910.49
|
| Rate for Payer: Prime Health Services Medicare |
$5,338.05
|
| Rate for Payer: Prime Health Services WC |
$7,673.18
|
| Rate for Payer: Riverside University Health System MISP |
$5,539.49
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$5,035.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Vantage Medical Group Senior |
$5,035.90
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, DEEP CERVICAL NODE(S)
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 38510
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$248.45 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,035.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,035.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,752.28
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,539.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,035.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,309.24
|
| Rate for Payer: EPIC Health Plan Senior |
$5,539.49
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,258.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$248.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5,035.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$274.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,050.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,748.11
|
| Rate for Payer: Multiplan WC |
$7,752.28
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5,035.90
|
| Rate for Payer: Preferred Health Network WC |
$7,910.49
|
| Rate for Payer: Prime Health Services Medicare |
$5,338.05
|
| Rate for Payer: Prime Health Services WC |
$7,673.18
|
| Rate for Payer: Riverside University Health System MISP |
$5,539.49
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$5,035.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Vantage Medical Group Senior |
$5,035.90
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, INGUINOFEMORAL NODE(S)
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 38531
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$647.41 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,035.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,035.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,752.28
|
| Rate for Payer: Blue Shield of California Commercial |
$6,228.07
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,539.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,035.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,309.24
|
| Rate for Payer: EPIC Health Plan Senior |
$5,539.49
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,258.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$647.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5,035.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$715.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,050.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,748.11
|
| Rate for Payer: Multiplan WC |
$7,752.28
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5,035.90
|
| Rate for Payer: Preferred Health Network WC |
$7,910.49
|
| Rate for Payer: Prime Health Services Medicare |
$5,338.05
|
| Rate for Payer: Prime Health Services WC |
$7,673.18
|
| Rate for Payer: Riverside University Health System MISP |
$5,539.49
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$5,035.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Vantage Medical Group Senior |
$5,035.90
|
|
|
BIOPSY OR EXCISION OF LYMPH NODE(S); OPEN, SUPERFICIAL
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 38500
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$165.21 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,035.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,035.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,752.28
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,539.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,035.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,309.24
|
| Rate for Payer: EPIC Health Plan Senior |
$5,539.49
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8,258.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$165.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5,035.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$182.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,050.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,748.11
|
| Rate for Payer: Multiplan WC |
$7,752.28
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5,035.90
|
| Rate for Payer: Preferred Health Network WC |
$7,910.49
|
| Rate for Payer: Prime Health Services Medicare |
$5,338.05
|
| Rate for Payer: Prime Health Services WC |
$7,673.18
|
| Rate for Payer: Riverside University Health System MISP |
$5,539.49
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$5,035.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,553.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,539.49
|
| Rate for Payer: Vantage Medical Group Senior |
$5,035.90
|
|
|
BIOPSY, PROSTATE, ANY APPROACH, NONIMAGING-GUIDED
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 55705
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$102.46 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,533.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,800.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,987.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,533.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,982.34
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,800.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,987.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,533.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,480.62
|
| Rate for Payer: EPIC Health Plan Senior |
$4,987.08
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,435.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$102.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,533.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$113.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,347.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,075.17
|
| Rate for Payer: Multiplan WC |
$6,982.34
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,533.71
|
| Rate for Payer: Preferred Health Network WC |
$7,124.84
|
| Rate for Payer: Prime Health Services Medicare |
$4,805.73
|
| Rate for Payer: Prime Health Services WC |
$6,911.09
|
| Rate for Payer: Riverside University Health System MISP |
$4,987.08
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,533.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,800.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,987.08
|
| Rate for Payer: Vantage Medical Group Senior |
$4,533.71
|
|
|
BIOPSY, PROSTATE; NEEDLE OR PUNCH, SINGLE OR MULTIPLE, ANY APPROACH
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 55700
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,165.61 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,147.14
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Multiplan WC |
$4,147.14
|
| Rate for Payer: Preferred Health Network WC |
$4,231.78
|
| Rate for Payer: Prime Health Services WC |
$4,104.83
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
|
|
BIOPSY, PROSTATE, TRANSPERINEAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 55709
