|
HC NASO/ORGSTRC TUBE PLCM FS GDNC
|
Facility
|
IP
|
$811.00
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
906743752
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$162.20 |
| Max. Negotiated Rate |
$729.90 |
| Rate for Payer: Adventist Health Commercial |
$162.20
|
| Rate for Payer: Cash Price |
$364.95
|
| Rate for Payer: Central Health Plan Commercial |
$648.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$567.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.40
|
| Rate for Payer: EPIC Health Plan Senior |
$324.40
|
| Rate for Payer: Galaxy Health WC |
$689.35
|
| Rate for Payer: Global Benefits Group Commercial |
$486.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$514.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$478.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.20
|
| Rate for Payer: Multiplan Commercial |
$608.25
|
| Rate for Payer: Networks By Design Commercial |
$527.15
|
| Rate for Payer: Prime Health Services Commercial |
$689.35
|
|
|
HC NASO/ORGSTRC TUBE PLCM FS GDNC
|
Facility
|
OP
|
$811.00
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
906743752
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$162.20 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$162.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$861.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$632.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$574.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$807.84
|
| Rate for Payer: Cash Price |
$364.95
|
| Rate for Payer: Cash Price |
$364.95
|
| Rate for Payer: Cash Price |
$364.95
|
| Rate for Payer: Cash Price |
$364.95
|
| Rate for Payer: Central Health Plan Commercial |
$648.80
|
| Rate for Payer: Cigna of CA HMO |
$519.04
|
| Rate for Payer: Cigna of CA PPO |
$600.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$861.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$632.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$574.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$567.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$948.02
|
| Rate for Payer: EPIC Health Plan Senior |
$632.02
|
| Rate for Payer: Galaxy Health WC |
$689.35
|
| Rate for Payer: Global Benefits Group Commercial |
$486.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$942.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$574.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$514.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$246.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$617.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$769.91
|
| Rate for Payer: Multiplan Commercial |
$608.25
|
| Rate for Payer: Multiplan WC |
$807.84
|
| Rate for Payer: Networks By Design Commercial |
$527.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$574.56
|
| Rate for Payer: Preferred Health Network WC |
$824.33
|
| Rate for Payer: Prime Health Services Commercial |
$689.35
|
| Rate for Payer: Prime Health Services Medicare |
$609.03
|
| Rate for Payer: Prime Health Services WC |
$799.60
|
| Rate for Payer: Riverside University Health System MISP |
$632.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$486.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$405.50
|
| Rate for Payer: United Healthcare All Other HMO |
$405.50
|
| Rate for Payer: United Healthcare HMO Rider |
$405.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$405.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$574.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$861.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$632.02
|
| Rate for Payer: Vantage Medical Group Senior |
$574.56
|
|
|
HC NASO/ORGSTRC TUBE PLCM FS GDNC
|
Facility
|
IP
|
$811.00
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
906743752
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$162.20 |
| Max. Negotiated Rate |
$729.90 |
| Rate for Payer: Adventist Health Commercial |
$162.20
|
| Rate for Payer: Cash Price |
$364.95
|
| Rate for Payer: Central Health Plan Commercial |
$648.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$567.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$324.40
|
| Rate for Payer: EPIC Health Plan Senior |
$324.40
|
| Rate for Payer: Galaxy Health WC |
$689.35
|
| Rate for Payer: Global Benefits Group Commercial |
$486.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$729.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$514.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$478.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.20
|
| Rate for Payer: Multiplan Commercial |
$608.25
|
| Rate for Payer: Networks By Design Commercial |
$527.15
|
| Rate for Payer: Prime Health Services Commercial |
$689.35
|
|
|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
|
IP
|
$899.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$179.80 |
| Max. Negotiated Rate |
$809.10 |
| Rate for Payer: Adventist Health Commercial |
$179.80
|
| Rate for Payer: Cash Price |
$404.55
|
| Rate for Payer: Central Health Plan Commercial |
$719.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$629.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$359.60
|
| Rate for Payer: EPIC Health Plan Senior |
$359.60
|
| Rate for Payer: Galaxy Health WC |
$764.15
|
| Rate for Payer: Global Benefits Group Commercial |
$539.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$809.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$570.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$530.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.80
|
| Rate for Payer: Multiplan Commercial |
$674.25
|
| Rate for Payer: Networks By Design Commercial |
$584.35
|
| Rate for Payer: Prime Health Services Commercial |
