|
HC LACTOSE TOLERANCE
|
Facility
|
OP
|
$49.00
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
900910313
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$114.22 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$94.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$93.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$114.22
|
| Rate for Payer: Blue Distinction Transplant |
$29.40
|
| Rate for Payer: Blue Shield of California Commercial |
$30.28
|
| Rate for Payer: Blue Shield of California EPN |
$23.81
|
| Rate for Payer: Caremore Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Central Health Plan Commercial |
$39.20
|
| Rate for Payer: Cigna of CA HMO |
$31.36
|
| Rate for Payer: Cigna of CA PPO |
$36.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.30
|
| Rate for Payer: Dignity Health Media |
$12.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.37
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.87
|
| Rate for Payer: Galaxy Health WC |
$41.65
|
| Rate for Payer: Global Benefits Group Commercial |
$29.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$36.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.87
|
| Rate for Payer: InnovAge PACE Commercial |
$19.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.25
|
| Rate for Payer: Multiplan Commercial |
$36.75
|
| Rate for Payer: Networks By Design Commercial |
$31.85
|
| Rate for Payer: Prime Health Services Commercial |
$41.65
|
| Rate for Payer: Prime Health Services Medicare |
$13.64
|
| Rate for Payer: Riverside University Health System MISP |
$14.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.42
|
| Rate for Payer: United Healthcare All Other HMO |
$10.42
|
| Rate for Payer: United Healthcare HMO Rider |
$10.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Vantage Medical Group Senior |
$12.87
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
IP
|
$116.00
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
900912027
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$104.40 |
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Central Health Plan Commercial |
$92.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.40
|
| Rate for Payer: Galaxy Health WC |
$98.60
|
| Rate for Payer: Global Benefits Group Commercial |
$69.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$104.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$77.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.20
|
| Rate for Payer: Multiplan Commercial |
$87.00
|
| Rate for Payer: Networks By Design Commercial |
$75.40
|
| Rate for Payer: Prime Health Services Commercial |
$98.60
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
OP
|
$73.00
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
900912027
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$138.91 |
| Rate for Payer: Adventist Health Medi-Cal |
$19.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$138.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.88
|
| Rate for Payer: Blue Distinction Transplant |
$43.80
|
| Rate for Payer: Blue Shield of California Commercial |
$45.11
|
| Rate for Payer: Blue Shield of California EPN |
$35.48
|
| Rate for Payer: Caremore Medicare Advantage |
$19.32
|
| Rate for Payer: Cash Price |
$32.85
|
| Rate for Payer: Cash Price |
$32.85
|
| Rate for Payer: Central Health Plan Commercial |
$58.40
|
| Rate for Payer: Cigna of CA HMO |
$46.72
|
| Rate for Payer: Cigna of CA PPO |
$54.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.98
|
| Rate for Payer: Dignity Health Media |
$19.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.08
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$19.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$19.32
|
| Rate for Payer: Galaxy Health WC |
$62.05
|
| Rate for Payer: Global Benefits Group Commercial |
$43.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$65.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$54.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19.32
|
| Rate for Payer: InnovAge PACE Commercial |
$28.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$48.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.89
|
| Rate for Payer: Multiplan Commercial |
$54.75
|
| Rate for Payer: Networks By Design Commercial |
$47.45
|
| Rate for Payer: Prime Health Services Commercial |
$62.05
|
| Rate for Payer: Prime Health Services Medicare |
$20.48
|
| Rate for Payer: Riverside University Health System MISP |
$21.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$43.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$43.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.65
|
| Rate for Payer: United Healthcare All Other HMO |
$15.65
|
| Rate for Payer: United Healthcare HMO Rider |
$15.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.25
|
| Rate for Payer: Vantage Medical Group Senior |
$19.32
|
|
|
HC LANGUAGE EVALUATION
|
Facility
|
OP
|
$1,031.00
|
|
| Hospital Charge Code |
905601211
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$196.00 |
| Max. Negotiated Rate |
$927.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$626.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$876.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$567.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$567.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$618.60
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$463.95
|
| Rate for Payer: Cash Price |
$463.95
|
| Rate for Payer: Cash Price |
$463.95
|
| Rate for Payer: Central Health Plan Commercial |
$824.80
|
| Rate for Payer: Cigna of CA HMO |
$659.84
|
| Rate for Payer: Cigna of CA PPO |
$762.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$876.35
|
| Rate for Payer: Dignity Health Media |
$876.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$876.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$412.40
|
| Rate for Payer: Galaxy Health WC |
$876.35
|
| Rate for Payer: Global Benefits Group Commercial |
$618.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$927.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$773.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$360.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$687.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$392.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$422.71
|
| Rate for Payer: Multiplan Commercial |
$773.25
|
| Rate for Payer: Networks By Design Commercial |
$670.15
|
| Rate for Payer: Prime Health Services Commercial |
$876.35
|
| Rate for Payer: Riverside University Health System MISP |
$412.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$618.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$618.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$876.35
|
| Rate for Payer: Vantage Medical Group Senior |
$876.35
|
|
|
HC LANGUAGE EVALUATION
|
Facility
|
IP
|
$1,031.00
|
|
| Hospital Charge Code |
905601211
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$206.20 |
