|
HC FLUORO GUIDANCE CNTRL VNS ACCESS DVC
|
Facility
|
IP
|
$1,340.00
|
|
|
Service Code
|
CPT 77001
|
| Hospital Charge Code |
909081673
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$268.00 |
| Max. Negotiated Rate |
$1,206.00 |
| Rate for Payer: Cash Price |
$603.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,072.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$536.00
|
| Rate for Payer: Galaxy Health WC |
$1,139.00
|
| Rate for Payer: Global Benefits Group Commercial |
$804.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,206.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$893.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$510.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$268.00
|
| Rate for Payer: Multiplan Commercial |
$1,005.00
|
| Rate for Payer: Networks By Design Commercial |
$871.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,139.00
|
|
|
HC FLUORO GUIDE NDL PLCMNT THRPY INJ
|
Facility
|
OP
|
$2,024.00
|
|
|
Service Code
|
CPT 77002
|
| Hospital Charge Code |
909001368
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$126.37 |
| Max. Negotiated Rate |
$1,821.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$270.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,720.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,113.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,113.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$350.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$427.14
|
| Rate for Payer: Blue Distinction Transplant |
$1,214.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,250.83
|
| Rate for Payer: Blue Shield of California EPN |
$983.66
|
| Rate for Payer: Cash Price |
$910.80
|
| Rate for Payer: Cash Price |
$910.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,619.20
|
| Rate for Payer: Cigna of CA HMO |
$1,295.36
|
| Rate for Payer: Cigna of CA PPO |
$1,497.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,720.40
|
| Rate for Payer: Dignity Health Media |
$1,720.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,720.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$809.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$809.60
|
| Rate for Payer: Galaxy Health WC |
$1,720.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,214.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,821.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,518.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$708.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$126.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$404.80
|
| Rate for Payer: Multiplan Commercial |
$1,518.00
|
| Rate for Payer: Networks By Design Commercial |
$1,315.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,720.40
|
| Rate for Payer: Riverside University Health System MISP |
$809.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,214.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,214.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,012.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,012.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,012.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,012.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,720.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,720.40
|
|
|
HC FLUORO GUIDE NDL PLCMNT THRPY INJ
|
Facility
|
IP
|
$2,024.00
|
|
|
Service Code
|
CPT 77002
|
| Hospital Charge Code |
909001368
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$404.80 |
| Max. Negotiated Rate |
$1,821.60 |
| Rate for Payer: Cash Price |
$910.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,619.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$809.60
|
| Rate for Payer: Galaxy Health WC |
$1,720.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,214.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,821.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,350.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$771.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$404.80
|
| Rate for Payer: Multiplan Commercial |
$1,518.00
|
| Rate for Payer: Networks By Design Commercial |
$1,315.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,720.40
|
|
|
HC FLUORO GUIDE SPINE OR PARASPINOUS
|
Facility
|
OP
|
$1,442.00
|
|
|
Service Code
|
CPT 77003
|
| Hospital Charge Code |
909001358
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$108.07 |
| Max. Negotiated Rate |
$1,297.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$184.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,225.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$793.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$793.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$267.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$326.30
|
| Rate for Payer: Blue Distinction Transplant |
$865.20
|
| Rate for Payer: Blue Shield of California Commercial |
$891.16
|
| Rate for Payer: Blue Shield of California EPN |
$700.81
|
| Rate for Payer: Cash Price |
$648.90
|
| Rate for Payer: Cash Price |
$648.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,153.60
|
| Rate for Payer: Cigna of CA HMO |
$922.88
|
| Rate for Payer: Cigna of CA PPO |
$1,067.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,225.70
|
| Rate for Payer: Dignity Health Media |
$1,225.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,225.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$576.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$576.80
|
| Rate for Payer: Galaxy Health WC |
$1,225.70
|
| Rate for Payer: Global Benefits Group Commercial |
$865.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,297.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,081.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$504.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$961.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$108.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.40
|
| Rate for Payer: Multiplan Commercial |
$1,081.50
|
| Rate for Payer: Networks By Design Commercial |
$937.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,225.70
|
| Rate for Payer: Riverside University Health System MISP |
$576.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$865.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$865.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$721.00
