|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
IP
|
$5,070.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
906745300
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,014.00 |
| Max. Negotiated Rate |
$4,563.00 |
| Rate for Payer: Adventist Health Commercial |
$1,014.00
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,056.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,549.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,028.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,028.00
|
| Rate for Payer: Galaxy Health WC |
$4,309.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,042.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,563.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,219.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,991.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,014.00
|
| Rate for Payer: Multiplan Commercial |
$3,802.50
|
| Rate for Payer: Networks By Design Commercial |
$3,295.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,309.50
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
OP
|
$5,070.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
900501380
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$68.61 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$2,078.70
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$295.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| 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 |
$1,845.73
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,056.00
|
| Rate for Payer: Cigna of CA HMO |
$3,244.80
|
| Rate for Payer: Cigna of CA PPO |
$3,751.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,549.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$4,309.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,042.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,563.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,219.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$68.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,285.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,014.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$3,802.50
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: Networks By Design Commercial |
$3,295.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Preferred Health Network WC |
$1,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,309.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Prime Health Services WC |
$1,826.90
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,042.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,042.00
|
| 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 |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
IP
|
$5,070.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
900501380
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,014.00 |
| Max. Negotiated Rate |
$4,563.00 |
| Rate for Payer: Adventist Health Commercial |
$1,014.00
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,056.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,549.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,028.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,028.00
|
| Rate for Payer: Galaxy Health WC |
$4,309.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,042.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,563.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,219.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,991.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,014.00
|
| Rate for Payer: Multiplan Commercial |
$3,802.50
|
| Rate for Payer: Networks By Design Commercial |
$3,295.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,309.50
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
OP
|
$5,070.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
900501380
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$68.61 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,014.00
|
| 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 |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| 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 |
$1,845.73
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,056.00
|
| Rate for Payer: Cigna of CA HMO |
$3,244.80
|
| Rate for Payer: Cigna of CA PPO |
$3,751.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,549.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$4,309.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,042.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,563.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,219.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$68.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,285.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,014.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$3,802.50
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: Networks By Design Commercial |
$3,295.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Preferred Health Network WC |
$1,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,309.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Prime Health Services WC |
$1,826.90
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,042.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,535.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,535.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,535.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,535.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
OP
|
$5,070.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
906745300
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,014.00
|
| Rate for Payer: Adventist Health Commercial |
$544.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| 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: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Cash Price |
$1,225.80
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Cash Price |
$1,225.80
|
| Rate for Payer: Cash Price |
$1,225.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,179.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,056.00
|
| Rate for Payer: Cigna of CA HMO |
$1,743.36
|
| Rate for Payer: Cigna of CA HMO |
$3,244.80
|
| Rate for Payer: Cigna of CA PPO |
$3,751.80
|
| Rate for Payer: Cigna of CA PPO |
