|
HC EP ST J ABLATION CABLE
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
906812640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC EP ST J COOL POINT TUBING
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
906812643
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$352.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$342.66
|
| Rate for Payer: Blue Distinction Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$364.82
|
| Rate for Payer: Blue Shield of California EPN |
$283.62
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Media |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$435.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health System MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC EP ST J COOL POINT TUBING
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
906812643
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC EPS VENT &/OR ATRIAL MAPPING
|
Facility
|
IP
|
$7,720.00
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
906811323
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,544.00 |
| Max. Negotiated Rate |
$6,948.00 |
| Rate for Payer: Cash Price |
$3,474.00
|
| Rate for Payer: Central Health Plan Commercial |
$6,176.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,088.00
|
| Rate for Payer: Galaxy Health WC |
$6,562.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,632.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,948.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,149.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,941.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,544.00
|
| Rate for Payer: Multiplan Commercial |
$5,790.00
|
| Rate for Payer: Networks By Design Commercial |
$5,018.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,562.00
|
|
|
HC EPS VENT &/OR ATRIAL MAPPING
|
Facility
|
IP
|
$7,720.00
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
906820042
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,544.00 |
| Max. Negotiated Rate |
$6,948.00 |
| Rate for Payer: Cash Price |
$3,474.00
|
| Rate for Payer: Central Health Plan Commercial |
$6,176.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,088.00
|
| Rate for Payer: Galaxy Health WC |
$6,562.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,632.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,948.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,149.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,941.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,544.00
|
| Rate for Payer: Multiplan Commercial |
$5,790.00
|
| Rate for Payer: Networks By Design Commercial |
$5,018.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,562.00
|
|
|
HC EPS VENT &/OR ATRIAL MAPPING
|
Facility
|
OP
|
$7,720.00
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
906820042
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$558.52 |
| Max. Negotiated Rate |
$9,620.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,562.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,246.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,246.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,632.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$3,474.00
|
| Rate for Payer: Cash Price |
$3,474.00
|
| Rate for Payer: Cash Price |
$3,474.00
|
| Rate for Payer: Central Health Plan Commercial |
$6,176.00
|
| Rate for Payer: Cigna of CA HMO |
$4,940.80
|
| Rate for Payer: Cigna of CA PPO |
$5,712.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,562.00
|
| Rate for Payer: Dignity Health Media |
$6,562.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,562.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,088.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,088.00
|
| Rate for Payer: Galaxy Health WC |
$6,562.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,632.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,948.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,790.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,702.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,149.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$558.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,544.00
|
| Rate for Payer: Multiplan Commercial |
$5,790.00
|
| Rate for Payer: Networks By Design Commercial |
$5,018.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,562.00
|
| Rate for Payer: Riverside University Health System MISP |
$3,088.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,632.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,632.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,562.00
|
| Rate for Payer: Vantage Medical Group Senior |
$6,562.00
|
|
|
HC EPS VENT &/OR ATRIAL MAPPING
|
Facility
|
OP
|
$7,720.00
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
906811323
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$558.52 |
| Max. Negotiated Rate |
$9,620.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,562.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,246.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,246.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,632.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$3,474.00
|
| Rate for Payer: Cash Price |
$3,474.00
|
| Rate for Payer: Cash Price |
$3,474.00
|
| Rate for Payer: Central Health Plan Commercial |
$6,176.00
|
| Rate for Payer: Cigna of CA HMO |
$4,940.80
|
| Rate for Payer: Cigna of CA PPO |
$5,712.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,562.00
|
| Rate for Payer: Dignity Health Media |
$6,562.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,562.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,088.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,088.00
|
| Rate for Payer: Galaxy Health WC |
$6,562.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,632.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,948.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,790.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,702.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,149.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$558.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,544.00
|
| Rate for Payer: Multiplan Commercial |
$5,790.00
|
| Rate for Payer: Networks By Design Commercial |
$5,018.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,562.00
|
| Rate for Payer: Riverside University Health System MISP |
$3,088.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,632.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,632.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,562.00
|
| Rate for Payer: Vantage Medical Group Senior |
$6,562.00
|
|
|
HC EPS VENTRICULAR PACING
|
Facility
|
OP
|
$7,412.00
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
906811325
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$201.17 |
| Max. Negotiated Rate |
$15,396.15 |
| Rate for Payer: Adventist Health Medi-Cal |
$9,331.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$399.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,447.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$9,331.00
|
| Rate for Payer: Cash Price |
$3,335.40
|
| Rate for Payer: Cash Price |
$3,335.40
|
| Rate for Payer: Cash Price |
$3,335.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,929.60