|
| Rate for Payer: United Healthcare All Other HMO |
$721.00
|
| Rate for Payer: United Healthcare HMO Rider |
$721.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$721.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,225.70
|
| Rate for Payer: Vantage Medical Group Senior |
$1,225.70
|
|
|
HC FLUORO GUIDE SPINE OR PARASPINOUS
|
Facility
|
IP
|
$1,442.00
|
|
|
Service Code
|
CPT 77003
|
| Hospital Charge Code |
909001358
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$288.40 |
| Max. Negotiated Rate |
$1,297.80 |
| Rate for Payer: Cash Price |
$648.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,153.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$576.80
|
| Rate for Payer: Galaxy Health WC |
$1,225.70
|
| Rate for Payer: Global Benefits Group Commercial |
$865.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,297.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$961.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$549.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.40
|
| Rate for Payer: Multiplan Commercial |
$1,081.50
|
| Rate for Payer: Networks By Design Commercial |
$937.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,225.70
|
|
|
HC FLUOROSCOPY LT 1HR
|
Facility
|
OP
|
$1,587.00
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
906820105
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.12 |
| Max. Negotiated Rate |
$1,428.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$306.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$236.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$288.84
|
| Rate for Payer: Blue Distinction Transplant |
$952.20
|
| Rate for Payer: Blue Shield of California Commercial |
$980.77
|
| Rate for Payer: Blue Shield of California EPN |
$771.28
|
| Rate for Payer: Caremore Medicare Advantage |
$306.16
|
| Rate for Payer: Cash Price |
$714.15
|
| Rate for Payer: Cash Price |
$714.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,269.60
|
| Rate for Payer: Cigna of CA HMO |
$1,015.68
|
| Rate for Payer: Cigna of CA PPO |
$1,174.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$459.24
|
| Rate for Payer: Dignity Health Media |
$306.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$336.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$413.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$306.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$306.16
|
| Rate for Payer: Galaxy Health WC |
$1,348.95
|
| Rate for Payer: Global Benefits Group Commercial |
$952.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,428.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,190.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$502.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$505.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.16
|
| Rate for Payer: InnovAge PACE Commercial |
$459.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,058.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$306.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$317.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$410.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$410.25
|
| Rate for Payer: Multiplan Commercial |
$1,190.25
|
| Rate for Payer: Networks By Design Commercial |
$1,031.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,348.95
|
| Rate for Payer: Prime Health Services Medicare |
$324.53
|
| Rate for Payer: Riverside University Health System MISP |
$336.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$952.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$952.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.63
|
| Rate for Payer: United Healthcare All Other HMO |
$225.63
|
| Rate for Payer: United Healthcare HMO Rider |
$225.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Vantage Medical Group Senior |
$306.16
|
|
|
HC FLUOROSCOPY LT 1HR
|
Facility
|
IP
|
$1,587.00
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
906811312
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$317.40 |
| Max. Negotiated Rate |
$1,428.30 |
| Rate for Payer: Cash Price |
$714.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,269.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$634.80
|
| Rate for Payer: Galaxy Health WC |
$1,348.95
|
| Rate for Payer: Global Benefits Group Commercial |
$952.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,428.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,058.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$604.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$317.40
|
| Rate for Payer: Multiplan Commercial |
$1,190.25
|
| Rate for Payer: Networks By Design Commercial |
$1,031.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,348.95
|
|
|
HC FLUOROSCOPY LT 1HR
|
Facility
|
OP
|
$1,587.00
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
906811312
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.12 |
| Max. Negotiated Rate |
$1,428.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$306.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$236.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$288.84
|
| Rate for Payer: Blue Distinction Transplant |
$952.20
|
| Rate for Payer: Blue Shield of California Commercial |
$980.77
|
| Rate for Payer: Blue Shield of California EPN |
$771.28
|
| Rate for Payer: Caremore Medicare Advantage |
$306.16
|
| Rate for Payer: Cash Price |
$714.15
|
| Rate for Payer: Cash Price |
$714.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,269.60
|
| Rate for Payer: Cigna of CA HMO |
$1,015.68
|
| Rate for Payer: Cigna of CA PPO |
$1,174.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$459.24
|
| Rate for Payer: Dignity Health Media |
$306.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$336.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$413.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$306.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$306.16
|
| Rate for Payer: Galaxy Health WC |
$1,348.95
|
| Rate for Payer: Global Benefits Group Commercial |
$952.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,428.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,190.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$502.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$505.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.16