$764.15
|
|
|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
|
IP
|
$899.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$179.80 |
| Max. Negotiated Rate |
$809.10 |
| Rate for Payer: Adventist Health Commercial |
$179.80
|
| Rate for Payer: Cash Price |
$404.55
|
| Rate for Payer: Central Health Plan Commercial |
$719.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$629.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$359.60
|
| Rate for Payer: EPIC Health Plan Senior |
$359.60
|
| Rate for Payer: Galaxy Health WC |
$764.15
|
| Rate for Payer: Global Benefits Group Commercial |
$539.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$809.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$570.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$530.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.80
|
| Rate for Payer: Multiplan Commercial |
$674.25
|
| Rate for Payer: Networks By Design Commercial |
$584.35
|
| Rate for Payer: Prime Health Services Commercial |
$764.15
|
|
|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
|
OP
|
$899.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$32.55 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$179.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$630.41
|
| Rate for Payer: Cash Price |
$404.55
|
| Rate for Payer: Cash Price |
$404.55
|
| Rate for Payer: Cash Price |
$404.55
|
| Rate for Payer: Cash Price |
$404.55
|
| Rate for Payer: Central Health Plan Commercial |
$719.20
|
| Rate for Payer: Cigna of CA HMO |
$575.36
|
| Rate for Payer: Cigna of CA PPO |
$665.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$629.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$764.15
|
| Rate for Payer: Global Benefits Group Commercial |
$539.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$809.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$570.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$298.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$674.25
|
| Rate for Payer: Multiplan WC |
$630.41
|
| Rate for Payer: Networks By Design Commercial |
$584.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Preferred Health Network WC |
$643.28
|
| Rate for Payer: Prime Health Services Commercial |
$764.15
|
| Rate for Payer: Prime Health Services Medicare |
$294.37
|
| Rate for Payer: Prime Health Services WC |
$623.98
|
| Rate for Payer: Riverside University Health System MISP |
$305.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$539.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$449.50
|
| Rate for Payer: United Healthcare All Other HMO |
$449.50
|
| Rate for Payer: United Healthcare HMO Rider |
$449.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$449.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
|
OP
|
$899.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$29.46 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$179.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$277.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$116.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$277.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$569.97
|
| Rate for Payer: Blue Shield of California EPN |
$358.70
|
| Rate for Payer: Cash Price |
$404.55
|
| Rate for Payer: Cash Price |
$404.55
|
| Rate for Payer: Cash Price |
$404.55
|
| Rate for Payer: Central Health Plan Commercial |
$719.20
|
| Rate for Payer: Cigna of CA HMO |
$575.36
|
| Rate for Payer: Cigna of CA PPO |
$665.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$416.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$305.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$277.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$629.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$458.22
|
| Rate for Payer: EPIC Health Plan Senior |
$305.48
|
| Rate for Payer: Galaxy Health WC |
$764.15
|
| Rate for Payer: Global Benefits Group Commercial |
$539.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$809.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$455.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$277.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$570.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$388.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$372.13
|
| Rate for Payer: Multiplan Commercial |
$674.25
|
| Rate for Payer: Networks By Design Commercial |
$584.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$277.71
|
| Rate for Payer: Prime Health Services Commercial |
$764.15
|
| Rate for Payer: Prime Health Services Medicare |
$294.37
|
| Rate for Payer: Riverside University Health System MISP |
$305.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$539.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$539.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$449.50
|
| Rate for Payer: United Healthcare All Other HMO |
$449.50
|
| Rate for Payer: United Healthcare HMO Rider |
$449.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$449.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$277.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$416.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$305.48
|
| Rate for Payer: Vantage Medical Group Senior |
$277.71
|
|
|
HC NASOPHARYNGOGRAM
|
Facility
|
OP
|
$797.00
|
|
|
Service Code
|
CPT 70370
|
| Hospital Charge Code |
909001253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$65.51 |
| Max. Negotiated Rate |
$717.30 |
| Rate for Payer: Adventist Health Commercial |
$159.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$111.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$418.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$271.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$377.01
