|
HC I&D RECTAL ABSCESS
|
Facility
|
OP
|
$9,117.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$339.53 |
| Max. Negotiated Rate |
$8,205.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,470.20
|
| Rate for Payer: Blue Shield of California Commercial |
$5,734.59
|
| Rate for Payer: Blue Shield of California EPN |
$4,458.21
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$4,102.65
|
| Rate for Payer: Cash Price |
$4,102.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,293.60
|
| Rate for Payer: Cigna of CA HMO |
$5,834.88
|
| Rate for Payer: Cigna of CA PPO |
$6,746.58
|
| 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 |
$7,749.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,470.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,205.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,837.75
|
| 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 |
$6,081.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,823.40
|
| 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 |
$6,837.75
|
| Rate for Payer: Networks By Design Commercial |
$5,926.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,749.45
|
| 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 |
$5,470.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,470.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,558.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,558.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,558.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,558.50
|
| 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 I&D RECTAL ABSCESS
|
Facility
|
OP
|
$9,117.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$339.53 |
| Max. Negotiated Rate |
$8,205.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,470.20
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$4,102.65
|
| Rate for Payer: Cash Price |
$4,102.65
|
| Rate for Payer: Cash Price |
$4,102.65
|
| Rate for Payer: Cash Price |
$4,102.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,293.60
|
| Rate for Payer: Cigna of CA PPO |
$6,746.58
|
| 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 |
$7,749.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,470.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,205.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,837.75
|
| 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 |
$6,081.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,823.40
|
| 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 |
$6,837.75
|
| Rate for Payer: Networks By Design Commercial |
$5,926.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,749.45
|
| 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 |
$5,470.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,558.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,558.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,558.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,558.50
|
| 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 I&D RECTAL ABSCESS
|
Facility
|
IP
|
$9,117.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,823.40 |
| Max. Negotiated Rate |
$8,205.30 |
| Rate for Payer: Cash Price |
$4,102.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,293.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,646.80
|
| Rate for Payer: Galaxy Health WC |
$7,749.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,470.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,205.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,081.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,473.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,823.40
|
| Rate for Payer: Multiplan Commercial |
$6,837.75
|
| Rate for Payer: Networks By Design Commercial |
$5,926.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,749.45
|
|
|
HC I&D RECTAL ABSCESS
|
Facility
|
OP
|
$9,117.00
|
|
|
Service Code
|
CPT 46040
|
| Hospital Charge Code |
900501335
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$339.53 |
| Max. Negotiated Rate |
$8,205.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,470.20
|
| Rate for Payer: Blue Shield of California Commercial |
$5,734.59
|
| Rate for Payer: Blue Shield of California EPN |
$4,458.21
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$4,102.65
|
| Rate for Payer: Cash Price |
$4,102.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,293.60
|
| Rate for Payer: Cigna of CA HMO |
$5,834.88
|
| Rate for Payer: Cigna of CA PPO |
$6,746.58
|
| 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 |
$7,749.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,470.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,205.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,837.75
|
| 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 |
$6,081.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$339.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,823.40
|
| 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 |
$6,837.75
|
| Rate for Payer: Networks By Design Commercial |
$5,926.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,749.45
|
| 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 |
$5,470.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,470.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,558.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,558.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,558.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,558.50
|
| 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 I & D THYROGLOSSAL DUCT CYST
|
Facility
|
IP
|
$3,545.00
|
|
|
Service Code
|
CPT 60000
|
| Hospital Charge Code |
900501674
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$709.00 |
| Max. Negotiated Rate |
$3,190.50 |
| Rate for Payer: Cash Price |
$1,595.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,836.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,418.00
|
| Rate for Payer: Galaxy Health WC |
$3,013.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,127.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,190.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,364.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,350.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$709.00
|
| Rate for Payer: Multiplan Commercial |
$2,658.75
|
| Rate for Payer: Networks By Design Commercial |
$2,304.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,013.25
|
|
|
HC I & D THYROGLOSSAL DUCT CYST
|
Facility
|
OP
|
$3,545.00
|
|
|
Service Code
|
CPT 60000
|
| Hospital Charge Code |
900501674
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$128.74 |
| Max. Negotiated Rate |
$3,190.50 |
| 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 |
$2,858.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,905.44
|
| 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 |
$2,127.00
|
| Rate for Payer: Caremore Medicare Advantage |
$1,905.44
|
| Rate for Payer: Cash Price |
$1,595.25
|
| Rate for Payer: Cash Price |
$1,595.25
|
| Rate for Payer: Cash Price |
$1,595.25
|
| Rate for Payer: Cash Price |