|
| Rate for Payer: InnovAge PACE Commercial |
$459.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,058.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$306.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$317.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$410.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$410.25
|
| Rate for Payer: Multiplan Commercial |
$1,190.25
|
| Rate for Payer: Networks By Design Commercial |
$1,031.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,348.95
|
| Rate for Payer: Prime Health Services Medicare |
$324.53
|
| Rate for Payer: Riverside University Health System MISP |
$336.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$952.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$952.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.63
|
| Rate for Payer: United Healthcare All Other HMO |
$225.63
|
| Rate for Payer: United Healthcare HMO Rider |
$225.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Vantage Medical Group Senior |
$306.16
|
|
|
HC FLUOROSCOPY LT 1HR
|
Facility
|
IP
|
$1,587.00
|
|
|
Service Code
|
CPT 76000
|
| Hospital Charge Code |
906820105
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$317.40 |
| Max. Negotiated Rate |
$1,428.30 |
| Rate for Payer: Cash Price |
$714.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,269.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$634.80
|
| Rate for Payer: Galaxy Health WC |
$1,348.95
|
| Rate for Payer: Global Benefits Group Commercial |
$952.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,428.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,058.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$604.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$317.40
|
| Rate for Payer: Multiplan Commercial |
$1,190.25
|
| Rate for Payer: Networks By Design Commercial |
$1,031.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,348.95
|
|
|
HC FLUORO XM G/COLON TUBE
|
Facility
|
OP
|
$2,093.00
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
906749465
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$268.09 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$306.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.16
|
| 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 |
$1,255.80
|
| 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 |
$306.16
|
| Rate for Payer: Cash Price |
$941.85
|
| Rate for Payer: Cash Price |
$941.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,674.40
|
| Rate for Payer: Cigna of CA PPO |
$1,548.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$459.24
|
| Rate for Payer: Dignity Health Media |
$306.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$336.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$413.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$306.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$306.16
|
| Rate for Payer: Galaxy Health WC |
$1,779.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,255.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,883.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,569.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$502.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$505.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.16
|
| Rate for Payer: InnovAge PACE Commercial |
$459.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,396.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$268.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$306.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$418.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$410.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$410.25
|
| Rate for Payer: Multiplan Commercial |
$1,569.75
|
| Rate for Payer: Networks By Design Commercial |
$1,360.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,779.05
|
| Rate for Payer: Prime Health Services Medicare |
$324.53
|
| Rate for Payer: Riverside University Health System MISP |
$336.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,255.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$367.39
|
| 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 |
$459.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Vantage Medical Group Senior |
$306.16
|
|
|
HC FLUORO XM G/COLON TUBE
|
Facility
|
IP
|
$3,297.00
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
906749465
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$659.40 |
| Max. Negotiated Rate |
$2,967.30 |
| Rate for Payer: Cash Price |
$1,483.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,637.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,318.80
|
| Rate for Payer: Galaxy Health WC |
$2,802.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,978.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,967.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,199.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,256.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$659.40
|
| Rate for Payer: Multiplan Commercial |
$2,472.75
|
| Rate for Payer: Networks By Design Commercial |
$2,143.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,802.45
|
|
|
HC FLUORO XM G/COLON TUBE
|
Facility
|
IP
|
$3,297.00
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
906749465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$659.40 |
| Max. Negotiated Rate |
$2,967.30 |
| Rate for Payer: Cash Price |
$1,483.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,637.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,318.80
|
| Rate for Payer: Galaxy Health WC |
$2,802.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,978.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,967.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,199.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,256.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$659.40
|
| Rate for Payer: Multiplan Commercial |
$2,472.75
|
| Rate for Payer: Networks By Design Commercial |
$2,143.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,802.45
|
|
|
HC FLUORO XM G/COLON TUBE
|
Facility
|
OP
|
$2,093.00
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