|
| Rate for Payer: Cigna of CA HMO |
$4,743.68
|
| Rate for Payer: Cigna of CA PPO |
$5,484.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Media |
$9,331.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,596.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,331.00
|
| Rate for Payer: Galaxy Health WC |
$6,300.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,447.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,670.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,559.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,302.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15,396.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,331.00
|
| Rate for Payer: InnovAge PACE Commercial |
$13,996.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,943.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,331.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,482.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,503.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,503.54
|
| Rate for Payer: Multiplan Commercial |
$5,559.00
|
| Rate for Payer: Networks By Design Commercial |
$4,817.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,300.20
|
| Rate for Payer: Prime Health Services Medicare |
$9,890.86
|
| Rate for Payer: Riverside University Health System MISP |
$10,264.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,447.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,447.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS VENTRICULAR PACING
|
Facility
|
OP
|
$7,412.00
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
906820044
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$201.17 |
| Max. Negotiated Rate |
$15,396.15 |
| Rate for Payer: Adventist Health Medi-Cal |
$9,331.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$399.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,331.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,447.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$9,331.00
|
| Rate for Payer: Cash Price |
$3,335.40
|
| Rate for Payer: Cash Price |
$3,335.40
|
| Rate for Payer: Cash Price |
$3,335.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,929.60
|
| Rate for Payer: Cigna of CA HMO |
$4,743.68
|
| Rate for Payer: Cigna of CA PPO |
$5,484.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Dignity Health Media |
$9,331.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,264.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,596.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,331.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,331.00
|
| Rate for Payer: Galaxy Health WC |
$6,300.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,447.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,670.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,559.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,302.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15,396.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,331.00
|
| Rate for Payer: InnovAge PACE Commercial |
$13,996.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,943.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,331.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,482.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,503.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,503.54
|
| Rate for Payer: Multiplan Commercial |
$5,559.00
|
| Rate for Payer: Networks By Design Commercial |
$4,817.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,300.20
|
| Rate for Payer: Prime Health Services Medicare |
$9,890.86
|
| Rate for Payer: Riverside University Health System MISP |
$10,264.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,447.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,447.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,996.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,264.10
|
| Rate for Payer: Vantage Medical Group Senior |
$9,331.00
|
|
|
HC EPS VENTRICULAR PACING
|
Facility
|
IP
|
$7,412.00
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
906820044
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,482.40 |
| Max. Negotiated Rate |
$6,670.80 |
| Rate for Payer: Cash Price |
$3,335.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,929.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,964.80
|
| Rate for Payer: Galaxy Health WC |
$6,300.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,447.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,670.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,943.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,823.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,482.40
|
| Rate for Payer: Multiplan Commercial |
$5,559.00
|
| Rate for Payer: Networks By Design Commercial |
$4,817.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,300.20
|
|
|
HC EPS VENTRICULAR PACING
|
Facility
|
IP
|
$7,412.00
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
906811325
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,482.40 |
| Max. Negotiated Rate |
$6,670.80 |
| Rate for Payer: Cash Price |
$3,335.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,929.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,964.80
|
| Rate for Payer: Galaxy Health WC |
$6,300.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,447.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,670.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,943.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,823.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,482.40
|
| Rate for Payer: Multiplan Commercial |
$5,559.00
|
| Rate for Payer: Networks By Design Commercial |
$4,817.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,300.20
|
|
|
HC ERCP BILIARY/SPHINCT
|
Facility
|
IP
|
$1,925.00
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
909001862
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$385.00 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: Cash Price |
$866.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,540.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$770.00
|
| Rate for Payer: Galaxy Health WC |
$1,636.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,155.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,732.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,283.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$733.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$385.00
|
| Rate for Payer: Multiplan Commercial |
$1,443.75
|
| Rate for Payer: Networks By Design Commercial |
$1,251.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,636.25
|
|
|
HC ERCP BILIARY/SPHINCT
|
Facility
|
OP
|
$1,925.00
|
|
|
Service Code
|
CPT 74328
|
| Hospital Charge Code |
909001862
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$218.75 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$460.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,636.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,058.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,058.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$651.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$795.26
|
| Rate for Payer: Blue Distinction Transplant |
$1,155.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,189.65