| Max. Negotiated Rate |
$927.90 |
| Rate for Payer: Cash Price |
$463.95
|
| Rate for Payer: Central Health Plan Commercial |
$824.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.40
|
| Rate for Payer: Galaxy Health WC |
$876.35
|
| Rate for Payer: Global Benefits Group Commercial |
$618.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$927.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$687.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$392.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.20
|
| Rate for Payer: Multiplan Commercial |
$773.25
|
| Rate for Payer: Networks By Design Commercial |
$670.15
|
| Rate for Payer: Prime Health Services Commercial |
$876.35
|
|
|
HC LARYNGOSCOPY DIRECT
|
Facility
|
OP
|
$7,351.00
|
|
|
Service Code
|
CPT 31515
|
| Hospital Charge Code |
900501121
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$133.68 |
| Max. Negotiated Rate |
$6,615.90 |
| 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 |
$765.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$561.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$510.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,410.60
|
| Rate for Payer: Caremore Medicare Advantage |
$510.18
|
| Rate for Payer: Cash Price |
$3,307.95
|
| Rate for Payer: Cash Price |
$3,307.95
|
| Rate for Payer: Cash Price |
$3,307.95
|
| Rate for Payer: Cash Price |
$3,307.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,880.80
|
| Rate for Payer: Cigna of CA PPO |
$5,439.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.27
|
| Rate for Payer: Dignity Health Media |
$510.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$561.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$688.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$510.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$510.18
|
| Rate for Payer: Galaxy Health WC |
$6,248.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,410.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,615.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,513.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$836.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$510.18
|
| Rate for Payer: InnovAge PACE Commercial |
$765.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,903.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$510.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,470.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$683.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$683.64
|
| Rate for Payer: Multiplan Commercial |
$5,513.25
|
| Rate for Payer: Networks By Design Commercial |
$4,778.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,248.35
|
| Rate for Payer: Prime Health Services Medicare |
$540.79
|
| Rate for Payer: Riverside University Health System MISP |
$561.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,410.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,675.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,675.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,675.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,675.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$561.20
|
| Rate for Payer: Vantage Medical Group Senior |
$510.18
|
|
|
HC LARYNGOSCOPY DIRECT
|
Facility
|
IP
|
$7,351.00
|
|
|
Service Code
|
CPT 31515
|
| Hospital Charge Code |
900501121
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,470.20 |
| Max. Negotiated Rate |
$6,615.90 |
| Rate for Payer: Cash Price |
$3,307.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,880.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,940.40
|
| Rate for Payer: Galaxy Health WC |
$6,248.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,410.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,615.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,903.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,800.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,470.20
|
| Rate for Payer: Multiplan Commercial |
$5,513.25
|
| Rate for Payer: Networks By Design Commercial |
$4,778.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,248.35
|
|
|
HC LARYNGOSCOPY FLEX FIBEROPTIC
|
Facility
|
IP
|
$754.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
900501260
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$502.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$287.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.80
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$490.10
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
|
|
HC LARYNGOSCOPY FLEX FIBEROPTIC
|
Facility
|
OP
|
$754.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
900501260
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$146.43 |
| 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 |
$371.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.49
|
| 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 |
$452.40
|
| Rate for Payer: Caremore Medicare Advantage |
$247.49
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: Cigna of CA PPO |
$557.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: Dignity Health Media |
$247.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$247.49
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$565.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$405.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$247.49
|
| Rate for Payer: InnovAge PACE Commercial |
$371.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$502.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$146.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$331.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.64
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$490.10
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: Prime Health Services Medicare |
$262.34
|
| Rate for Payer: Riverside University Health System MISP |
$272.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$452.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$377.00
|
| Rate for Payer: United Healthcare All Other HMO |
$377.00
|
| Rate for Payer: United Healthcare HMO Rider |
$377.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$377.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC LARYNGOSCOPY FLEX FIBEROPTIC
|
Facility
|
OP
|
$754.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
900501260
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$146.43 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$247.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.49
|
| 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 |
$452.40
|
| Rate for Payer: Blue Shield of California Commercial |
$474.27
|
| Rate for Payer: Blue Shield of California EPN |
$368.71
|
| Rate for Payer: Caremore Medicare Advantage |
$247.49
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: Cigna of CA HMO |
$482.56
|
| Rate for Payer: Cigna of CA PPO |
$557.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: Dignity Health Media |