906749465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$268.09 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$306.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.16
|
| 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 |
$1,255.80
|
| 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 |
$306.16
|
| Rate for Payer: Cash Price |
$941.85
|
| Rate for Payer: Cash Price |
$941.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,674.40
|
| Rate for Payer: Cigna of CA PPO |
$1,548.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$459.24
|
| Rate for Payer: Dignity Health Media |
$306.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$336.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$413.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$306.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$306.16
|
| Rate for Payer: Galaxy Health WC |
$1,779.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,255.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,883.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,569.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$502.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$505.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.16
|
| Rate for Payer: InnovAge PACE Commercial |
$459.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,396.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$268.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$306.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$418.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$410.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$410.25
|
| Rate for Payer: Multiplan Commercial |
$1,569.75
|
| Rate for Payer: Networks By Design Commercial |
$1,360.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,779.05
|
| Rate for Payer: Prime Health Services Medicare |
$324.53
|
| Rate for Payer: Riverside University Health System MISP |
$336.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,255.80
|
| 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 |
$459.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Vantage Medical Group Senior |
$306.16
|
|
|
HC FMRI BRAIN BY PHYS/PSYCH
|
Facility
|
IP
|
$2,916.00
|
|
|
Service Code
|
CPT 70555
|
| Hospital Charge Code |
908801023
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$583.20 |
| Max. Negotiated Rate |
$2,624.40 |
| Rate for Payer: Cash Price |
$1,312.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,332.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.40
|
| Rate for Payer: Galaxy Health WC |
$2,478.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,749.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,624.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,944.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,111.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$583.20
|
| Rate for Payer: Multiplan Commercial |
$2,187.00
|
| Rate for Payer: Networks By Design Commercial |
$1,895.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,478.60
|
|
|
HC FMRI BRAIN BY PHYS/PSYCH
|
Facility
|
OP
|
$1,352.00
|
|
|
Service Code
|
CPT 70555
|
| Hospital Charge Code |
908801023
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$188.12 |
| Max. Negotiated Rate |
$3,311.29 |
| Rate for Payer: Adventist Health Medi-Cal |
$306.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,311.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$798.76
|
| Rate for Payer: Blue Distinction Transplant |
$811.20
|
| Rate for Payer: Blue Shield of California Commercial |
$835.54
|
| Rate for Payer: Blue Shield of California EPN |
$657.07
|
| Rate for Payer: Caremore Medicare Advantage |
$306.16
|
| Rate for Payer: Cash Price |
$608.40
|
| Rate for Payer: Cash Price |
$608.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,081.60
|
| Rate for Payer: Cigna of CA HMO |
$865.28
|
| Rate for Payer: Cigna of CA PPO |
$1,000.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$459.24
|
| Rate for Payer: Dignity Health Media |
$306.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$336.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$413.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$306.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$306.16
|
| Rate for Payer: Galaxy Health WC |
$1,149.20
|
| Rate for Payer: Global Benefits Group Commercial |
$811.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,216.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,014.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$502.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$505.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.16
|
| Rate for Payer: InnovAge PACE Commercial |
$459.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$901.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$306.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$410.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$410.25
|
| Rate for Payer: Multiplan Commercial |
$1,014.00
|
| Rate for Payer: Networks By Design Commercial |
$878.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,149.20
|
| Rate for Payer: Prime Health Services Medicare |
$324.53
|
| Rate for Payer: Riverside University Health System MISP |
$336.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$811.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$811.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Vantage Medical Group Senior |
$306.16
|
|
|
HC FMRI BRAIN BY TECH
|
Facility
|
OP
|
$1,352.00
|
|
|
Service Code
|
CPT 70554
|
| Hospital Charge Code |
908801022
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$270.40 |
| Max. Negotiated Rate |
$2,711.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$306.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,055.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,711.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$798.76
|
| Rate for Payer: Blue Distinction Transplant |
$811.20
|
| Rate for Payer: Blue Shield of California Commercial |
$835.54
|
| Rate for Payer: Blue Shield of California EPN |
$657.07
|
| Rate for Payer: Caremore Medicare Advantage |
$306.16
|
| Rate for Payer: Cash Price |
$608.40
|
| Rate for Payer: Cash Price |
$608.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,081.60
|
| Rate for Payer: Cigna of CA HMO |