|
| Rate for Payer: Blue Shield of California Commercial |
$502.11
|
| Rate for Payer: Blue Shield of California EPN |
$316.41
|
| Rate for Payer: Cash Price |
$358.65
|
| Rate for Payer: Cash Price |
$358.65
|
| Rate for Payer: Central Health Plan Commercial |
$637.60
|
| Rate for Payer: Cigna of CA HMO |
$510.08
|
| Rate for Payer: Cigna of CA PPO |
$589.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$557.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.68
|
| Rate for Payer: EPIC Health Plan Senior |
$123.12
|
| Rate for Payer: Galaxy Health WC |
$677.45
|
| Rate for Payer: Global Benefits Group Commercial |
$478.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$717.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$65.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$506.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$149.99
|
| Rate for Payer: Multiplan Commercial |
$597.75
|
| Rate for Payer: Networks By Design Commercial |
$518.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$111.93
|
| Rate for Payer: Prime Health Services Commercial |
$677.45
|
| Rate for Payer: Prime Health Services Medicare |
$118.65
|
| Rate for Payer: Riverside University Health System MISP |
$123.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$478.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$478.20
|
| 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: Upland Medical Group Pediatric |
$111.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Vantage Medical Group Senior |
$111.93
|
|
|
HC NASOPHARYNGOGRAM
|
Facility
|
IP
|
$797.00
|
|
|
Service Code
|
CPT 70370
|
| Hospital Charge Code |
909001253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$159.40 |
| Max. Negotiated Rate |
$717.30 |
| Rate for Payer: Adventist Health Commercial |
$159.40
|
| Rate for Payer: Cash Price |
$358.65
|
| Rate for Payer: Central Health Plan Commercial |
$637.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$557.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$318.80
|
| Rate for Payer: EPIC Health Plan Senior |
$318.80
|
| Rate for Payer: Galaxy Health WC |
$677.45
|
| Rate for Payer: Global Benefits Group Commercial |
$478.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$717.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$506.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$470.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.40
|
| Rate for Payer: Multiplan Commercial |
$597.75
|
| Rate for Payer: Networks By Design Commercial |
$518.05
|
| Rate for Payer: Prime Health Services Commercial |
$677.45
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
OP
|
$1,200.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$79.40 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$240.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$256.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$393.03
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Central Health Plan Commercial |
$960.00
|
| Rate for Payer: Cigna of CA HMO |
$768.00
|
| Rate for Payer: Cigna of CA PPO |
$888.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$385.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$282.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$256.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.60
|
| Rate for Payer: EPIC Health Plan Senior |
$282.40
|
| Rate for Payer: Galaxy Health WC |
$1,020.00
|
| Rate for Payer: Global Benefits Group Commercial |
$720.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,080.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$421.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$256.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$762.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$275.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$240.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$344.02
|
| Rate for Payer: Multiplan Commercial |
$900.00
|
| Rate for Payer: Multiplan WC |
$393.03
|
| Rate for Payer: Networks By Design Commercial |
$780.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$256.73
|
| Rate for Payer: Preferred Health Network WC |
$401.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,020.00
|
| Rate for Payer: Prime Health Services Medicare |
$272.13
|
| Rate for Payer: Prime Health Services WC |
$389.02
|
| Rate for Payer: Riverside University Health System MISP |
$282.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$720.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$600.00
|
| Rate for Payer: United Healthcare All Other HMO |
$600.00
|
| Rate for Payer: United Healthcare HMO Rider |
$600.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$600.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$256.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Vantage Medical Group Senior |
$256.73
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
OP
|
$1,200.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$71.88 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$492.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$256.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$362.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$256.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Central Health Plan Commercial |
$960.00
|
| Rate for Payer: Cigna of CA HMO |
$768.00
|
| Rate for Payer: Cigna of CA PPO |
$888.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$385.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$282.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$256.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.60
|
| Rate for Payer: EPIC Health Plan Senior |
$282.40