$2,015.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,906.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,549.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$4,309.50
|
| Rate for Payer: Galaxy Health WC |
$2,315.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,634.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,042.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,451.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,563.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$62.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$62.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,729.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,219.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$68.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$68.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,014.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$544.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$3,802.50
|
| Rate for Payer: Multiplan Commercial |
$2,043.00
|
| Rate for Payer: Networks By Design Commercial |
$3,295.50
|
| Rate for Payer: Networks By Design Commercial |
$1,770.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Prime Health Services Commercial |
$2,315.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,309.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,634.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,042.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,535.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,362.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
IP
|
$5,070.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
900501380
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,014.00 |
| Max. Negotiated Rate |
$4,563.00 |
| Rate for Payer: Adventist Health Commercial |
$1,014.00
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,056.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,549.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,028.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,028.00
|
| Rate for Payer: Galaxy Health WC |
$4,309.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,042.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,563.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,219.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,991.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,014.00
|
| Rate for Payer: Multiplan Commercial |
$3,802.50
|
| Rate for Payer: Networks By Design Commercial |
$3,295.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,309.50
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
OP
|
$5,070.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
900501380
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,014.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$295.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| 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 |
$3,214.38
|
| Rate for Payer: Blue Shield of California EPN |
$2,022.93
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,056.00
|
| Rate for Payer: Cigna of CA HMO |
$3,244.80
|
| Rate for Payer: Cigna of CA PPO |
$3,751.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,549.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$4,309.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,042.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,563.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$62.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,219.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$68.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,014.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$3,802.50
|
| Rate for Payer: Networks By Design Commercial |
$3,295.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Prime Health Services Commercial |
$4,309.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,042.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,042.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,535.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,535.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,535.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,535.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
IP
|
$5,070.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
900501380
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,014.00 |
| Max. Negotiated Rate |
$4,563.00 |
| Rate for Payer: Adventist Health Commercial |
$1,014.00
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,056.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,549.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,028.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,028.00
|
| Rate for Payer: Galaxy Health WC |
$4,309.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,042.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,563.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,219.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,991.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,014.00
|
| Rate for Payer: Multiplan Commercial |
$3,802.50
|
| Rate for Payer: Networks By Design Commercial |
$3,295.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,309.50
|
|
|
HC PROCTOSIGMOIDOSCPY RIG W/BX
|
Facility
|
OP
|
$2,296.00
|
|
|
Service Code
|
CPT 45305
|
| Hospital Charge Code |
906745305
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$87.08 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$459.20
|
| Rate for Payer: Adventist Health Commercial |
$291.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| 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: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Cash Price |
$656.55
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Cash Price |
$656.55
|
| Rate for Payer: Cash Price |
$656.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,167.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,836.80
|
| Rate for Payer: Cigna of CA HMO |
$933.76
|
| Rate for Payer: Cigna of CA HMO |
$1,469.44
|
| Rate for Payer: Cigna of CA PPO |
$1,699.04
|
| Rate for Payer: Cigna of CA PPO |
$1,079.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,021.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,607.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$1,951.60
|
| Rate for Payer: Galaxy Health WC |