$865.28
|
| Rate for Payer: Cigna of CA PPO |
$1,000.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$459.24
|
| Rate for Payer: Dignity Health Media |
$306.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$336.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$413.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$306.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$306.16
|
| Rate for Payer: Galaxy Health WC |
$1,149.20
|
| Rate for Payer: Global Benefits Group Commercial |
$811.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,216.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,014.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$502.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$505.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.16
|
| Rate for Payer: InnovAge PACE Commercial |
$459.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$901.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$710.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$306.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$270.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$410.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$410.25
|
| Rate for Payer: Multiplan Commercial |
$1,014.00
|
| Rate for Payer: Networks By Design Commercial |
$878.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,149.20
|
| Rate for Payer: Prime Health Services Medicare |
$324.53
|
| Rate for Payer: Riverside University Health System MISP |
$336.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$811.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$811.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$866.34
|
| Rate for Payer: United Healthcare All Other HMO |
$866.34
|
| Rate for Payer: United Healthcare HMO Rider |
$866.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$866.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Vantage Medical Group Senior |
$306.16
|
|
|
HC FMRI BRAIN BY TECH
|
Facility
|
IP
|
$2,332.00
|
|
|
Service Code
|
CPT 70554
|
| Hospital Charge Code |
908801022
|
|
Hospital Revenue Code
|
611
|
| Min. Negotiated Rate |
$466.40 |
| Max. Negotiated Rate |
$2,098.80 |
| Rate for Payer: Cash Price |
$1,049.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,865.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$932.80
|
| Rate for Payer: Galaxy Health WC |
$1,982.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,399.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,098.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,555.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$888.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$466.40
|
| Rate for Payer: Multiplan Commercial |
$1,749.00
|
| Rate for Payer: Networks By Design Commercial |
$1,515.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,982.20
|
|
|
HC FNA BX W/CT GDN 1ST LESION
|
Facility
|
IP
|
$2,146.00
|
|
|
Service Code
|
CPT 10009
|
| Hospital Charge Code |
909010009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$429.20 |
| Max. Negotiated Rate |
$1,931.40 |
| Rate for Payer: Cash Price |
$965.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,716.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$858.40
|
| Rate for Payer: Galaxy Health WC |
$1,824.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,287.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,931.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,431.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$817.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.20
|
| Rate for Payer: Multiplan Commercial |
$1,609.50
|
| Rate for Payer: Networks By Design Commercial |
$1,394.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,824.10
|
|
|
HC FNA BX W/CT GDN 1ST LESION
|
Facility
|
OP
|
$2,146.00
|
|
|
Service Code
|
CPT 10009
|
| Hospital Charge Code |
909010009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$429.20 |
| Max. Negotiated Rate |
$4,846.00 |
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,287.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$965.70
|
| Rate for Payer: Cash Price |
$965.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,716.80
|
| Rate for Payer: Cigna of CA PPO |
$1,588.04
|
| 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 |
$1,824.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,287.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,931.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,609.50
|
| 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 |
$1,431.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$814.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.20
|
| 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 |
$1,609.50
|
| Rate for Payer: Networks By Design Commercial |
$1,394.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,824.10
|
| 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 |
$1,287.60
|
| 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 FNA BX W/CT GDN EA ADDL LSN
|
Facility
|
IP
|
$1,073.00
|
|
|
Service Code
|
CPT 10010
|
| Hospital Charge Code |
909010010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$214.60 |
| Max. Negotiated Rate |
$965.70 |
| Rate for Payer: Cash Price |
$482.85
|
| Rate for Payer: Central Health Plan Commercial |
$858.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.20
|
| Rate for Payer: Galaxy Health WC |
$912.05
|
| Rate for Payer: Global Benefits Group Commercial |
$643.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$965.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$715.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$408.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$214.60
|
| Rate for Payer: Multiplan Commercial |
$804.75
|
| Rate for Payer: Networks By Design Commercial |
$697.45
|
| Rate for Payer: Prime Health Services Commercial |
$912.05
|
|
|
HC FNA BX W/CT GDN EA ADDL LSN
|
Facility
|
OP
|
$1,073.00
|
|
|
Service Code
|
CPT 10010
|
| Hospital Charge Code |
909010010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$214.60 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$912.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$590.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$590.15
|
| 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 |