|
| Rate for Payer: Galaxy Health WC |
$1,020.00
|
| Rate for Payer: Global Benefits Group Commercial |
$720.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,080.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$421.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$71.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$256.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$762.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$359.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$492.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$344.02
|
| Rate for Payer: Multiplan Commercial |
$900.00
|
| Rate for Payer: Networks By Design Commercial |
$780.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$256.73
|
| Rate for Payer: Prime Health Services Commercial |
$1,020.00
|
| Rate for Payer: Prime Health Services Medicare |
$272.13
|
| Rate for Payer: Riverside University Health System MISP |
$282.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$720.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$308.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$256.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Vantage Medical Group Senior |
$256.73
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
IP
|
$1,200.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$240.00 |
| Max. Negotiated Rate |
$1,080.00 |
| Rate for Payer: Adventist Health Commercial |
$240.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Central Health Plan Commercial |
$960.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$480.00
|
| Rate for Payer: EPIC Health Plan Senior |
$480.00
|
| Rate for Payer: Galaxy Health WC |
$1,020.00
|
| Rate for Payer: Global Benefits Group Commercial |
$720.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,080.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$762.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$708.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$240.00
|
| Rate for Payer: Multiplan Commercial |
$900.00
|
| Rate for Payer: Networks By Design Commercial |
$780.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,020.00
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
OP
|
$1,200.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$79.40 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$492.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$362.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$256.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$393.03
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Central Health Plan Commercial |
$960.00
|
| Rate for Payer: Cigna of CA HMO |
$768.00
|
| Rate for Payer: Cigna of CA PPO |
$888.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$385.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$282.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$256.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.60
|
| Rate for Payer: EPIC Health Plan Senior |
$282.40
|
| Rate for Payer: Galaxy Health WC |
$1,020.00
|
| Rate for Payer: Global Benefits Group Commercial |
$720.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,080.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$421.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$256.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$762.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$275.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$240.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$344.02
|
| Rate for Payer: Multiplan Commercial |
$900.00
|
| Rate for Payer: Multiplan WC |
$393.03
|
| Rate for Payer: Networks By Design Commercial |
$780.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$256.73
|
| Rate for Payer: Preferred Health Network WC |
$401.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,020.00
|
| Rate for Payer: Prime Health Services Medicare |
$272.13
|
| Rate for Payer: Prime Health Services WC |
$389.02
|
| Rate for Payer: Riverside University Health System MISP |
$282.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$720.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$720.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$256.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Vantage Medical Group Senior |
$256.73
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
IP
|
$1,200.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$240.00 |
| Max. Negotiated Rate |
$1,080.00 |
| Rate for Payer: Adventist Health Commercial |
$240.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Central Health Plan Commercial |
$960.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$480.00
|
| Rate for Payer: EPIC Health Plan Senior |
$480.00
|
| Rate for Payer: Galaxy Health WC |
$1,020.00
|
| Rate for Payer: Global Benefits Group Commercial |
$720.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,080.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$762.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$708.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$240.00
|
| Rate for Payer: Multiplan Commercial |
$900.00
|
| Rate for Payer: Networks By Design Commercial |
$780.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,020.00
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
IP
|
$1,200.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$240.00 |
| Max. Negotiated Rate |
$1,080.00 |
| Rate for Payer: Adventist Health Commercial |
$240.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Central Health Plan Commercial |
$960.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$480.00
|
| Rate for Payer: EPIC Health Plan Senior |
$480.00
|
| Rate for Payer: Galaxy Health WC |
$1,020.00
|