|
| Rate for Payer: Blue Shield of California EPN |
$935.55
|
| Rate for Payer: Cash Price |
$866.25
|
| Rate for Payer: Cash Price |
$866.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,540.00
|
| Rate for Payer: Cigna of CA HMO |
$1,232.00
|
| Rate for Payer: Cigna of CA PPO |
$1,424.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,636.25
|
| Rate for Payer: Dignity Health Media |
$1,636.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,636.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$770.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$770.00
|
| Rate for Payer: Galaxy Health WC |
$1,636.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1,155.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,732.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,443.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$673.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,283.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$385.00
|
| Rate for Payer: Multiplan Commercial |
$1,443.75
|
| Rate for Payer: Networks By Design Commercial |
$1,251.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,636.25
|
| Rate for Payer: Riverside University Health System MISP |
$770.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,155.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,155.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$962.50
|
| Rate for Payer: United Healthcare All Other HMO |
$962.50
|
| Rate for Payer: United Healthcare HMO Rider |
$962.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$962.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,636.25
|
| Rate for Payer: Vantage Medical Group Senior |
$1,636.25
|
|
|
HC ERCP COMBINED SPHINCT
|
Facility
|
OP
|
$2,291.00
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
909001863
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$218.75 |
| Max. Negotiated Rate |
$2,061.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$685.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,947.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,260.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,260.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$651.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$795.26
|
| Rate for Payer: Blue Distinction Transplant |
$1,374.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,415.84
|
| Rate for Payer: Blue Shield of California EPN |
$1,113.43
|
| Rate for Payer: Cash Price |
$1,030.95
|
| Rate for Payer: Cash Price |
$1,030.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,832.80
|
| Rate for Payer: Cigna of CA HMO |
$1,466.24
|
| Rate for Payer: Cigna of CA PPO |
$1,695.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,947.35
|
| Rate for Payer: Dignity Health Media |
$1,947.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,947.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$916.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$916.40
|
| Rate for Payer: Galaxy Health WC |
$1,947.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,374.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,061.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,718.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$801.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,528.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$458.20
|
| Rate for Payer: Multiplan Commercial |
$1,718.25
|
| Rate for Payer: Networks By Design Commercial |
$1,489.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,947.35
|
| Rate for Payer: Riverside University Health System MISP |
$916.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,374.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,374.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,145.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,145.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,145.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,145.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,947.35
|
| Rate for Payer: Vantage Medical Group Senior |
$1,947.35
|
|
|
HC ERCP COMBINED SPHINCT
|
Facility
|
IP
|
$2,291.00
|
|
|
Service Code
|
CPT 74330
|
| Hospital Charge Code |
909001863
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$458.20 |
| Max. Negotiated Rate |
$2,061.90 |
| Rate for Payer: Cash Price |
$1,030.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,832.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$916.40
|
| Rate for Payer: Galaxy Health WC |
$1,947.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,374.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,061.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,528.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$872.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$458.20
|
| Rate for Payer: Multiplan Commercial |
$1,718.25
|
| Rate for Payer: Networks By Design Commercial |
$1,489.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,947.35
|
|
|
HC ERCP DIAG W/ OR W/O COLLECT SP
|
Facility
|
OP
|
$4,620.00
|
|
|
Service Code
|
CPT 43260
|
| Hospital Charge Code |
906743260
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$587.12 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,785.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,177.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,263.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,785.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,772.00
|
| 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 |
$4,785.03
|
| Rate for Payer: Cash Price |
$2,079.00
|
| Rate for Payer: Cash Price |
$2,079.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,696.00
|
| Rate for Payer: Cigna of CA PPO |
$3,418.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,177.54
|
| Rate for Payer: Dignity Health Media |
$4,785.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,263.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,459.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,785.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,785.03
|
| Rate for Payer: Galaxy Health WC |
$3,927.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,772.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,158.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,465.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,847.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,895.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,785.03
|
| Rate for Payer: InnovAge PACE Commercial |
$7,177.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,081.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$587.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,785.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$924.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,411.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,411.94
|
| Rate for Payer: Multiplan Commercial |
$3,465.00
|
| Rate for Payer: Networks By Design Commercial |
$3,003.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,927.00
|
| Rate for Payer: Prime Health Services Medicare |
$5,072.13
|
| Rate for Payer: Riverside University Health System MISP |
$5,263.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,772.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,742.04