$247.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$247.49
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$565.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$405.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$408.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$247.49
|
| Rate for Payer: InnovAge PACE Commercial |
$371.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$502.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$146.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$331.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.64
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$490.10
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: Prime Health Services Medicare |
$262.34
|
| Rate for Payer: Riverside University Health System MISP |
$272.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$452.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$452.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$377.00
|
| Rate for Payer: United Healthcare All Other HMO |
$377.00
|
| Rate for Payer: United Healthcare HMO Rider |
$377.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$377.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC LARYNGOSCOPY FLEX FIBEROPTIC
|
Facility
|
OP
|
$754.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
900501260
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$146.43 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$247.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.49
|
| 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 |
$452.40
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$247.49
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: Cigna of CA PPO |
$557.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: Dignity Health Media |
$247.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$247.49
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$565.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$405.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$408.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$247.49
|
| Rate for Payer: InnovAge PACE Commercial |
$371.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$502.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$146.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$331.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.64
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$490.10
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: Prime Health Services Medicare |
$262.34
|
| Rate for Payer: Riverside University Health System MISP |
$272.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$452.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC LARYNGOSCOPY FLEX FIBEROPTIC
|
Facility
|
IP
|
$754.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
900501260
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$502.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$287.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.80
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$490.10
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
|
|
HC LARYNGOSCOPY FLEX FIBEROPTIC
|
Facility
|
IP
|
$754.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
900501260
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$502.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$287.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.80
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$490.10
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
|
|
HC LARYNGOSCOPY FLEX FIBEROPTIC
|
Facility
|
OP
|
$754.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
900501260
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$146.43 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$247.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.49
|
| 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 |
$452.40
|
| Rate for Payer: Blue Shield of California Commercial |
$474.27
|
| Rate for Payer: Blue Shield of California EPN |
$368.71
|
| Rate for Payer: Caremore Medicare Advantage |
$247.49
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: Cigna of CA HMO |
$482.56
|
| Rate for Payer: Cigna of CA PPO |
$557.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: Dignity Health Media |
$247.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$247.49
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$565.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$405.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$408.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$247.49
|
| Rate for Payer: InnovAge PACE Commercial |
$371.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$502.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$146.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$331.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.64
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$490.10
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: Prime Health Services Medicare |
$262.34
|
| Rate for Payer: Riverside University Health System MISP |
$272.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$452.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$452.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$377.00
|
| Rate for Payer: United Healthcare All Other HMO |
$377.00
|
| Rate for Payer: United Healthcare HMO Rider |
$377.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$377.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC LARYNGOSCOPY FLEX FIBEROPTIC
|
Facility
|
IP
|
$754.00
|
|
|
Service Code
|
CPT 31575
|
| Hospital Charge Code |
900501260
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$502.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$287.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.80
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$490.10
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
|
|
HC LARYNGOSCOPY INDIRECT
|
Facility
|
IP
|
$657.00
|
|
|
Service Code
|
CPT 31505
|
| Hospital Charge Code |
900501120
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$131.40 |
| Max. Negotiated Rate |
$591.30 |
| Rate for Payer: Cash Price |
$295.65
|
| Rate for Payer: Central Health Plan Commercial |
$525.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$438.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$250.32
|
| 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 LARYNGOSCOPY INDIRECT
|
Facility
|
OP
|
$657.00
|
|
|
Service Code
|
CPT 31505
|
| Hospital Charge Code |
900501120
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$112.48 |
| Max. Negotiated Rate |
$2,696.00 |
| 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 |
$371.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.49
|
| 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 |
$394.20
|
| Rate for Payer: Caremore Medicare Advantage |
$247.49
|
| Rate for Payer: Cash Price |
$295.65
|
| Rate for Payer: Cash Price |
$295.65
|