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,533.71 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,533.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,800.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,987.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,533.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,800.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,987.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,533.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,480.62
|
| Rate for Payer: EPIC Health Plan Senior |
$4,987.08
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,435.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,533.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,347.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,075.17
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,533.71
|
| Rate for Payer: Prime Health Services Medicare |
$4,805.73
|
| Rate for Payer: Riverside University Health System MISP |
$4,987.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,533.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,800.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,987.08
|
| Rate for Payer: Vantage Medical Group Senior |
$4,533.71
|
|
|
BIOPSY, SOFT TISSUE OF PELVIS AND HIP AREA; SUPERFICIAL
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 27040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,069.82 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,124.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
|
|
BIOPSY, SOFT TISSUE OF UPPER ARM OR ELBOW AREA; DEEP (SUBFASCIAL OR INTRAMUSCULAR)
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 24066
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$378.45 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,735.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,735.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$5,794.14
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,109.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,735.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,164.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4,109.55
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,126.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$378.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$418.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,230.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,006.17
|
| Rate for Payer: Multiplan WC |
$5,794.14
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,735.95
|
| Rate for Payer: Preferred Health Network WC |
$5,912.39
|
| Rate for Payer: Prime Health Services Medicare |
$3,960.11
|
| Rate for Payer: Prime Health Services WC |
$5,735.02
|
| Rate for Payer: Riverside University Health System MISP |
$4,109.55
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,735.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,603.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,109.55
|
| Rate for Payer: Vantage Medical Group Senior |
$3,735.95
|
|
|
BIOTIN 5 MG CAPSULE [9277]
|
Facility
|
OP
|
$0.27
|
|
|
Service Code
|
NDC 0039413012
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.24 |
| Rate for Payer: Adventist Health Commercial |
$0.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Blue Shield of California Commercial |
$0.17
|
| Rate for Payer: Blue Shield of California EPN |
$0.11
|
| 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: Dignity Health Commercial/Exchange |
$0.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.11
|
| Rate for Payer: EPIC Health Plan Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.19
|
| 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
|
| Rate for Payer: Riverside University Health System MISP |
$0.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.14
|
| Rate for Payer: United Healthcare All Other HMO |
$0.14
|
| Rate for Payer: United Healthcare HMO Rider |
$0.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.23
|
| Rate for Payer: Vantage Medical Group Senior |
$0.23
|
|
|
BIOTIN 5 MG CAPSULE [9277]
|
Facility
|
IP
|
$0.27
|
|
|
Service Code
|
NDC 0039413012
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.24 |
| Rate for Payer: Adventist Health Commercial |
$0.05
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.11
|
| Rate for Payer: EPIC Health Plan Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.16
|
| 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
|
|
|
BIOTIN 5 MG TABLET [100231]
|
Facility
|
OP
|
$0.13
|
|
|
Service Code
|
NDC 3504600186
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.12 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.08
|
| Rate for Payer: Blue Shield of California Commercial |
$0.08
|
| Rate for Payer: Blue Shield of California EPN |
$0.05
|
| Rate for Payer: Cash Price |
$0.06
|
| Rate for Payer: Central Health Plan Commercial |
$0.10
|
| Rate for Payer: Cigna of CA HMO |
$0.09
|
| Rate for Payer: Cigna of CA PPO |
$0.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.05
|
| Rate for Payer: EPIC Health Plan Senior |
$0.05
|
| Rate for Payer: Galaxy Health WC |
$0.11
|
| Rate for Payer: Global Benefits Group Commercial |
$0.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.09
|
| Rate for Payer: Multiplan Commercial |
$0.10
|
| Rate for Payer: Networks By Design Commercial |
$0.08
|
| Rate for Payer: Prime Health Services Commercial |
$0.11
|
| Rate for Payer: Riverside University Health System MISP |
$0.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.07
|
| Rate for Payer: United Healthcare All Other HMO |
$0.07
|
| Rate for Payer: United Healthcare HMO Rider |
$0.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.11
|
| Rate for Payer: Vantage Medical Group Senior |
$0.11
|
|
|
BIOTIN 5 MG TABLET [100231]
|
Facility
|
IP
|
$0.13
|
|
|
Service Code
|
NDC 3504600186
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.12 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Blue Shield of California Commercial |
$0.10
|
| Rate for Payer: Blue Shield of California EPN |
$0.07
|
| Rate for Payer: Cash Price |
$0.06
|
| Rate for Payer: Central Health Plan Commercial |
$0.10
|
| Rate for Payer: Cigna of CA HMO |
$0.09
|
| Rate for Payer: Cigna of CA PPO |
$0.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.05
|
| Rate for Payer: EPIC Health Plan Senior |
$0.05
|
| Rate for Payer: Galaxy Health WC |
$0.11
|
| Rate for Payer: Global Benefits Group Commercial |
$0.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Multiplan Commercial |
$0.10
|
| Rate for Payer: Networks By Design Commercial |
$0.08
|
| Rate for Payer: Prime Health Services Commercial |
$0.11
|
|
|
BIPOLAR DISORDERS
|
Facility
|
IP
|
$13,901.94
|
|
|
Service Code
|
APR-DRG 7533
|
| Min. Negotiated Rate |
$8,780.17 |
| Max. Negotiated Rate |
$13,901.94 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,780.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10,463.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13,901.94
|
|
|
BIPOLAR DISORDERS
|
Facility
|
IP
|
$25,946.80
|
|
|
Service Code
|
APR-DRG 7534
|
| Min. Negotiated Rate |
$16,387.45 |
| Max. Negotiated Rate |
$25,946.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$16,387.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19,528.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25,946.80
|
|