$1,595.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,836.00
|
| Rate for Payer: Cigna of CA PPO |
$2,623.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Dignity Health Media |
$1,905.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,095.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,572.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,905.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,905.44
|
| Rate for Payer: Galaxy Health WC |
$3,013.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,127.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,190.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,658.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,124.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,905.44
|
| Rate for Payer: InnovAge PACE Commercial |
$2,858.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,364.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$128.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,905.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$709.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,553.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,553.29
|
| Rate for Payer: Multiplan Commercial |
$2,658.75
|
| Rate for Payer: Networks By Design Commercial |
$2,304.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,013.25
|
| Rate for Payer: Prime Health Services Medicare |
$2,019.77
|
| Rate for Payer: Riverside University Health System MISP |
$2,095.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,127.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,772.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,772.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,772.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,772.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,858.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,095.98
|
| Rate for Payer: Vantage Medical Group Senior |
$1,905.44
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
IP
|
$5,166.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,033.20 |
| Max. Negotiated Rate |
$4,649.40 |
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,132.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,066.40
|
| Rate for Payer: Galaxy Health WC |
$4,391.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,099.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,649.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,445.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,968.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,033.20
|
| Rate for Payer: Multiplan Commercial |
$3,874.50
|
| Rate for Payer: Networks By Design Commercial |
$3,357.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,391.10
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
OP
|
$5,166.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$552.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: 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 |
$3,099.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,249.41
|
| Rate for Payer: Blue Shield of California EPN |
$2,526.17
|
| Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,132.80
|
| Rate for Payer: Cigna of CA HMO |
$3,306.24
|
| Rate for Payer: Cigna of CA PPO |
$3,822.84
|
| 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 |
$4,391.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,099.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,649.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,874.50
|
| 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 |
$3,445.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,968.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,033.20
|
| 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 |
$3,874.50
|
| Rate for Payer: Networks By Design Commercial |
$3,357.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,391.10
|
| 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 |
$3,099.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,099.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| 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 I & D VAGINAL HEMATOMA
|
Facility
|
IP
|
$5,166.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,033.20 |
| Max. Negotiated Rate |
$4,649.40 |
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,132.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,066.40
|
| Rate for Payer: Galaxy Health WC |
$4,391.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,099.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,649.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,445.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,968.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,033.20
|
| Rate for Payer: Multiplan Commercial |
$3,874.50
|
| Rate for Payer: Networks By Design Commercial |
$3,357.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,391.10
|
|
|
HC I & D VAGINAL HEMATOMA
|
Facility
|
OP
|
$5,166.00
|
|
|
Service Code
|
CPT 57022
|
| Hospital Charge Code |
902400747
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| 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 |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,099.60
|
| Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Cash Price |
$2,324.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,132.80
|
| Rate for Payer: Cigna of CA PPO |
$3,822.84
|
| 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 |
$4,391.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3,099.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,649.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,874.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| 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 |
$3,445.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,968.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,033.20
|
| 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 |
$3,874.50
|
| Rate for Payer: Networks By Design Commercial |
$3,357.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,391.10
|
| 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 |
$3,099.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,583.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,583.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,583.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,583.00
|
| 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 IHC EACH ADDL SINGLE MULTI PER SPEC MEDI
|
Facility
|
IP
|
$676.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
903800243
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$135.20 |
| Max. Negotiated Rate |
$608.40 |
| Rate for Payer: Cash Price |
$304.20
|
| Rate for Payer: Central Health Plan Commercial |
$540.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$270.40
|
| Rate for Payer: Galaxy Health WC |
$574.60
|
| Rate for Payer: Global Benefits Group Commercial |
$405.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$608.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$450.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$257.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.20
