|
HC NASAL ENDOSCOPY DIAGNOSTIC
|
Facility
OP
|
$877.00
|
|
|
Service Code
|
CPT 31231
|
| Hospital Charge Code |
900800914
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$175.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$247.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$247.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$526.20
|
| 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 |
$394.65
|
| Rate for Payer: Cash Price |
$394.65
|
| Rate for Payer: Cash Price |
$394.65
|
| Rate for Payer: Central Health Plan Commercial |
$701.60
|
| Rate for Payer: Cigna of CA PPO |
$648.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| 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 |
$745.45
|
| Rate for Payer: Global Benefits Group Commercial |
$526.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$789.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$657.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$405.88
|
| Rate for Payer: IEHP medi-cal |
$408.36
|
| Rate for Payer: IEHP Medicare Advantage |
$247.49
|
| Rate for Payer: Innovage PACE Commercial |
$371.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$584.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.40
|
| 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 |
$657.75
|
| Rate for Payer: Networks By Design Commercial |
$570.05
|
| Rate for Payer: Prime Health Services Commercial |
$745.45
|
| Rate for Payer: Prime Health Services Medicare |
$262.34
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$526.20
|
| Rate for Payer: Riverside University Health MISP |
$272.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$526.20
|
| 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 NASAL ENDOSCOPY DIAGNOSTIC
|
Facility
IP
|
$877.00
|
|
|
Service Code
|
CPT 31231
|
| Hospital Charge Code |
900800914
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$175.40 |
| Max. Negotiated Rate |
$789.30 |
| Rate for Payer: Cash Price |
$394.65
|
| Rate for Payer: Central Health Plan Commercial |
$701.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$350.80
|
| Rate for Payer: Galaxy Health WC |
$745.45
|
| Rate for Payer: Global Benefits Group Commercial |
$526.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$789.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$584.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$175.40
|
| Rate for Payer: Multiplan Commercial |
$657.75
|
| Rate for Payer: Networks By Design Commercial |
$570.05
|
| Rate for Payer: Prime Health Services Commercial |
$745.45
|
|
|
HC NASAL ENDOSCOPY W/CONT HEMORRH
|
Facility
OP
|
$8,547.00
|
|
|
Service Code
|
CPT 31238
|
| Hospital Charge Code |
900501753
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$7,692.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| 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: BCBS Transplant Transplant |
$5,128.20
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Cash Price |
$3,846.15
|
| Rate for Payer: Cash Price |
$3,846.15
|
| Rate for Payer: Cash Price |
$3,846.15
|
| Rate for Payer: Cash Price |
$3,846.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,837.60
|
| Rate for Payer: Cigna of CA PPO |
$6,324.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$7,264.95
|
| Rate for Payer: Global Benefits Group Commercial |
$5,128.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,692.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,410.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,120.62
|
| Rate for Payer: Innovage PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,700.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,709.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$6,410.25
|
| Rate for Payer: Networks By Design Commercial |
$5,555.55
|
| Rate for Payer: Prime Health Services Commercial |
$7,264.95
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,128.20
|
| Rate for Payer: Riverside University Health MISP |
$2,332.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,128.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,273.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,273.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,273.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,273.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC NASAL ENDOSCOPY W/CONT HEMORRH
|
Facility
IP
|
$8,547.00
|
|
|
Service Code
|
CPT 31238
|
| Hospital Charge Code |
900501753
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,709.40 |
| Max. Negotiated Rate |
$7,692.30 |
| Rate for Payer: Cash Price |
$3,846.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,837.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,418.80
|
| Rate for Payer: Galaxy Health WC |
$7,264.95
|
| Rate for Payer: Global Benefits Group Commercial |
$5,128.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,692.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,700.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,709.40
|
| Rate for Payer: Multiplan Commercial |
$6,410.25
|
| Rate for Payer: Networks By Design Commercial |
$5,555.55
|
| Rate for Payer: Prime Health Services Commercial |
$7,264.95
|
|
|
HC NASAL I&D OF ABSCESS
|
Facility
OP
|
$1,408.00
|
|
|
Service Code
|
CPT 30000
|
| Hospital Charge Code |
902890339
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$281.60 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$305.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| 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: BCBS Transplant Transplant |
$844.80
|
| Rate for Payer: Blue Shield of California Commercial |
$885.63
|
| Rate for Payer: Blue Shield of California EPN |
$688.51
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,126.40
|
| Rate for Payer: Cigna of CA HMO |
$901.12
|
| Rate for Payer: Cigna of CA PPO |
$1,041.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$1,196.80
|
| Rate for Payer: Global Benefits Group Commercial |
$844.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,267.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,056.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: IEHP medi-cal |
$503.56
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Innovage PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$939.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$1,056.00
|
| Rate for Payer: Networks By Design Commercial |
$915.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,196.80
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$844.80
|
| Rate for Payer: Riverside University Health MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$844.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$844.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$704.00
|
| Rate for Payer: United Healthcare All Other HMO |
$704.00
|
| Rate for Payer: United Healthcare HMO Rider |
$704.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$704.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC NASAL I&D OF ABSCESS
|
Facility
IP
|
$1,408.00
|
|
|
Service Code
|
CPT 30000
|
| Hospital Charge Code |
902890339
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$281.60 |
| Max. Negotiated Rate |
$1,267.20 |
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,126.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$563.20
|
| Rate for Payer: Galaxy Health WC |
$1,196.80
|
| Rate for Payer: Global Benefits Group Commercial |
$844.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,267.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$939.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.60
|
