|
HC EXC SKIN LESION 1.1-2.0 CM
|
Facility
|
IP
|
$5,099.00
|
|
|
Service Code
|
CPT 11422
|
| Hospital Charge Code |
902890017
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,019.80 |
| Max. Negotiated Rate |
$4,589.10 |
| Rate for Payer: Cash Price |
$2,294.55
|
| Rate for Payer: Central Health Plan Commercial |
$4,079.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,039.60
|
| Rate for Payer: Galaxy Health WC |
$4,334.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,059.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,589.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,401.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,942.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,019.80
|
| Rate for Payer: Multiplan Commercial |
$3,824.25
|
| Rate for Payer: Networks By Design Commercial |
$3,314.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,334.15
|
|
|
HC EXCSN EXT THROMBOTC HEMORRHOID
|
Facility
|
IP
|
$7,437.00
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
900501158
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,487.40 |
| Max. Negotiated Rate |
$6,693.30 |
| Rate for Payer: Cash Price |
$3,346.65
|
| Rate for Payer: Central Health Plan Commercial |
$5,949.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,974.80
|
| Rate for Payer: Galaxy Health WC |
$6,321.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,462.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,693.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,960.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,833.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,487.40
|
| Rate for Payer: Multiplan Commercial |
$5,577.75
|
| Rate for Payer: Networks By Design Commercial |
$4,834.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,321.45
|
|
|
HC EXCSN EXT THROMBOTC HEMORRHOID
|
Facility
|
OP
|
$7,437.00
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
900501158
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$176.13 |
| Max. Negotiated Rate |
$6,693.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,462.20
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$3,346.65
|
| Rate for Payer: Cash Price |
$3,346.65
|
| Rate for Payer: Cash Price |
$3,346.65
|
| Rate for Payer: Cash Price |
$3,346.65
|
| Rate for Payer: Central Health Plan Commercial |
$5,949.60
|
| Rate for Payer: Cigna of CA PPO |
$5,503.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Media |
$1,474.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$6,321.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,462.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,693.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,577.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: InnovAge PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,960.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$176.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,487.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$5,577.75
|
| Rate for Payer: Networks By Design Commercial |
$4,834.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,321.45
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Riverside University Health System MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,462.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,718.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,718.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,718.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,718.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC EXCSN EXT THROMBOTC HEMORRHOID
|
Facility
|
IP
|
$7,437.00
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
900501158
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,487.40 |
| Max. Negotiated Rate |
$6,693.30 |
| Rate for Payer: Cash Price |
$3,346.65
|
| Rate for Payer: Central Health Plan Commercial |
$5,949.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,974.80
|
| Rate for Payer: Galaxy Health WC |
$6,321.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,462.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,693.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,960.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,833.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,487.40
|
| Rate for Payer: Multiplan Commercial |
$5,577.75
|
| Rate for Payer: Networks By Design Commercial |
$4,834.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,321.45
|
|
|
HC EXCSN EXT THROMBOTC HEMORRHOID
|
Facility
|
OP
|
$7,437.00
|
|
|
Service Code
|
CPT 46320
|
| Hospital Charge Code |
900501158
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$176.13 |
| Max. Negotiated Rate |
$6,693.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,462.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,677.87
|
| Rate for Payer: Blue Shield of California EPN |
$3,636.69
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$3,346.65
|
| Rate for Payer: Cash Price |
$3,346.65
|
| Rate for Payer: Cash Price |
$3,346.65
|
| Rate for Payer: Central Health Plan Commercial |
$5,949.60
|
| Rate for Payer: Cigna of CA HMO |
$4,759.68
|
| Rate for Payer: Cigna of CA PPO |
$5,503.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Media |
$1,474.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$6,321.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,462.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,693.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,577.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,432.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: InnovAge PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,960.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$176.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,487.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$5,577.75
|
| Rate for Payer: Networks By Design Commercial |
$4,834.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,321.45
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Riverside University Health System MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,462.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,462.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,718.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,718.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,718.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,718.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC EXCSN,TUMOR, FOOT, S/C TISSUE