$643.80
|
| 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 |
$482.85
|
| Rate for Payer: Cash Price |
$482.85
|
| Rate for Payer: Cash Price |
$482.85
|
| Rate for Payer: Central Health Plan Commercial |
$858.40
|
| Rate for Payer: Cigna of CA PPO |
$794.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$912.05
|
| Rate for Payer: Dignity Health Media |
$912.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$912.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$429.20
|
| Rate for Payer: Galaxy Health WC |
$912.05
|
| Rate for Payer: Global Benefits Group Commercial |
$643.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$965.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$804.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$375.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$715.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$488.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$214.60
|
| Rate for Payer: Multiplan Commercial |
$804.75
|
| Rate for Payer: Networks By Design Commercial |
$697.45
|
| Rate for Payer: Prime Health Services Commercial |
$912.05
|
| Rate for Payer: Riverside University Health System MISP |
$429.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$643.80
|
| 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 Medi-Cal |
$912.05
|
| Rate for Payer: Vantage Medical Group Senior |
$912.05
|
|
|
HC FNA BX W/FLUOR GDN 1ST LESION
|
Facility
|
OP
|
$2,146.00
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
909010007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$429.20 |
| Max. Negotiated Rate |
$4,846.00 |
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,287.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$965.70
|
| Rate for Payer: Cash Price |
$965.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,716.80
|
| Rate for Payer: Cigna of CA PPO |
$1,588.04
|
| 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 |
$1,824.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,287.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,931.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,609.50
|
| 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 |
$1,431.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$493.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.20
|
| 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 |
$1,609.50
|
| Rate for Payer: Networks By Design Commercial |
$1,394.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,824.10
|
| 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 |
$1,287.60
|
| 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 FNA BX W/FLUOR GDN 1ST LESION
|
Facility
|
IP
|
$2,146.00
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
909010007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$429.20 |
| Max. Negotiated Rate |
$1,931.40 |
| Rate for Payer: Cash Price |
$965.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,716.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$858.40
|
| Rate for Payer: Galaxy Health WC |
$1,824.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,287.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,931.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,431.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$817.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.20
|
| Rate for Payer: Multiplan Commercial |
$1,609.50
|
| Rate for Payer: Networks By Design Commercial |
$1,394.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,824.10
|
|
|
HC FNA BX W/FLUOR GDN EA ADDL LSN
|
Facility
|
IP
|
$1,073.00
|
|
|
Service Code
|
CPT 10008
|
| Hospital Charge Code |
909010008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$214.60 |
| Max. Negotiated Rate |
$965.70 |
| Rate for Payer: Cash Price |
$482.85
|
| Rate for Payer: Central Health Plan Commercial |
$858.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.20
|
| Rate for Payer: Galaxy Health WC |
$912.05
|
| Rate for Payer: Global Benefits Group Commercial |
$643.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$965.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$715.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$408.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$214.60
|
| Rate for Payer: Multiplan Commercial |
$804.75
|
| Rate for Payer: Networks By Design Commercial |
$697.45
|
| Rate for Payer: Prime Health Services Commercial |
$912.05
|
|
|
HC FNA BX W/FLUOR GDN EA ADDL LSN
|
Facility
|
OP
|
$1,073.00
|
|
|
Service Code
|
CPT 10008
|
| Hospital Charge Code |
909010008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$214.60 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$912.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$590.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$590.15
|
| 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 |
$643.80
|
| 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 |
$482.85
|
| Rate for Payer: Cash Price |
$482.85
|
| Rate for Payer: Cash Price |
$482.85
|
| Rate for Payer: Central Health Plan Commercial |
$858.40
|
| Rate for Payer: Cigna of CA PPO |
$794.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$912.05
|
| Rate for Payer: Dignity Health Media |
$912.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$912.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$429.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$429.20
|
| Rate for Payer: Galaxy Health WC |
$912.05
|
| Rate for Payer: Global Benefits Group Commercial |
$643.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$965.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$804.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$375.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$715.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$276.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$214.60
|
| Rate for Payer: Multiplan Commercial |
$804.75
|
| Rate for Payer: Networks By Design Commercial |
$697.45
|
| Rate for Payer: Prime Health Services Commercial |
$912.05
|
| Rate for Payer: Riverside University Health System MISP |
$429.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$643.80
|
| 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 Medi-Cal |
$912.05
|
| Rate for Payer: Vantage Medical Group Senior |
$912.05
|
|