$1,240.15
|
| Rate for Payer: Global Benefits Group Commercial |
$875.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,377.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,313.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,066.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$926.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,457.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$459.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$291.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$1,722.00
|
| Rate for Payer: Multiplan Commercial |
$1,094.25
|
| Rate for Payer: Networks By Design Commercial |
$1,492.40
|
| Rate for Payer: Networks By Design Commercial |
$948.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Prime Health Services Commercial |
$1,240.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,951.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$875.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,377.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,148.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$729.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC PROCTOSIGMOIDOSCPY RIG W/BX
|
Facility
|
IP
|
$2,296.00
|
|
|
Service Code
|
CPT 45305
|
| Hospital Charge Code |
906745305
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$459.20 |
| Max. Negotiated Rate |
$2,066.40 |
| Rate for Payer: Adventist Health Commercial |
$459.20
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,836.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,607.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$918.40
|
| Rate for Payer: EPIC Health Plan Senior |
$918.40
|
| Rate for Payer: Galaxy Health WC |
$1,951.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,377.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,066.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,457.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,354.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$459.20
|
| Rate for Payer: Multiplan Commercial |
$1,722.00
|
| Rate for Payer: Networks By Design Commercial |
$1,492.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,951.60
|
|
|
HC PROCTOSIGMOIDOSCPY RIG W/BX
|
Facility
|
OP
|
$2,296.00
|
|
|
Service Code
|
CPT 45305
|
| Hospital Charge Code |
906745305
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$87.08 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$459.20
|
| Rate for Payer: Adventist Health Commercial |
$291.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$439.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$439.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| 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: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$925.01
|
| Rate for Payer: Blue Shield of California Commercial |
$1,455.66
|
| Rate for Payer: Blue Shield of California EPN |
$916.10
|
| Rate for Payer: Blue Shield of California EPN |
$582.14
|
| Rate for Payer: Cash Price |
$656.55
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Cash Price |
$656.55
|
| Rate for Payer: Cash Price |
$656.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,836.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,167.20
|
| Rate for Payer: Cigna of CA HMO |
$933.76
|
| Rate for Payer: Cigna of CA HMO |
$1,469.44
|
| Rate for Payer: Cigna of CA PPO |
$1,079.66
|
| Rate for Payer: Cigna of CA PPO |
$1,699.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,607.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,021.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$1,240.15
|
| Rate for Payer: Galaxy Health WC |
$1,951.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,377.60
|
| Rate for Payer: Global Benefits Group Commercial |
$875.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,066.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,313.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$87.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,457.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$926.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$291.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$459.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$1,094.25
|
| Rate for Payer: Multiplan Commercial |
$1,722.00
|
| Rate for Payer: Networks By Design Commercial |
$948.35
|
| Rate for Payer: Networks By Design Commercial |
$1,492.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Prime Health Services Commercial |
$1,240.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,951.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,377.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$875.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$875.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,377.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,148.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$729.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,148.00
|
| Rate for Payer: United Healthcare All Other HMO |
$729.50
|
| Rate for Payer: United Healthcare HMO Rider |
$729.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,148.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,148.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$729.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC PROCTOSIGMOIDOSCPY RIG W/BX
|
Facility
|
IP
|
$2,296.00
|
|
|
Service Code
|
CPT 45305
|
| Hospital Charge Code |
906745305
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$459.20 |
| Max. Negotiated Rate |
$2,066.40 |
| Rate for Payer: Adventist Health Commercial |
$459.20
|
| Rate for Payer: Cash Price |
$1,033.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,836.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,607.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$918.40
|
| Rate for Payer: EPIC Health Plan Senior |
$918.40
|
| Rate for Payer: Galaxy Health WC |
$1,951.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,377.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,066.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,457.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,354.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$459.20
|
| Rate for Payer: Multiplan Commercial |
$1,722.00
|
| Rate for Payer: Networks By Design Commercial |