|
Facility
|
OP
|
$9,424.00
|
|
|
Service Code
|
CPT 28043
|
| Hospital Charge Code |
902890285
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$573.69 |
| Max. Negotiated Rate |
$8,481.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| 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 |
$5,654.40
|
| Rate for Payer: Blue Shield of California Commercial |
$5,927.70
|
| Rate for Payer: Blue Shield of California EPN |
$4,608.34
|
| Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Central Health Plan Commercial |
$7,539.20
|
| Rate for Payer: Cigna of CA HMO |
$6,031.36
|
| Rate for Payer: Cigna of CA PPO |
$6,973.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$8,010.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,654.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,481.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,068.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,285.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$573.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,884.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$7,068.00
|
| Rate for Payer: Networks By Design Commercial |
$6,125.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,010.40
|
| Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
| Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,654.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,654.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,712.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,712.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,712.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC EXCSN,TUMOR, FOOT, S/C TISSUE
|
Facility
|
IP
|
$9,424.00
|
|
|
Service Code
|
CPT 28043
|
| Hospital Charge Code |
902890285
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,884.80 |
| Max. Negotiated Rate |
$8,481.60 |
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Central Health Plan Commercial |
$7,539.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,769.60
|
| Rate for Payer: Galaxy Health WC |
$8,010.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,654.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,481.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,285.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,590.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,884.80
|
| Rate for Payer: Multiplan Commercial |
$7,068.00
|
| Rate for Payer: Networks By Design Commercial |
$6,125.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,010.40
|
|
|
HC EXC THIGH/KNEE LES SC GT 3 CM
|
Facility
|
OP
|
$9,040.00
|
|
|
Service Code
|
CPT 27337
|
| Hospital Charge Code |
904000007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$655.73 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,325.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,905.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
| 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 |
$5,424.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
| Rate for Payer: Cash Price |
$4,068.00
|
| Rate for Payer: Cash Price |
$4,068.00
|
| Rate for Payer: Central Health Plan Commercial |
$7,232.00
|
| Rate for Payer: Cigna of CA PPO |
$6,689.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
| Rate for Payer: Dignity Health Media |
$3,550.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,905.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
| Rate for Payer: Galaxy Health WC |
$7,684.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,424.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,136.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,780.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,857.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,550.26
|
| Rate for Payer: InnovAge PACE Commercial |
$5,325.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,029.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$655.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,808.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
| Rate for Payer: Multiplan Commercial |
$6,780.00
|
| Rate for Payer: Networks By Design Commercial |
$5,876.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,684.00
|
| Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
| Rate for Payer: Riverside University Health System MISP |
$3,905.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,424.00
|
| 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 |
$5,325.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
| Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
|
HC EXC THIGH/KNEE LES SC GT 3 CM
|
Facility
|
IP
|
$9,040.00
|
|
|
Service Code
|
CPT 27337
|
| Hospital Charge Code |
904000007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,808.00 |
| Max. Negotiated Rate |
$8,136.00 |
| Rate for Payer: Cash Price |
$4,068.00
|
| Rate for Payer: Central Health Plan Commercial |
$7,232.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,616.00
|
| Rate for Payer: Galaxy Health WC |
$7,684.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,424.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,136.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,029.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,444.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,808.00
|
| Rate for Payer: Multiplan Commercial |
$6,780.00
|
| Rate for Payer: Networks By Design Commercial |
$5,876.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,684.00
|
|
|
HC EXC TST BRNCHSPSM WO EC RCRDG
|
Facility
|
OP
|
$181.00
|
|
|
Service Code
|
CPT 94619
|
| Hospital Charge Code |
900894619
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$36.20 |
| Max. Negotiated Rate |
$725.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$76.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$303.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$87.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$106.93
|
| Rate for Payer: Blue Distinction Transplant |
$108.60
|
| Rate for Payer: Blue Shield of California Commercial |
$111.86
|
| Rate for Payer: Blue Shield of California EPN |
$87.97
|
| Rate for Payer: Caremore Medicare Advantage |
$76.42
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Central Health Plan Commercial |
$144.80
|
| Rate for Payer: Cigna of CA HMO |
$115.84
|
| Rate for Payer: Cigna of CA PPO |