|
| Rate for Payer: Multiplan Commercial |
$507.00
|
| Rate for Payer: Networks By Design Commercial |
$439.40
|
| Rate for Payer: Prime Health Services Commercial |
$574.60
|
|
|
HC IHC EACH ADDL SINGLE MULTI PER SPEC MEDI
|
Facility
|
OP
|
$676.00
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
903800243
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$135.20 |
| Max. Negotiated Rate |
$741.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$449.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$433.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$494.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$449.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$543.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$663.05
|
| Rate for Payer: Blue Distinction Transplant |
$405.60
|
| Rate for Payer: Blue Shield of California Commercial |
$417.77
|
| Rate for Payer: Blue Shield of California EPN |
$328.54
|
| Rate for Payer: Caremore Medicare Advantage |
$449.11
|
| Rate for Payer: Cash Price |
$304.20
|
| Rate for Payer: Cash Price |
$304.20
|
| Rate for Payer: Central Health Plan Commercial |
$540.80
|
| Rate for Payer: Cigna of CA HMO |
$432.64
|
| Rate for Payer: Cigna of CA PPO |
$500.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.66
|
| Rate for Payer: Dignity Health Media |
$449.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$494.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$606.30
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$449.11
|
| Rate for Payer: EPIC Health Plan Transplant |
$449.11
|
| Rate for Payer: Galaxy Health WC |
$574.60
|
| Rate for Payer: Global Benefits Group Commercial |
$405.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$608.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$507.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$736.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$741.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$449.11
|
| Rate for Payer: InnovAge PACE Commercial |
$673.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$450.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$199.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$449.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$601.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.81
|
| Rate for Payer: Multiplan Commercial |
$507.00
|
| Rate for Payer: Networks By Design Commercial |
$439.40
|
| Rate for Payer: Prime Health Services Commercial |
$574.60
|
| Rate for Payer: Prime Health Services Medicare |
$476.06
|
| Rate for Payer: Riverside University Health System MISP |
$494.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$405.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$405.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.94
|
| Rate for Payer: United Healthcare All Other HMO |
$240.94
|
| Rate for Payer: United Healthcare HMO Rider |
$240.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$494.02
|
| Rate for Payer: Vantage Medical Group Senior |
$449.11
|
|
|
HC IHC FIRST SINGLE MULTI PER SPEC MEDI
|
Facility
|
IP
|
$546.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800242
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$109.20 |
| Max. Negotiated Rate |
$491.40 |
| Rate for Payer: Cash Price |
$245.70
|
| Rate for Payer: Central Health Plan Commercial |
$436.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$218.40
|
| Rate for Payer: Galaxy Health WC |
$464.10
|
| Rate for Payer: Global Benefits Group Commercial |
$327.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$491.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$364.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$208.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.20
|
| Rate for Payer: Multiplan Commercial |
$409.50
|
| Rate for Payer: Networks By Design Commercial |
$354.90
|
| Rate for Payer: Prime Health Services Commercial |
$464.10
|
|
|
HC IHC FIRST SINGLE MULTI PER SPEC MEDI
|
Facility
|
OP
|
$546.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
903800242
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$69.35 |
| Max. Negotiated Rate |
$491.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$213.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$352.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$213.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$69.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.59
|
| Rate for Payer: Blue Distinction Transplant |
$327.60
|
| Rate for Payer: Blue Shield of California Commercial |
$337.43
|
| Rate for Payer: Blue Shield of California EPN |
$265.36
|
| Rate for Payer: Caremore Medicare Advantage |
$213.41
|
| Rate for Payer: Cash Price |
$245.70
|
| Rate for Payer: Cash Price |
$245.70
|
| Rate for Payer: Central Health Plan Commercial |
$436.80
|
| Rate for Payer: Cigna of CA HMO |
$349.44
|
| Rate for Payer: Cigna of CA PPO |
$404.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.12
|
| Rate for Payer: Dignity Health Media |
$213.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$234.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$213.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$213.41
|
| Rate for Payer: Galaxy Health WC |
$464.10
|
| Rate for Payer: Global Benefits Group Commercial |
$327.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$491.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$409.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$349.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$352.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$213.41
|
| Rate for Payer: InnovAge PACE Commercial |
$320.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$364.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$213.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$285.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$285.97
|
| Rate for Payer: Multiplan Commercial |
$409.50
|
| Rate for Payer: Networks By Design Commercial |
$354.90
|
| Rate for Payer: Prime Health Services Commercial |
$464.10
|
| Rate for Payer: Prime Health Services Medicare |
$226.21
|
| Rate for Payer: Riverside University Health System MISP |
$234.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$327.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$327.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Vantage Medical Group Senior |
$213.41
|
|
|
HC ILAC ART ANGIO CARDIAC CATH
|
Facility
|
OP
|
$2,852.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906820131
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$68.29 |
| Max. Negotiated Rate |
$2,566.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,424.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,568.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,568.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$83.46
|
| Rate for Payer: Blue Distinction Transplant |
$1,711.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,762.54