| 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 PPO |
$486.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: Dignity Health Media |
$247.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$247.49
|
| 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: Health Plan of Nevada (Sierra) Other |
$492.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$405.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$247.49
|
| Rate for Payer: InnovAge PACE Commercial |
$371.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$438.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$112.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$331.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.64
|
| 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
|
| Rate for Payer: Prime Health Services Medicare |
$262.34
|
| Rate for Payer: Riverside University Health System MISP |
$272.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$394.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$328.50
|
| Rate for Payer: United Healthcare All Other HMO |
$328.50
|
| Rate for Payer: United Healthcare HMO Rider |
$328.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$328.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC LARYNGOSCOPY INDIRECT
|
Facility
|
OP
|
$657.00
|
|
|
Service Code
|
CPT 31505
|
| Hospital Charge Code |
900501120
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$112.48 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$247.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.49
|
| 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 |
$394.20
|
| Rate for Payer: Blue Shield of California Commercial |
$413.25
|
| Rate for Payer: Blue Shield of California EPN |
$321.27
|
| Rate for Payer: Caremore Medicare Advantage |
$247.49
|
| Rate for Payer: Cash Price |
$295.65
|
| 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 |
$371.24
|
| Rate for Payer: Dignity Health Media |
$247.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$247.49
|
| 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: Health Plan of Nevada (Sierra) Other |
$492.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$405.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$408.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$247.49
|
| Rate for Payer: InnovAge PACE Commercial |
$371.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$438.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$112.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$331.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.64
|
| 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
|
| Rate for Payer: Prime Health Services Medicare |
$262.34
|
| Rate for Payer: Riverside University Health System MISP |
$272.24
|
| 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 |
$328.50
|
| Rate for Payer: United Healthcare All Other HMO |
$328.50
|
| Rate for Payer: United Healthcare HMO Rider |
$328.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$328.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC LARYNGOSCOPY INDIRECT
|
Facility
|
IP
|
$657.00
|
|
|
Service Code
|
CPT 31505
|
| Hospital Charge Code |
900501120
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$131.40 |
| Max. Negotiated Rate |
$591.30 |
| Rate for Payer: Cash Price |
$295.65
|
| Rate for Payer: Central Health Plan Commercial |
$525.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$438.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$250.32
|
| 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 LARYNGOSCOPY W/RMVL F.B.
|
Facility
|
IP
|
$3,020.00
|
|
|
Service Code
|
CPT 31577
|
| Hospital Charge Code |
900501549
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$604.00 |
| Max. Negotiated Rate |
$2,718.00 |
| Rate for Payer: Cash Price |
$1,359.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,416.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,208.00
|
| Rate for Payer: Galaxy Health WC |
$2,567.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,812.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,718.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,014.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,150.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$604.00
|
| Rate for Payer: Multiplan Commercial |
$2,265.00
|
| Rate for Payer: Networks By Design Commercial |
$1,963.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,567.00
|
|
|
HC LARYNGOSCOPY W/RMVL F.B.
|
Facility
|
OP
|
$3,020.00
|
|
|
Service Code
|
CPT 31577
|
| Hospital Charge Code |
900501549
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$288.61 |
| 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 |
$765.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$561.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$510.18
|
| 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 |
$1,812.00
|
| Rate for Payer: Caremore Medicare Advantage |
$510.18
|
| Rate for Payer: Cash Price |
$1,359.00
|
| Rate for Payer: Cash Price |
$1,359.00
|
| Rate for Payer: Cash Price |
$1,359.00
|
| Rate for Payer: Cash Price |
$1,359.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,416.00
|
| Rate for Payer: Cigna of CA PPO |
$2,234.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.27
|
| Rate for Payer: Dignity Health Media |
$510.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$561.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$688.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$510.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$510.18
|
| Rate for Payer: Galaxy Health WC |
$2,567.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,812.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,718.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,265.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$836.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$510.18
|
| Rate for Payer: InnovAge PACE Commercial |
$765.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,014.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$288.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$510.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$604.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$683.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$683.64
|
| Rate for Payer: Multiplan Commercial |
$2,265.00
|
| Rate for Payer: Networks By Design Commercial |
$1,963.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,567.00
|
| Rate for Payer: Prime Health Services Medicare |
$540.79
|
| Rate for Payer: Riverside University Health System MISP |
$561.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,812.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,510.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,510.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,510.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,510.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$561.20
|
| Rate for Payer: Vantage Medical Group Senior |