$1,492.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,951.60
|
|
|
HC PROCTOSIGMOIDOSCPY W DECOM
|
Facility
|
OP
|
$5,195.00
|
|
|
Service Code
|
CPT 45321
|
| Hospital Charge Code |
900501352
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.53 |
| Max. Negotiated Rate |
$5,890.43 |
| Rate for Payer: Adventist Health Commercial |
$1,039.00
|
| 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 |
$5,354.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,569.96
|
| 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 |
$5,551.91
|
| Rate for Payer: Cash Price |
$2,337.75
|
| Rate for Payer: Cash Price |
$2,337.75
|
| Rate for Payer: Cash Price |
$2,337.75
|
| Rate for Payer: Cash Price |
$2,337.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,156.00
|
| Rate for Payer: Cigna of CA HMO |
$3,324.80
|
| Rate for Payer: Cigna of CA PPO |
$3,844.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,926.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,569.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,636.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,890.43
|
| Rate for Payer: EPIC Health Plan Senior |
$3,926.96
|
| Rate for Payer: Galaxy Health WC |
$4,415.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,117.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,675.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,854.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,298.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$165.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,837.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,039.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,783.75
|
| Rate for Payer: Multiplan Commercial |
$3,896.25
|
| Rate for Payer: Multiplan WC |
$5,551.91
|
| Rate for Payer: Networks By Design Commercial |
$3,376.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Preferred Health Network WC |
$5,665.21
|
| Rate for Payer: Prime Health Services Commercial |
$4,415.75
|
| Rate for Payer: Prime Health Services Medicare |
$3,784.16
|
| Rate for Payer: Prime Health Services WC |
$5,495.25
|
| Rate for Payer: Riverside University Health System MISP |
$3,926.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,117.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,597.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,597.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,597.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,597.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,569.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,569.96
|
|
|
HC PROCTOSIGMOIDOSCPY W DECOM
|
Facility
|
IP
|
$5,195.00
|
|
|
Service Code
|
CPT 45321
|
| Hospital Charge Code |
900501352
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,039.00 |
| Max. Negotiated Rate |
$4,675.50 |
| Rate for Payer: Adventist Health Commercial |
$1,039.00
|
| Rate for Payer: Cash Price |
$2,337.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,156.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,636.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,078.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,078.00
|
| Rate for Payer: Galaxy Health WC |
$4,415.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,117.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,675.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,298.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,065.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,039.00
|
| Rate for Payer: Multiplan Commercial |
$3,896.25
|
| Rate for Payer: Networks By Design Commercial |
$3,376.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,415.75
|
|
|
HC PROCTOSIGMOIDOSCPY W DECOM
|
Facility
|
OP
|
$5,195.00
|
|
|
Service Code
|
CPT 45321
|
| Hospital Charge Code |
900501352
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$165.53 |
| Max. Negotiated Rate |
$5,890.43 |
| Rate for Payer: Adventist Health Commercial |
$2,129.95
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$602.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,569.96
|
| 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 |
$5,551.91
|
| Rate for Payer: Cash Price |
$2,337.75
|
| Rate for Payer: Cash Price |
$2,337.75
|
| Rate for Payer: Cash Price |
$2,337.75
|
| Rate for Payer: Cash Price |
$2,337.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,156.00
|
| Rate for Payer: Cigna of CA HMO |
$3,324.80
|
| Rate for Payer: Cigna of CA PPO |
$3,844.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,926.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,569.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,636.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,890.43
|
| Rate for Payer: EPIC Health Plan Senior |
$3,926.96
|
| Rate for Payer: Galaxy Health WC |
$4,415.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,117.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,675.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,854.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,298.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$165.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,837.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,039.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,783.75
|
| Rate for Payer: Multiplan Commercial |
$3,896.25
|
| Rate for Payer: Multiplan WC |
$5,551.91
|
| Rate for Payer: Networks By Design Commercial |
$3,376.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Preferred Health Network WC |
$5,665.21
|
| Rate for Payer: Prime Health Services Commercial |
$4,415.75
|
| Rate for Payer: Prime Health Services Medicare |
$3,784.16
|
| Rate for Payer: Prime Health Services WC |
$5,495.25
|
| Rate for Payer: Riverside University Health System MISP |
$3,926.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,117.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,117.00
|
| 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 |
$3,569.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,569.96
|
|
|
HC PROCTOSIGMOIDOSCPY W DECOM
|
Facility
|
IP
|
$5,195.00
|
|
|
Service Code
|
CPT 45321
|
| Hospital Charge Code |
900501352
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,039.00 |
| Max. Negotiated Rate |
$4,675.50 |
| Rate for Payer: Adventist Health Commercial |