|
| Rate for Payer: Blue Shield of California EPN |
$1,386.07
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,281.60
|
| Rate for Payer: Cigna of CA HMO |
$1,825.28
|
| Rate for Payer: Cigna of CA PPO |
$2,110.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,424.20
|
| Rate for Payer: Dignity Health Media |
$2,424.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,424.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,140.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,140.80
|
| Rate for Payer: Galaxy Health WC |
$2,424.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,711.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,566.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,139.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$998.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,902.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,086.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$570.40
|
| Rate for Payer: Multiplan Commercial |
$2,139.00
|
| Rate for Payer: Networks By Design Commercial |
$1,853.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,424.20
|
| Rate for Payer: Riverside University Health System MISP |
$1,140.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,711.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,711.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,426.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,426.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,426.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,426.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,424.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,424.20
|
|
|
HC ILAC ART ANGIO CARDIAC CATH
|
Facility
|
OP
|
$2,852.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811387
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$68.29 |
| Max. Negotiated Rate |
$2,566.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,424.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,568.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,568.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$83.46
|
| Rate for Payer: Blue Distinction Transplant |
$1,711.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,762.54
|
| Rate for Payer: Blue Shield of California EPN |
$1,386.07
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,281.60
|
| Rate for Payer: Cigna of CA HMO |
$1,825.28
|
| Rate for Payer: Cigna of CA PPO |
$2,110.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,424.20
|
| Rate for Payer: Dignity Health Media |
$2,424.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,424.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,140.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,140.80
|
| Rate for Payer: Galaxy Health WC |
$2,424.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,711.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,566.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,139.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$998.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,902.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,086.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$570.40
|
| Rate for Payer: Multiplan Commercial |
$2,139.00
|
| Rate for Payer: Networks By Design Commercial |
$1,853.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,424.20
|
| Rate for Payer: Riverside University Health System MISP |
$1,140.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,711.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,711.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,426.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,426.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,426.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,426.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,424.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,424.20
|
|
|
HC ILAC ART ANGIO CARDIAC CATH
|
Facility
|
IP
|
$2,852.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811387
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$570.40 |
| Max. Negotiated Rate |
$2,566.80 |
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,281.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,140.80
|
| Rate for Payer: Galaxy Health WC |
$2,424.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,711.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,566.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,902.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,086.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$570.40
|
| Rate for Payer: Multiplan Commercial |
$2,139.00
|
| Rate for Payer: Networks By Design Commercial |
$1,853.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,424.20
|
|
|
HC ILAC ART ANGIO CARDIAC CATH
|
Facility
|
IP
|
$2,852.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906820131
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$570.40 |
| Max. Negotiated Rate |
$2,566.80 |
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,281.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,140.80
|
| Rate for Payer: Galaxy Health WC |
$2,424.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,711.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,566.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,902.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,086.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$570.40
|
| Rate for Payer: Multiplan Commercial |
$2,139.00
|
| Rate for Payer: Networks By Design Commercial |
$1,853.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,424.20
|
|
|
HC ILEOSCOPY STOMA W/BALLOON DILATION
|
Facility
|
OP
|
$5,582.00
|
|
|
Service Code
|
CPT 44381
|
| Hospital Charge Code |
950442410
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,116.40 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,377.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| 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 |
$3,349.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$2,377.45
|
| Rate for Payer: Cash Price |
$2,511.90
|
| Rate for Payer: Cash Price |
$2,511.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,465.60
|
| Rate for Payer: Cigna of CA PPO |
$4,130.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Dignity Health Media |
$2,377.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,615.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,209.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,377.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,377.45
|
| Rate for Payer: Galaxy Health WC |
$4,744.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,349.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,023.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,186.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,899.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,922.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,377.45
|
| Rate for Payer: InnovAge PACE Commercial |