| Rate for Payer: Global Benefits Group Commercial |
$720.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,080.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$762.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$708.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$240.00
|
| Rate for Payer: Multiplan Commercial |
$900.00
|
| Rate for Payer: Networks By Design Commercial |
$780.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,020.00
|
|
|
HC NASOPHARYNGOSCOPY W ENDOSCOPE MCAL
|
Facility
|
IP
|
$1,200.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
907000031
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$240.00 |
| Max. Negotiated Rate |
$1,080.00 |
| Rate for Payer: Adventist Health Commercial |
$240.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Central Health Plan Commercial |
$960.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$480.00
|
| Rate for Payer: EPIC Health Plan Senior |
$480.00
|
| Rate for Payer: Galaxy Health WC |
$1,020.00
|
| Rate for Payer: Global Benefits Group Commercial |
$720.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,080.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$762.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$708.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$240.00
|
| Rate for Payer: Multiplan Commercial |
$900.00
|
| Rate for Payer: Networks By Design Commercial |
$780.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,020.00
|
|
|
HC NASOPHARYNGOSCOPY W ENDOSCOPE MCAL
|
Facility
|
OP
|
$1,200.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
907000031
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$71.88 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$492.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$256.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$362.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$256.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Cash Price |
$540.00
|
| Rate for Payer: Central Health Plan Commercial |
$960.00
|
| Rate for Payer: Cigna of CA HMO |
$768.00
|
| Rate for Payer: Cigna of CA PPO |
$888.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$385.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$282.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$256.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$840.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$423.60
|
| Rate for Payer: EPIC Health Plan Senior |
$282.40
|
| Rate for Payer: Galaxy Health WC |
$1,020.00
|
| Rate for Payer: Global Benefits Group Commercial |
$720.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,080.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$421.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$71.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$256.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$762.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$359.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$492.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$344.02
|
| Rate for Payer: Multiplan Commercial |
$900.00
|
| Rate for Payer: Networks By Design Commercial |
$780.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$256.73
|
| Rate for Payer: Prime Health Services Commercial |
$1,020.00
|
| Rate for Payer: Prime Health Services Medicare |
$272.13
|
| Rate for Payer: Riverside University Health System MISP |
$282.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$720.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$308.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$256.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$385.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$282.40
|
| Rate for Payer: Vantage Medical Group Senior |
$256.73
|
|
|
HC NASOTRACHEAL SUCTIONING
|
Facility
|
IP
|
$413.00
|
|
|
Service Code
|
CPT 31720
|
| Hospital Charge Code |
900800380
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$82.60 |
| Max. Negotiated Rate |
$371.70 |
| Rate for Payer: Adventist Health Commercial |
$82.60
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Central Health Plan Commercial |
$330.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$289.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$165.20
|
| Rate for Payer: EPIC Health Plan Senior |
$165.20
|
| Rate for Payer: Galaxy Health WC |
$351.05
|
| Rate for Payer: Global Benefits Group Commercial |
$247.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$371.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$243.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.60
|
| Rate for Payer: Multiplan Commercial |
$309.75
|
| Rate for Payer: Networks By Design Commercial |
$268.45
|
| Rate for Payer: Prime Health Services Commercial |
$351.05
|
|
|
HC NASOTRACHEAL SUCTIONING
|
Facility
|
OP
|
$413.00
|
|
|
Service Code
|
CPT 31720
|
| Hospital Charge Code |
900800380
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$82.60 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$82.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$281.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$280.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$422.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$309.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$281.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$261.84
|
| Rate for Payer: Blue Shield of California EPN |
$164.79
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Cash Price |
$185.85
|
| Rate for Payer: Central Health Plan Commercial |
$330.40
|
| Rate for Payer: Cigna of CA HMO |
$264.32
|
| Rate for Payer: Cigna of CA PPO |