$133.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$114.63
|
| Rate for Payer: Dignity Health Media |
$76.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$76.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$76.42
|
| Rate for Payer: Galaxy Health WC |
$153.85
|
| Rate for Payer: Global Benefits Group Commercial |
$108.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$135.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$125.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$126.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$76.42
|
| Rate for Payer: InnovAge PACE Commercial |
$114.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$126.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.40
|
| Rate for Payer: Multiplan Commercial |
$135.75
|
| Rate for Payer: Networks By Design Commercial |
$117.65
|
| Rate for Payer: Prime Health Services Commercial |
$153.85
|
| Rate for Payer: Prime Health Services Medicare |
$81.01
|
| Rate for Payer: Riverside University Health System MISP |
$84.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$108.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$108.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$725.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$696.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$636.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$114.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.06
|
| Rate for Payer: Vantage Medical Group Senior |
$76.42
|
|
|
HC EXC TST BRNCHSPSM WO EC RCRDG
|
Facility
|
IP
|
$181.00
|
|
|
Service Code
|
CPT 94619
|
| Hospital Charge Code |
900894619
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$36.20 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Cash Price |
$81.45
|
| Rate for Payer: Central Health Plan Commercial |
$144.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.40
|
| Rate for Payer: Galaxy Health WC |
$153.85
|
| Rate for Payer: Global Benefits Group Commercial |
$108.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.20
|
| Rate for Payer: Multiplan Commercial |
$135.75
|
| Rate for Payer: Networks By Design Commercial |
$117.65
|
| Rate for Payer: Prime Health Services Commercial |
$153.85
|
|
|
HC EXERCISE TEST BRONCHOSPASM
|
Facility
|
OP
|
$345.00
|
|
|
Service Code
|
CPT 94617
|
| Hospital Charge Code |
900894620
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$69.00 |
| Max. Negotiated Rate |
$725.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$380.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$370.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$203.83
|
| Rate for Payer: Blue Distinction Transplant |
$207.00
|
| Rate for Payer: Blue Shield of California Commercial |
$213.21
|
| Rate for Payer: Blue Shield of California EPN |
$167.67
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Central Health Plan Commercial |
$276.00
|
| Rate for Payer: Cigna of CA HMO |
$220.80
|
| Rate for Payer: Cigna of CA PPO |
$255.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$293.25
|
| Rate for Payer: Global Benefits Group Commercial |
$207.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$310.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$258.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: InnovAge PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$230.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$258.75
|
| Rate for Payer: Networks By Design Commercial |
$224.25
|
| Rate for Payer: Prime Health Services Commercial |
$293.25
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health System MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$207.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$207.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$725.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$696.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$636.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC EXERCISE TEST BRONCHOSPASM
|
Facility
|
IP
|
$345.00
|
|
|
Service Code
|
CPT 94617
|
| Hospital Charge Code |
900894620
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$69.00 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Central Health Plan Commercial |
$276.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$138.00
|
| Rate for Payer: Galaxy Health WC |
$293.25
|
| Rate for Payer: Global Benefits Group Commercial |
$207.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$310.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$230.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$131.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.00
|
| Rate for Payer: Multiplan Commercial |
$258.75
|
| Rate for Payer: Networks By Design Commercial |
$224.25
|
| Rate for Payer: Prime Health Services Commercial |
$293.25
|
|
|
HC EX FOR SPEECH DEVICE RX ADDL
|
Facility
|
IP
|
$348.00
|
|
|
Service Code
|
CPT 92608
|
| Hospital Charge Code |
905601817
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$69.60 |
| Max. Negotiated Rate |
$313.20 |
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Central Health Plan Commercial |
$278.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$139.20
|
| Rate for Payer: Galaxy Health WC |
$295.80
|
| Rate for Payer: Global Benefits Group Commercial |
$208.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$313.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$232.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.60
|
| Rate for Payer: Multiplan Commercial |
$261.00
|
| Rate for Payer: Networks By Design Commercial |
$226.20
|
| Rate for Payer: Prime Health Services Commercial |
$295.80
|
|
|
HC EX FOR SPEECH DEVICE RX ADDL
|
Facility
|
OP
|
$348.00
|
|
|
Service Code
|
CPT 92608
|
| Hospital Charge Code |
905601817
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$35.72 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$305.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$295.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$191.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$191.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$208.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Central Health Plan Commercial |
$278.40
|
| Rate for Payer: Cigna of CA HMO |
$222.72
|
| Rate for Payer: Cigna of CA PPO |
$257.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.80
|
| Rate for Payer: Dignity Health Media |