|
| 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 |
$7,177.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,263.53
|
| Rate for Payer: Vantage Medical Group Senior |
$4,785.03
|
|
|
HC ERCP DIAG W/ OR W/O COLLECT SP
|
Facility
|
IP
|
$8,641.00
|
|
|
Service Code
|
CPT 43260
|
| Hospital Charge Code |
906743260
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,728.20 |
| Max. Negotiated Rate |
$7,776.90 |
| Rate for Payer: Cash Price |
$3,888.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,912.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,456.40
|
| Rate for Payer: Galaxy Health WC |
$7,344.85
|
| Rate for Payer: Global Benefits Group Commercial |
$5,184.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,776.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,763.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,292.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,728.20
|
| Rate for Payer: Multiplan Commercial |
$6,480.75
|
| Rate for Payer: Networks By Design Commercial |
$5,616.65
|
| Rate for Payer: Prime Health Services Commercial |
$7,344.85
|
|
|
HC ERCP DUCT STENT PLACEMENT
|
Facility
|
IP
|
$10,349.00
|
|
|
Service Code
|
CPT 43274
|
| Hospital Charge Code |
900100019
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,069.80 |
| Max. Negotiated Rate |
$9,314.10 |
| Rate for Payer: Cash Price |
$4,657.05
|
| Rate for Payer: Central Health Plan Commercial |
$8,279.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,139.60
|
| Rate for Payer: Galaxy Health WC |
$8,796.65
|
| Rate for Payer: Global Benefits Group Commercial |
$6,209.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,314.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,902.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,942.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,069.80
|
| Rate for Payer: Multiplan Commercial |
$7,761.75
|
| Rate for Payer: Networks By Design Commercial |
$6,726.85
|
| Rate for Payer: Prime Health Services Commercial |
$8,796.65
|
|
|
HC ERCP DUCT STENT PLACEMENT
|
Facility
|
OP
|
$6,916.00
|
|
|
Service Code
|
CPT 43274
|
| Hospital Charge Code |
900100019
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$788.01 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,120.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,120.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,149.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$7,120.83
|
| Rate for Payer: Cash Price |
$3,112.20
|
| Rate for Payer: Cash Price |
$3,112.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,532.80
|
| Rate for Payer: Cigna of CA PPO |
$5,117.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Dignity Health Media |
$7,120.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,832.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,613.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,120.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,120.83
|
| Rate for Payer: Galaxy Health WC |
$5,878.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,149.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,224.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,187.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,678.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,749.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,120.83
|
| Rate for Payer: InnovAge PACE Commercial |
$10,681.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,612.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$788.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,120.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,383.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,541.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,541.91
|
| Rate for Payer: Multiplan Commercial |
$5,187.00
|
| Rate for Payer: Networks By Design Commercial |
$4,495.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,878.60
|
| Rate for Payer: Prime Health Services Medicare |
$7,548.08
|
| Rate for Payer: Riverside University Health System MISP |
$7,832.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,149.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,545.00
|
| 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 |
$10,681.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: Vantage Medical Group Senior |
$7,120.83
|
|
|
HC ERCP EA DUCT/AMPULLA DILATATION
|
Facility
|
IP
|
$12,715.00
|
|
|
Service Code
|
CPT 43277
|
| Hospital Charge Code |
900100020
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,543.00 |
| Max. Negotiated Rate |
$11,443.50 |
| Rate for Payer: Cash Price |
$5,721.75
|
| Rate for Payer: Central Health Plan Commercial |
$10,172.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,086.00
|
| Rate for Payer: Galaxy Health WC |
$10,807.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,629.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,443.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,480.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,844.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,543.00
|
| Rate for Payer: Multiplan Commercial |
$9,536.25
|
| Rate for Payer: Networks By Design Commercial |
$8,264.75
|
| Rate for Payer: Prime Health Services Commercial |
$10,807.75
|
|
|
HC ERCP EA DUCT/AMPULLA DILATATION
|
Facility
|
OP
|
$8,498.00
|
|
|
Service Code
|
CPT 43277
|
| Hospital Charge Code |
900100020
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$653.62 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,785.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,177.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,263.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,785.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,098.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$4,785.03
|
| Rate for Payer: Cash Price |
$3,824.10
|
| Rate for Payer: Cash Price |
$3,824.10
|
| Rate for Payer: Central Health Plan Commercial |
$6,798.40
|
| Rate for Payer: Cigna of CA PPO |
$6,288.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,177.54
|
| Rate for Payer: Dignity Health Media |
$4,785.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,263.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,459.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,785.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,785.03
|
| Rate for Payer: Galaxy Health WC |
$7,223.30
|
| Rate for Payer: Global Benefits Group Commercial |
$5,098.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,648.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,373.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,847.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,895.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,785.03
|
| Rate for Payer: InnovAge PACE Commercial |
$7,177.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,668.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$653.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,785.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,699.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,411.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,411.94
|
| Rate for Payer: Multiplan Commercial |
$6,373.50
|