$305.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$422.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$309.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$281.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$289.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$464.71
|
| Rate for Payer: EPIC Health Plan Senior |
$309.80
|
| Rate for Payer: Galaxy Health WC |
$351.05
|
| Rate for Payer: Global Benefits Group Commercial |
$247.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$371.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$461.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$281.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$394.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$377.40
|
| Rate for Payer: Multiplan Commercial |
$309.75
|
| Rate for Payer: Networks By Design Commercial |
$268.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$281.64
|
| Rate for Payer: Prime Health Services Commercial |
$351.05
|
| Rate for Payer: Prime Health Services Medicare |
$298.54
|
| Rate for Payer: Riverside University Health System MISP |
$309.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$247.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$247.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$206.50
|
| Rate for Payer: United Healthcare All Other HMO |
$206.50
|
| Rate for Payer: United Healthcare HMO Rider |
$206.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$281.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$422.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$309.80
|
| Rate for Payer: Vantage Medical Group Senior |
$281.64
|
|
|
HC N BLOCK,SPHENOPALATINE GANGLIN
|
Facility
|
IP
|
$1,827.00
|
|
|
Service Code
|
CPT 64505
|
| Hospital Charge Code |
900501686
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$365.40 |
| Max. Negotiated Rate |
$1,644.30 |
| Rate for Payer: Adventist Health Commercial |
$365.40
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,461.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,278.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$730.80
|
| Rate for Payer: EPIC Health Plan Senior |
$730.80
|
| Rate for Payer: Galaxy Health WC |
$1,552.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,096.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,644.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,160.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,077.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$365.40
|
| Rate for Payer: Multiplan Commercial |
$1,370.25
|
| Rate for Payer: Networks By Design Commercial |
$1,187.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,552.95
|
|
|
HC N BLOCK,SPHENOPALATINE GANGLIN
|
Facility
|
OP
|
$1,827.00
|
|
|
Service Code
|
CPT 64505
|
| Hospital Charge Code |
900501686
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.29 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$365.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$597.61
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Cash Price |
$822.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,461.60
|
| Rate for Payer: Cigna of CA HMO |
$1,169.28
|
| Rate for Payer: Cigna of CA PPO |
$1,351.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,278.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,552.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,096.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,644.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,160.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$115.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$424.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$365.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$1,370.25
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$1,187.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$394.79
|
| Rate for Payer: Preferred Health Network WC |
$609.81
|
| Rate for Payer: Prime Health Services Commercial |
$1,552.95
|
| Rate for Payer: Prime Health Services Medicare |
$418.48
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Riverside University Health System MISP |
$434.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,096.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$913.50
|
| Rate for Payer: United Healthcare All Other HMO |
$913.50
|
| Rate for Payer: United Healthcare HMO Rider |
$913.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$913.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC N-CARDIAC VASC FLOW IMAG
|
Facility
|
IP
|
$1,556.00
|
|
|
Service Code
|
CPT 78445
|
| Hospital Charge Code |
909301349
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$311.20 |
| Max. Negotiated Rate |
$1,400.40 |
| Rate for Payer: Adventist Health Commercial |
$311.20
|
| Rate for Payer: Cash Price |
$700.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,244.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,089.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$622.40
|
| Rate for Payer: EPIC Health Plan Senior |
$622.40
|
| Rate for Payer: Galaxy Health WC |
$1,322.60
|
| Rate for Payer: Global Benefits Group Commercial |
$933.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,400.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$988.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$918.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.20
|
| Rate for Payer: Multiplan Commercial |
$1,167.00
|
| Rate for Payer: Networks By Design Commercial |
$1,011.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,322.60
|
|
|
HC N-CARDIAC VASC FLOW IMAG
|
Facility
|
OP
|
$1,556.00
|
|
|
Service Code
|
CPT 78445
|
| Hospital Charge Code |
909301349
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$207.83 |
| Max. Negotiated Rate |
$1,400.40 |
| Rate for Payer: Adventist Health Commercial |