$295.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$295.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$139.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$139.20
|
| Rate for Payer: Galaxy Health WC |
$295.80
|
| Rate for Payer: Global Benefits Group Commercial |
$208.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$313.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$261.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$121.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$232.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.68
|
| Rate for Payer: Multiplan Commercial |
$261.00
|
| Rate for Payer: Networks By Design Commercial |
$226.20
|
| Rate for Payer: Prime Health Services Commercial |
$295.80
|
| Rate for Payer: Riverside University Health System MISP |
$139.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$208.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$208.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$295.80
|
| Rate for Payer: Vantage Medical Group Senior |
$295.80
|
|
|
HC EX MALIGNANT LES 1.1 - 2.0 CM
|
Facility
|
OP
|
$1,831.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
902890378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$160.57 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$498.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$498.20
|
| 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 |
$1,098.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$498.20
|
| Rate for Payer: Cash Price |
$823.95
|
| Rate for Payer: Cash Price |
$823.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,464.80
|
| Rate for Payer: Cigna of CA PPO |
$1,354.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.30
|
| Rate for Payer: Dignity Health Media |
$498.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$548.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$498.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$498.20
|
| Rate for Payer: Galaxy Health WC |
$1,556.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,098.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,647.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,373.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$817.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$822.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$498.20
|
| Rate for Payer: InnovAge PACE Commercial |
$747.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,221.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$366.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.59
|
| Rate for Payer: Multiplan Commercial |
$1,373.25
|
| Rate for Payer: Networks By Design Commercial |
$1,190.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,556.35
|
| Rate for Payer: Prime Health Services Medicare |
$528.09
|
| Rate for Payer: Riverside University Health System MISP |
$548.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,098.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$548.02
|
| Rate for Payer: Vantage Medical Group Senior |
$498.20
|
|
|
HC EX MALIGNANT LES 1.1 - 2.0 CM
|
Facility
|
IP
|
$1,831.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
902890378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$366.20 |
| Max. Negotiated Rate |
$1,647.90 |
| Rate for Payer: Cash Price |
$823.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,464.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$732.40
|
| Rate for Payer: Galaxy Health WC |
$1,556.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,098.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,647.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,221.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$697.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$366.20
|
| Rate for Payer: Multiplan Commercial |
$1,373.25
|
| Rate for Payer: Networks By Design Commercial |
$1,190.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,556.35
|
|
|
HC EX MALIGNANT LES 2.1 - 3.0 CM
|
Facility
|
IP
|
$3,177.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
900501792
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$635.40 |
| Max. Negotiated Rate |
$2,859.30 |
| Rate for Payer: Cash Price |
$1,429.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,541.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,270.80
|
| Rate for Payer: Galaxy Health WC |
$2,700.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,906.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,859.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,119.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,210.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$635.40
|
| Rate for Payer: Multiplan Commercial |
$2,382.75
|
| Rate for Payer: Networks By Design Commercial |
$2,065.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,700.45
|
|
|
HC EX MALIGNANT LES 2.1 - 3.0 CM
|
Facility
|
OP
|
$3,177.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
900501792
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$319.73 |
| Max. Negotiated Rate |
$5,779.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,906.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$1,429.65
|
| Rate for Payer: Cash Price |
$1,429.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,541.60
|
| Rate for Payer: Cigna of CA PPO |
$2,350.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$2,700.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,906.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,859.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,382.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,450.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: InnovAge PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,119.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$319.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$635.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$2,382.75
|
| Rate for Payer: Networks By Design Commercial |
$2,065.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,700.45
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Riverside University Health System MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,906.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC EX MALIGNANT LES GT 4.0 CM
|
Facility
|
IP
|
$6,105.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
900501793
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,221.00 |