$1,039.00
|
| Rate for Payer: Cash Price |
$2,337.75
|
| Rate for Payer: Central Health Plan Commercial |
$4,156.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,636.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,078.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,078.00
|
| Rate for Payer: Galaxy Health WC |
$4,415.75
|
| Rate for Payer: Global Benefits Group Commercial |
$3,117.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,675.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,298.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,065.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,039.00
|
| Rate for Payer: Multiplan Commercial |
$3,896.25
|
| Rate for Payer: Networks By Design Commercial |
$3,376.75
|
| Rate for Payer: Prime Health Services Commercial |
$4,415.75
|
|
|
HC PROGESTERONE
|
Facility
|
OP
|
$106.00
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
900912132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.89 |
| Max. Negotiated Rate |
$211.01 |
| Rate for Payer: Adventist Health Commercial |
$21.20
|
| Rate for Payer: Adventist Health Commercial |
$50.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$20.86
|
| Rate for Payer: Adventist Health Medi-Cal |
$20.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$153.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$153.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$151.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$151.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$211.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$211.01
|
| Rate for Payer: Blue Shield of California Commercial |
$157.50
|
| Rate for Payer: Blue Shield of California Commercial |
$66.78
|
| Rate for Payer: Blue Shield of California EPN |
$99.25
|
| Rate for Payer: Blue Shield of California EPN |
$42.08
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Cash Price |
$47.70
|
| Rate for Payer: Cash Price |
$47.70
|
| Rate for Payer: Central Health Plan Commercial |
$84.80
|
| Rate for Payer: Central Health Plan Commercial |
$200.00
|
| Rate for Payer: Cigna of CA HMO |
$160.00
|
| Rate for Payer: Cigna of CA HMO |
$67.84
|
| Rate for Payer: Cigna of CA PPO |
$185.00
|
| Rate for Payer: Cigna of CA PPO |
$78.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$74.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$175.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.42
|
| Rate for Payer: EPIC Health Plan Senior |
$22.95
|
| Rate for Payer: EPIC Health Plan Senior |
$22.95
|
| Rate for Payer: Galaxy Health WC |
$212.50
|
| Rate for Payer: Galaxy Health WC |
$90.10
|
| Rate for Payer: Global Benefits Group Commercial |
$150.00
|
| Rate for Payer: Global Benefits Group Commercial |
$63.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$95.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.21
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$67.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.95
|
| Rate for Payer: Multiplan Commercial |
$187.50
|
| Rate for Payer: Multiplan Commercial |
$79.50
|
| Rate for Payer: Networks By Design Commercial |
$68.90
|
| Rate for Payer: Networks By Design Commercial |
$162.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20.86
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20.86
|
| Rate for Payer: Prime Health Services Commercial |
$212.50
|
| Rate for Payer: Prime Health Services Commercial |
$90.10
|
| Rate for Payer: Prime Health Services Medicare |
$22.11
|
| Rate for Payer: Prime Health Services Medicare |
$22.11
|
| Rate for Payer: Riverside University Health System MISP |
$22.95
|
| Rate for Payer: Riverside University Health System MISP |
$22.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$150.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$150.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.89
|
| Rate for Payer: United Healthcare All Other HMO |
$16.89
|
| Rate for Payer: United Healthcare All Other HMO |
$16.89
|
| Rate for Payer: United Healthcare HMO Rider |
$16.89
|
| Rate for Payer: United Healthcare HMO Rider |
$16.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.89
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.86
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.95
|
| Rate for Payer: Vantage Medical Group Senior |
$20.86
|
| Rate for Payer: Vantage Medical Group Senior |
$20.86
|
|
|
HC PROGESTERONE
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
900912132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Adventist Health Commercial |
$50.00
|
| Rate for Payer: Cash Price |
$112.50
|
| Rate for Payer: Central Health Plan Commercial |
$200.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$175.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$100.00
|
| Rate for Payer: Galaxy Health WC |
$212.50
|
| Rate for Payer: Global Benefits Group Commercial |
$150.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$225.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$147.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Multiplan Commercial |
$187.50
|
| Rate for Payer: Networks By Design Commercial |
$162.50
|
| Rate for Payer: Prime Health Services Commercial |
$212.50
|
|
|
HC PROLACTIN
|
Facility
|
OP
|
$440.00
|
|
|
Service Code
|
CPT 84146
|
| Hospital Charge Code |
900910808
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.70 |
| Max. Negotiated Rate |
$396.00 |
| Rate for Payer: Adventist Health Commercial |
$88.00
|
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$19.38
|
| Rate for Payer: Adventist Health Medi-Cal |
$19.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$142.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$142.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$140.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$140.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$195.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$195.96
|
| Rate for Payer: Blue Shield of California Commercial |
$52.92
|
| Rate for Payer: Blue Shield of California Commercial |
$277.20
|
| Rate for Payer: Blue Shield of California EPN |
$33.35
|
| Rate for Payer: Blue Shield of California EPN |
$174.68
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$198.00
|
| Rate for Payer: Cash Price |
$198.00