| Rate for Payer: Networks By Design Commercial |
$5,523.70
|
| Rate for Payer: Prime Health Services Commercial |
$7,223.30
|
| Rate for Payer: Prime Health Services Medicare |
$5,072.13
|
| Rate for Payer: Riverside University Health System MISP |
$5,263.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,098.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,742.04
|
| 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 |
$7,177.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,263.53
|
| Rate for Payer: Vantage Medical Group Senior |
$4,785.03
|
|
|
HC ERCP LESION ABLAT W DILATION
|
Facility
|
IP
|
$6,756.00
|
|
|
Service Code
|
CPT 43278
|
| Hospital Charge Code |
906743278
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,351.20 |
| Max. Negotiated Rate |
$6,080.40 |
| Rate for Payer: Cash Price |
$3,040.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,404.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,702.40
|
| Rate for Payer: Galaxy Health WC |
$5,742.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,053.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,080.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,506.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,574.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,351.20
|
| Rate for Payer: Multiplan Commercial |
$5,067.00
|
| Rate for Payer: Networks By Design Commercial |
$4,391.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,742.60
|
|
|
HC ERCP LESION ABLAT W DILATION
|
Facility
|
OP
|
$5,328.00
|
|
|
Service Code
|
CPT 43278
|
| Hospital Charge Code |
906743278
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$743.45 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,785.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,177.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,263.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,785.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,196.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$4,785.03
|
| Rate for Payer: Cash Price |
$2,397.60
|
| Rate for Payer: Cash Price |
$2,397.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,262.40
|
| Rate for Payer: Cigna of CA PPO |
$3,942.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,177.54
|
| Rate for Payer: Dignity Health Media |
$4,785.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,263.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,459.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,785.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,785.03
|
| Rate for Payer: Galaxy Health WC |
$4,528.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,196.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,795.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,996.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,847.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,895.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,785.03
|
| Rate for Payer: InnovAge PACE Commercial |
$7,177.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,553.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$743.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,785.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,065.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,411.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,411.94
|
| Rate for Payer: Multiplan Commercial |
$3,996.00
|
| Rate for Payer: Networks By Design Commercial |
$3,463.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,528.80
|
| Rate for Payer: Prime Health Services Medicare |
$5,072.13
|
| Rate for Payer: Riverside University Health System MISP |
$5,263.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,196.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,742.04
|
| 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 |
$7,177.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,263.53
|
| Rate for Payer: Vantage Medical Group Senior |
$4,785.03
|
|
|
HC ERCP PANCREATIC/SPHINCT
|
Facility
|
IP
|
$1,741.00
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
909001830
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$348.20 |
| Max. Negotiated Rate |
$1,566.90 |
| Rate for Payer: Cash Price |
$783.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,392.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$696.40
|
| Rate for Payer: Galaxy Health WC |
$1,479.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,044.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,566.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,161.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$663.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$348.20
|
| Rate for Payer: Multiplan Commercial |
$1,305.75
|
| Rate for Payer: Networks By Design Commercial |
$1,131.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,479.85
|
|
|
HC ERCP PANCREATIC/SPHINCT
|
Facility
|
OP
|
$1,741.00
|
|
|
Service Code
|
CPT 74329
|
| Hospital Charge Code |
909001830
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$218.75 |
| Max. Negotiated Rate |
$1,566.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$366.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,479.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$957.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$957.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$651.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$795.26
|
| Rate for Payer: Blue Distinction Transplant |
$1,044.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,075.94
|
| Rate for Payer: Blue Shield of California EPN |
$846.13
|
| Rate for Payer: Cash Price |
$783.45
|
| Rate for Payer: Cash Price |
$783.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,392.80
|
| Rate for Payer: Cigna of CA HMO |
$1,114.24
|
| Rate for Payer: Cigna of CA PPO |
$1,288.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,479.85
|
| Rate for Payer: Dignity Health Media |
$1,479.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,479.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$696.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$696.40
|
| Rate for Payer: Galaxy Health WC |
$1,479.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,044.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,566.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,305.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$609.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,161.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$218.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$348.20
|
| Rate for Payer: Multiplan Commercial |
$1,305.75
|
| Rate for Payer: Networks By Design Commercial |
$1,131.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,479.85
|
| Rate for Payer: Riverside University Health System MISP |
$696.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,044.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,044.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$870.50
|
| Rate for Payer: United Healthcare All Other HMO |
$870.50
|
| Rate for Payer: United Healthcare HMO Rider |
$870.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$870.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,479.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,479.85
|
|