| Max. Negotiated Rate |
$5,494.50 |
| Rate for Payer: Cash Price |
$2,747.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,884.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,442.00
|
| Rate for Payer: Galaxy Health WC |
$5,189.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,494.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,072.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,326.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,221.00
|
| Rate for Payer: Multiplan Commercial |
$4,578.75
|
| Rate for Payer: Networks By Design Commercial |
$3,968.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,189.25
|
|
|
HC EX MALIGNANT LES GT 4.0 CM
|
Facility
|
OP
|
$6,105.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
900501793
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$431.49 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| 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 |
$3,663.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
| Rate for Payer: Cash Price |
$2,747.25
|
| Rate for Payer: Cash Price |
$2,747.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,884.00
|
| Rate for Payer: Cigna of CA PPO |
$4,517.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$5,189.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,494.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,578.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,072.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$431.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,221.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$4,578.75
|
| Rate for Payer: Networks By Design Commercial |
$3,968.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,189.25
|
| Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
| Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,663.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC EX MALIGNANT LES INC MARGINS 0.6 - 1.0 CM
|
Facility
|
OP
|
$2,507.00
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
900501795
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$239.80 |
| Max. Negotiated Rate |
$5,779.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,504.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$1,128.15
|
| Rate for Payer: Cash Price |
$1,128.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,005.60
|
| Rate for Payer: Cigna of CA PPO |
$1,855.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$2,130.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,504.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,256.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,880.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,450.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: InnovAge PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,672.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$239.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$501.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$1,880.25
|
| Rate for Payer: Networks By Design Commercial |
$1,629.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,130.95
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Riverside University Health System MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,504.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC EX MALIGNANT LES INC MARGINS 0.6 - 1.0 CM
|
Facility
|
IP
|
$2,507.00
|
|
|
Service Code
|
CPT 11621
|
| Hospital Charge Code |
900501795
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$501.40 |
| Max. Negotiated Rate |
$2,256.30 |
| Rate for Payer: Cash Price |
$1,128.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,005.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,002.80
|
| Rate for Payer: Galaxy Health WC |
$2,130.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,504.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,256.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,672.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$955.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$501.40
|
| Rate for Payer: Multiplan Commercial |
$1,880.25
|
| Rate for Payer: Networks By Design Commercial |
$1,629.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,130.95
|
|
|
HC EX MALIGNANT LES INC MARGINS 2.1 - 3.0 CM
|
Facility
|
OP
|
$3,177.00
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
900501796
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$348.02 |
| Max. Negotiated Rate |
$5,779.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,906.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
| Rate for Payer: Cash Price |
$1,429.65
|
| Rate for Payer: Cash Price |
$1,429.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,541.60
|
| Rate for Payer: Cigna of CA PPO |
$2,350.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$2,700.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,906.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,859.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,382.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,119.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$348.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$635.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$2,382.75
|
| Rate for Payer: Networks By Design Commercial |
$2,065.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,700.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
| Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,906.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC EX MALIGNANT LES INC MARGINS 2.1 - 3.0 CM
|
Facility
|
IP
|
$3,177.00
|
|
|
Service Code
|
CPT 11623
|
| Hospital Charge Code |
900501796
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$635.40 |
| Max. Negotiated Rate |
$2,859.30 |
| Rate for Payer: Cash Price |
$1,429.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,541.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,270.80
|
| Rate for Payer: Galaxy Health WC |
$2,700.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,906.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,859.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,119.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,210.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$635.40
|
| Rate for Payer: Multiplan Commercial |
$2,382.75
|
| Rate for Payer: Networks By Design Commercial |
$2,065.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,700.45
|
|