|
| Rate for Payer: Central Health Plan Commercial |
$352.00
|
| Rate for Payer: Central Health Plan Commercial |
$67.20
|
| Rate for Payer: Cigna of CA HMO |
$53.76
|
| Rate for Payer: Cigna of CA HMO |
$281.60
|
| Rate for Payer: Cigna of CA PPO |
$62.16
|
| Rate for Payer: Cigna of CA PPO |
$325.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$308.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.98
|
| Rate for Payer: EPIC Health Plan Senior |
$21.32
|
| Rate for Payer: EPIC Health Plan Senior |
$21.32
|
| Rate for Payer: Galaxy Health WC |
$71.40
|
| Rate for Payer: Galaxy Health WC |
$374.00
|
| Rate for Payer: Global Benefits Group Commercial |
$50.40
|
| Rate for Payer: Global Benefits Group Commercial |
$264.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$75.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$396.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.78
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$31.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$19.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$279.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$25.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$25.97
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: Multiplan Commercial |
$330.00
|
| Rate for Payer: Networks By Design Commercial |
$286.00
|
| Rate for Payer: Networks By Design Commercial |
$54.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$19.38
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$19.38
|
| Rate for Payer: Prime Health Services Commercial |
$71.40
|
| Rate for Payer: Prime Health Services Commercial |
$374.00
|
| Rate for Payer: Prime Health Services Medicare |
$20.54
|
| Rate for Payer: Prime Health Services Medicare |
$20.54
|
| Rate for Payer: Riverside University Health System MISP |
$21.32
|
| Rate for Payer: Riverside University Health System MISP |
$21.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$264.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$264.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.70
|
| Rate for Payer: United Healthcare All Other HMO |
$15.70
|
| Rate for Payer: United Healthcare All Other HMO |
$15.70
|
| Rate for Payer: United Healthcare HMO Rider |
$15.70
|
| Rate for Payer: United Healthcare HMO Rider |
$15.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.70
|
| Rate for Payer: Upland Medical Group Pediatric |
$19.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$19.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.32
|
| Rate for Payer: Vantage Medical Group Senior |
$19.38
|
| Rate for Payer: Vantage Medical Group Senior |
$19.38
|
|
|
HC PROLACTIN
|
Facility
|
IP
|
$440.00
|
|
|
Service Code
|
CPT 84146
|
| Hospital Charge Code |
900910808
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$396.00 |
| Rate for Payer: Adventist Health Commercial |
$88.00
|
| Rate for Payer: Cash Price |
$198.00
|
| Rate for Payer: Central Health Plan Commercial |
$352.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$308.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.00
|
| Rate for Payer: EPIC Health Plan Senior |
$176.00
|
| Rate for Payer: Galaxy Health WC |
$374.00
|
| Rate for Payer: Global Benefits Group Commercial |
$264.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$396.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$279.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$259.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.00
|
| Rate for Payer: Multiplan Commercial |
$330.00
|
| Rate for Payer: Networks By Design Commercial |
$286.00
|
| Rate for Payer: Prime Health Services Commercial |
$374.00
|
|
|
HC PROPHYLAXIS OF RETINAL DETCHMNT
|
Facility
|
IP
|
$1,249.00
|
|
|
Service Code
|
CPT 67141
|
| Hospital Charge Code |
900567141
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$249.80 |
| Max. Negotiated Rate |
$1,124.10 |
| Rate for Payer: Adventist Health Commercial |
$249.80
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Central Health Plan Commercial |
$999.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$874.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.60
|
| Rate for Payer: EPIC Health Plan Senior |
$499.60
|
| Rate for Payer: Galaxy Health WC |
$1,061.65
|
| Rate for Payer: Global Benefits Group Commercial |
$749.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,124.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$793.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$736.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.80
|
| Rate for Payer: Multiplan Commercial |
$936.75
|
| Rate for Payer: Networks By Design Commercial |
$811.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,061.65
|
|
|
HC PROPHYLAXIS OF RETINAL DETCHMNT
|
Facility
|
OP
|
$1,249.00
|
|
|
Service Code
|
CPT 67141
|
| Hospital Charge Code |
900567141
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$154.91 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$249.80
|
| 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 |
$612.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$408.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$605.18
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Central Health Plan Commercial |
$999.20
|
| Rate for Payer: Cigna of CA HMO |
$799.36
|
| Rate for Payer: Cigna of CA PPO |
$924.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$612.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$449.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$408.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$874.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$673.60
|
| Rate for Payer: EPIC Health Plan Senior |
$449.06
|
| Rate for Payer: Galaxy Health WC |
$1,061.65
|
| Rate for Payer: Global Benefits Group Commercial |
$749.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,124.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$669.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$408.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$793.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$154.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$438.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$249.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$547.04
|
| Rate for Payer: Multiplan Commercial |