$510.18
|
|
|
HC LARYNGOSCOPY W/TUMOR EXC W/SCO
|
Facility
|
IP
|
$14,589.00
|
|
|
Service Code
|
CPT 31541
|
| Hospital Charge Code |
900501640
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$2,917.80 |
| Max. Negotiated Rate |
$13,130.10 |
| Rate for Payer: Cash Price |
$6,565.05
|
| Rate for Payer: Central Health Plan Commercial |
$11,671.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,835.60
|
| Rate for Payer: Galaxy Health WC |
$12,400.65
|
| Rate for Payer: Global Benefits Group Commercial |
$8,753.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,130.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,730.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,558.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,917.80
|
| Rate for Payer: Multiplan Commercial |
$10,941.75
|
| Rate for Payer: Networks By Design Commercial |
$9,482.85
|
| Rate for Payer: Prime Health Services Commercial |
$12,400.65
|
|
|
HC LARYNGOSCOPY W/TUMOR EXC W/SCO
|
Facility
|
OP
|
$14,589.00
|
|
|
Service Code
|
CPT 31541
|
| Hospital Charge Code |
900501640
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$509.31 |
| Max. Negotiated Rate |
$13,130.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,678.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,678.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,753.40
|
| Rate for Payer: Blue Shield of California Commercial |
$9,176.48
|
| Rate for Payer: Blue Shield of California EPN |
$7,134.02
|
| Rate for Payer: Caremore Medicare Advantage |
$4,678.93
|
| Rate for Payer: Cash Price |
$6,565.05
|
| Rate for Payer: Cash Price |
$6,565.05
|
| Rate for Payer: Central Health Plan Commercial |
$11,671.20
|
| Rate for Payer: Cigna of CA HMO |
$9,336.96
|
| Rate for Payer: Cigna of CA PPO |
$10,795.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Dignity Health Media |
$4,678.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,146.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,316.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,678.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,678.93
|
| Rate for Payer: Galaxy Health WC |
$12,400.65
|
| Rate for Payer: Global Benefits Group Commercial |
$8,753.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,130.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,941.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,673.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,720.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,678.93
|
| Rate for Payer: InnovAge PACE Commercial |
$7,018.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,730.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$509.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,678.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,917.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,269.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,269.77
|
| Rate for Payer: Multiplan Commercial |
$10,941.75
|
| Rate for Payer: Networks By Design Commercial |
$9,482.85
|
| Rate for Payer: Prime Health Services Commercial |
$12,400.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,959.67
|
| Rate for Payer: Riverside University Health System MISP |
$5,146.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,753.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,753.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,294.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,294.50
|
| Rate for Payer: United Healthcare HMO Rider |
$7,294.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,294.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4,678.93
|
|
|
HC LARYNGOSCOPY W/TUMOR EXC W/SCO
|
Facility
|
IP
|
$14,589.00
|
|
|
Service Code
|
CPT 31541
|
| Hospital Charge Code |
900501640
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,917.80 |
| Max. Negotiated Rate |
$13,130.10 |
| Rate for Payer: Cash Price |
$6,565.05
|
| Rate for Payer: Central Health Plan Commercial |
$11,671.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,835.60
|
| Rate for Payer: Galaxy Health WC |
$12,400.65
|
| Rate for Payer: Global Benefits Group Commercial |
$8,753.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,130.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,730.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,558.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,917.80
|
| Rate for Payer: Multiplan Commercial |
$10,941.75
|
| Rate for Payer: Networks By Design Commercial |
$9,482.85
|
| Rate for Payer: Prime Health Services Commercial |
$12,400.65
|
|
|
HC LARYNGOSCOPY W/TUMOR EXC W/SCO
|
Facility
|
OP
|
$14,589.00
|
|
|
Service Code
|
CPT 31541
|
| Hospital Charge Code |
900501640
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$13,130.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,678.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,753.40
|
| Rate for Payer: Caremore Medicare Advantage |
$4,678.93
|
| Rate for Payer: Cash Price |
$6,565.05
|
| Rate for Payer: Cash Price |
$6,565.05
|
| Rate for Payer: Cash Price |
$6,565.05
|
| Rate for Payer: Cash Price |
$6,565.05
|
| Rate for Payer: Central Health Plan Commercial |
$11,671.20
|
| Rate for Payer: Cigna of CA PPO |
$10,795.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Dignity Health Media |
$4,678.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,146.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,316.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,678.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,678.93
|
| Rate for Payer: Galaxy Health WC |
$12,400.65
|
| Rate for Payer: Global Benefits Group Commercial |
$8,753.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,130.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,941.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,673.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,678.93
|
| Rate for Payer: InnovAge PACE Commercial |
$7,018.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,730.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$509.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,678.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,917.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,269.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,269.77
|
| Rate for Payer: Multiplan Commercial |
$10,941.75
|
| Rate for Payer: Networks By Design Commercial |
$9,482.85
|
| Rate for Payer: Prime Health Services Commercial |
$12,400.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,959.67
|
| Rate for Payer: Riverside University Health System MISP |
$5,146.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,753.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,294.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,294.50
|
| Rate for Payer: United Healthcare HMO Rider |
$7,294.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,294.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4,678.93
|
|