$3,566.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,723.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,116.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,185.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,185.78
|
| Rate for Payer: Multiplan Commercial |
$4,186.50
|
| Rate for Payer: Networks By Design Commercial |
$3,628.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,744.70
|
| Rate for Payer: Prime Health Services Medicare |
$2,520.10
|
| Rate for Payer: Riverside University Health System MISP |
$2,615.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,349.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,852.94
|
| 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 |
$3,566.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,377.45
|
|
|
HC ILEOSCOPY STOMA W/BALLOON DILATION
|
Facility
|
IP
|
$5,582.00
|
|
|
Service Code
|
CPT 44381
|
| Hospital Charge Code |
950442410
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,116.40 |
| Max. Negotiated Rate |
$5,023.80 |
| Rate for Payer: Cash Price |
$2,511.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,465.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,232.80
|
| Rate for Payer: Galaxy Health WC |
$4,744.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,349.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,023.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,723.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,126.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,116.40
|
| Rate for Payer: Multiplan Commercial |
$4,186.50
|
| Rate for Payer: Networks By Design Commercial |
$3,628.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,744.70
|
|
|
HC ILEOSCOPY STOMA W BX
|
Facility
|
IP
|
$8,255.00
|
|
|
Service Code
|
CPT 44382
|
| Hospital Charge Code |
906744382
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,651.00 |
| Max. Negotiated Rate |
$7,429.50 |
| Rate for Payer: Cash Price |
$3,714.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,604.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,302.00
|
| Rate for Payer: Galaxy Health WC |
$7,016.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,953.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,429.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,506.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,145.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,651.00
|
| Rate for Payer: Multiplan Commercial |
$6,191.25
|
| Rate for Payer: Networks By Design Commercial |
$5,365.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,016.75
|
|
|
HC ILEOSCOPY STOMA W BX
|
Facility
|
OP
|
$4,558.00
|
|
|
Service Code
|
CPT 44382
|
| Hospital Charge Code |
906744382
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$207.25 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| 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 |
$2,734.80
|
| 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 |
$1,132.59
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,646.40
|
| Rate for Payer: Cigna of CA PPO |
$3,372.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$3,874.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,734.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,102.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,418.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,868.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: InnovAge PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,040.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$911.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$3,418.50
|
| Rate for Payer: Networks By Design Commercial |
$2,962.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,874.30
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,734.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,359.11
|
| 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 |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
IP
|
$8,255.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,651.00 |
| Max. Negotiated Rate |
$7,429.50 |
| Rate for Payer: Cash Price |
$3,714.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,604.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,302.00
|
| Rate for Payer: Galaxy Health WC |
$7,016.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,953.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,429.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,506.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,145.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,651.00
|
| Rate for Payer: Multiplan Commercial |
$6,191.25
|
| Rate for Payer: Networks By Design Commercial |
$5,365.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,016.75
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
IP
|
$8,255.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,651.00 |
| Max. Negotiated Rate |
$7,429.50 |
| Rate for Payer: Cash Price |
$3,714.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,604.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,302.00
|
| Rate for Payer: Galaxy Health WC |
$7,016.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,953.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,429.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,506.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,145.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,651.00
|
| Rate for Payer: Multiplan Commercial |
$6,191.25
|
| Rate for Payer: Networks By Design Commercial |
$5,365.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,016.75
|
|
|
HC ILEOSCOPY STOMA W WO COLLECT
|
Facility
|
OP
|
$4,558.00
|
|
|
Service Code
|
CPT 44380
|
| Hospital Charge Code |
906744380
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$159.87 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| 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 |
$2,734.80
|
| 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 |
$1,132.59
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Cash Price |
$2,051.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,646.40
|
| Rate for Payer: Cigna of CA PPO |
$3,372.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$3,874.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,734.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,102.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,418.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,868.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: InnovAge PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,040.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$159.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$911.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$3,418.50
|
| Rate for Payer: Networks By Design Commercial |
$2,962.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,874.30
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,734.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,359.11
|
| 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 |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