$936.75
|
| Rate for Payer: Multiplan WC |
$605.18
|
| Rate for Payer: Networks By Design Commercial |
$811.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$408.24
|
| Rate for Payer: Preferred Health Network WC |
$617.53
|
| Rate for Payer: Prime Health Services Commercial |
$1,061.65
|
| Rate for Payer: Prime Health Services Medicare |
$432.73
|
| Rate for Payer: Prime Health Services WC |
$599.00
|
| Rate for Payer: Riverside University Health System MISP |
$449.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$749.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$624.50
|
| Rate for Payer: United Healthcare All Other HMO |
$624.50
|
| Rate for Payer: United Healthcare HMO Rider |
$624.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$624.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$408.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$612.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$449.06
|
| Rate for Payer: Vantage Medical Group Senior |
$408.24
|
|
|
HC PROS ADD ENDO EXIAL ROTAT UNIT
|
Facility
|
IP
|
$2,034.00
|
|
|
Service Code
|
CPT L5984
|
| Hospital Charge Code |
915355984
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$406.80 |
| Max. Negotiated Rate |
$1,830.60 |
| Rate for Payer: United Healthcare HMO Rider |
$726.95
|
| Rate for Payer: Adventist Health Commercial |
$406.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,631.27
|
| Rate for Payer: Blue Shield of California EPN |
$1,025.14
|
| Rate for Payer: Cash Price |
$915.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,627.20
|
| Rate for Payer: Cigna of CA HMO |
$1,423.80
|
| Rate for Payer: Cigna of CA PPO |
$1,423.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,423.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$813.60
|
| Rate for Payer: EPIC Health Plan Senior |
$813.60
|
| Rate for Payer: Galaxy Health WC |
$1,728.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,830.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,291.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,200.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$406.80
|
| Rate for Payer: Multiplan Commercial |
$1,525.50
|
| Rate for Payer: Networks By Design Commercial |
$1,322.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,728.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$763.36
|
| Rate for Payer: United Healthcare All Other HMO |
$743.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$666.13
|
|
|
HC PROS ADD ENDO EXIAL ROTAT UNIT
|
Facility
|
OP
|
$2,034.00
|
|
|
Service Code
|
CPT L5984
|
| Hospital Charge Code |
915355984
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$581.45 |
| Max. Negotiated Rate |
$1,830.60 |
| Rate for Payer: Adventist Health Commercial |
$833.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,728.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,118.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,525.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,183.18
|
| Rate for Payer: Blue Shield of California Commercial |
$1,631.27
|
| Rate for Payer: Blue Shield of California EPN |
$1,025.14
|
| Rate for Payer: Cash Price |
$915.30
|
| Rate for Payer: Cash Price |
$915.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,627.20
|
| Rate for Payer: Cigna of CA HMO |
$1,423.80
|
| Rate for Payer: Cigna of CA PPO |
$1,423.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,728.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,728.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,728.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,423.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$813.60
|
| Rate for Payer: EPIC Health Plan Senior |
$813.60
|
| Rate for Payer: Galaxy Health WC |
$1,728.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,830.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$581.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,291.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$642.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,200.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$833.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,423.80
|
| Rate for Payer: Multiplan Commercial |
$1,525.50
|
| Rate for Payer: Networks By Design Commercial |
$1,017.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,728.90
|
| Rate for Payer: Riverside University Health System MISP |
$813.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$763.36
|
| Rate for Payer: United Healthcare All Other HMO |
$743.02
|
| Rate for Payer: United Healthcare HMO Rider |
$726.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$666.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,728.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,728.90
|
| Rate for Payer: Vantage Medical Group Senior |
$1,728.90
|
|
|
HC PROS ADD ENDO EXIAL ROTAT UNIT
|
Facility
|
IP
|
$2,034.00
|
|
|
Service Code
|
CPT L5984
|
| Hospital Charge Code |
905355984
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$406.80 |
| Max. Negotiated Rate |
$1,830.60 |
| Rate for Payer: Adventist Health Commercial |
$406.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,631.27
|
| Rate for Payer: Blue Shield of California EPN |
$1,025.14
|
| Rate for Payer: Cash Price |
$915.30
|
| Rate for Payer: Central Health Plan Commercial |
$1,627.20
|
| Rate for Payer: Cigna of CA HMO |
$1,423.80
|
| Rate for Payer: Cigna of CA PPO |
$1,423.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,423.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$813.60
|
| Rate for Payer: EPIC Health Plan Senior |
$813.60
|
| Rate for Payer: Galaxy Health WC |
$1,728.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,830.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,291.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,200.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$406.80
|
| Rate for Payer: Multiplan Commercial |
$1,525.50
|
| Rate for Payer: Networks By Design Commercial |
$1,322.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,728.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$763.36
|
| Rate for Payer: United Healthcare All Other HMO |
$743.02
|
| Rate for Payer: United Healthcare HMO Rider |
$726.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$666.13
|
|