$311.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$514.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$937.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$384.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$905.13
|
| Rate for Payer: Blue Shield of California Commercial |
$980.28
|
| Rate for Payer: Blue Shield of California EPN |
$617.73
|
| Rate for Payer: Cash Price |
$700.20
|
| Rate for Payer: Cash Price |
$700.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,244.80
|
| Rate for Payer: Cigna of CA HMO |
$995.84
|
| Rate for Payer: Cigna of CA PPO |
$1,151.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$771.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$565.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$514.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,089.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$848.38
|
| Rate for Payer: EPIC Health Plan Senior |
$565.59
|
| Rate for Payer: Galaxy Health WC |
$1,322.60
|
| Rate for Payer: Global Benefits Group Commercial |
$933.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,400.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$843.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$207.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$514.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$988.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$229.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$719.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$688.99
|
| Rate for Payer: Multiplan Commercial |
$1,167.00
|
| Rate for Payer: Networks By Design Commercial |
$1,011.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$514.17
|
| Rate for Payer: Prime Health Services Commercial |
$1,322.60
|
| Rate for Payer: Prime Health Services Medicare |
$545.02
|
| Rate for Payer: Riverside University Health System MISP |
$565.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$933.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$933.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.46
|
| Rate for Payer: United Healthcare All Other HMO |
$396.46
|
| Rate for Payer: United Healthcare HMO Rider |
$396.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$396.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$514.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$771.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$565.59
|
| Rate for Payer: Vantage Medical Group Senior |
$514.17
|
|
|
HC NECK SOFT TISSUE
|
Facility
|
IP
|
$657.00
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
909001201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$131.40 |
| Max. Negotiated Rate |
$591.30 |
| Rate for Payer: Adventist Health Commercial |
$131.40
|
| Rate for Payer: Cash Price |
$295.65
|
| Rate for Payer: Central Health Plan Commercial |
$525.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$459.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.80
|
| Rate for Payer: EPIC Health Plan Senior |
$262.80
|
| Rate for Payer: Galaxy Health WC |
$558.45
|
| Rate for Payer: Global Benefits Group Commercial |
$394.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$591.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$417.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$387.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.40
|
| Rate for Payer: Multiplan Commercial |
$492.75
|
| Rate for Payer: Networks By Design Commercial |
$427.05
|
| Rate for Payer: Prime Health Services Commercial |
$558.45
|
|
|
HC NECK SOFT TISSUE
|
Facility
|
OP
|
$657.00
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
909001201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$591.30 |
| Rate for Payer: Adventist Health Commercial |
$131.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$111.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$122.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.97
|
| Rate for Payer: Blue Shield of California Commercial |
$413.91
|
| Rate for Payer: Blue Shield of California EPN |
$260.83
|
| Rate for Payer: Cash Price |
$295.65
|
| Rate for Payer: Cash Price |
$295.65
|
| Rate for Payer: Central Health Plan Commercial |
$525.60
|
| Rate for Payer: Cigna of CA HMO |
$420.48
|
| Rate for Payer: Cigna of CA PPO |
$486.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$167.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$123.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$459.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$184.68
|
| Rate for Payer: EPIC Health Plan Senior |
$123.12
|
| Rate for Payer: Galaxy Health WC |
$558.45
|
| Rate for Payer: Global Benefits Group Commercial |
$394.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$591.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$183.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$111.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$417.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$149.99
|
| Rate for Payer: Multiplan Commercial |
$492.75
|
| Rate for Payer: Networks By Design Commercial |
$427.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$111.93
|
| Rate for Payer: Prime Health Services Commercial |
$558.45
|
| Rate for Payer: Prime Health Services Medicare |
$118.65
|
| Rate for Payer: Riverside University Health System MISP |
$123.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$394.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$394.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$111.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$167.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$123.12
|
| Rate for Payer: Vantage Medical Group Senior |
$111.93
|
|