| Rate for Payer: Multiplan Commercial |
$1,056.00
|
| Rate for Payer: Networks By Design Commercial |
$915.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,196.80
|
|
|
HC NASAL I&D OF ABSCESS
|
Facility
OP
|
$1,408.00
|
|
|
Service Code
|
CPT 30000
|
| Hospital Charge Code |
902890339
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$281.60 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| 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: BCBS Transplant Transplant |
$844.80
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,126.40
|
| Rate for Payer: Cigna of CA PPO |
$1,041.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$1,196.80
|
| Rate for Payer: Global Benefits Group Commercial |
$844.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,267.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,056.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Innovage PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$939.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$1,056.00
|
| Rate for Payer: Networks By Design Commercial |
$915.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,196.80
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$844.80
|
| Rate for Payer: Riverside University Health MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$844.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$704.00
|
| Rate for Payer: United Healthcare All Other HMO |
$704.00
|
| Rate for Payer: United Healthcare HMO Rider |
$704.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$704.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC NASAL I&D OF ABSCESS
|
Facility
IP
|
$1,408.00
|
|
|
Service Code
|
CPT 30000
|
| Hospital Charge Code |
902890339
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$281.60 |
| Max. Negotiated Rate |
$1,267.20 |
| Rate for Payer: Cash Price |
$633.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,126.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$563.20
|
| Rate for Payer: Galaxy Health WC |
$1,196.80
|
| Rate for Payer: Global Benefits Group Commercial |
$844.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,267.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$939.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$281.60
|
| Rate for Payer: Multiplan Commercial |
$1,056.00
|
| Rate for Payer: Networks By Design Commercial |
$915.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,196.80
|
|
|
HC NASOGASTRIC CORTRAK EAS
|
Facility
OP
|
$350.00
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901606374
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.66 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.66
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$192.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.78
|
| Rate for Payer: BCBS Transplant Transplant |
$210.00
|
| Rate for Payer: Blue Shield of California Commercial |
$220.15
|
| Rate for Payer: Blue Shield of California EPN |
$171.15
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$262.50
|
| Rate for Payer: IEHP medi-cal |
$122.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: Riverside University Health MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC NASOGASTRIC CORTRAK EAS
|
Facility
IP
|
$350.00
|
|
|
Service Code
|
CPT B4081
|
| Hospital Charge Code |
901606374
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC NASO/ORGSTRC TUBE PLCM FS GDNC
|
Facility
IP
|
$613.00
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
906743752
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$122.60 |
| Max. Negotiated Rate |
$551.70 |
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Central Health Plan Commercial |
$490.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$245.20
|
| Rate for Payer: Galaxy Health WC |
$521.05
|
| Rate for Payer: Global Benefits Group Commercial |
$367.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$551.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$408.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.60
|
| Rate for Payer: Multiplan Commercial |
$459.75
|
| Rate for Payer: Networks By Design Commercial |
$398.45
|
| Rate for Payer: Prime Health Services Commercial |
$521.05
|
|
|
HC NASO/ORGSTRC TUBE PLCM FS GDNC
|
Facility
IP
|
$613.00
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
906743752
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$122.60 |
| Max. Negotiated Rate |
$551.70 |
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Central Health Plan Commercial |
$490.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$245.20
|
| Rate for Payer: Galaxy Health WC |
$521.05
|
| Rate for Payer: Global Benefits Group Commercial |
$367.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$551.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$408.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.60
|
| Rate for Payer: Multiplan Commercial |
$459.75
|
| Rate for Payer: Networks By Design Commercial |
$398.45
|
| Rate for Payer: Prime Health Services Commercial |
$521.05
|
|
|
HC NASO/ORGSTRC TUBE PLCM FS GDNC
|
Facility
OP
|
$613.00
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
906743752
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$122.60 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$497.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$497.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$367.80
|
| 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 |
$497.82
|
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Central Health Plan Commercial |
$490.40
|
| Rate for Payer: Cigna of CA PPO |
$453.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$746.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$497.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$497.82
|
| Rate for Payer: Galaxy Health WC |
$521.05
|
| Rate for Payer: Global Benefits Group Commercial |
$367.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$551.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$459.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$816.42
|
| Rate for Payer: IEHP medi-cal |
$821.40
|
| Rate for Payer: IEHP Medicare Advantage |
$497.82
|
| Rate for Payer: Innovage PACE Commercial |
$746.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$408.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$497.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.08
|
| Rate for Payer: Multiplan Commercial |
$459.75
|
| Rate for Payer: Networks By Design Commercial |
$398.45
|
| Rate for Payer: Prime Health Services Commercial |
$521.05
|
| Rate for Payer: Prime Health Services Medicare |
$527.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$547.60
|
| Rate for Payer: Riverside University Health MISP |
$547.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$367.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$597.38
|
| 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 |
$746.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: Vantage Medical Group Senior |
$497.82
|
|
|
HC NASO/ORGSTRC TUBE PLCM FS GDNC
|
Facility
OP
|
$613.00
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
906743752
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$122.60 |
| 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: AlphaCare Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$497.82
|
| 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: BCBS Transplant Transplant |
$367.80
|
| Rate for Payer: Caremore Medicare Advantage |
$497.82
|
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Central Health Plan Commercial |
$490.40
|
| Rate for Payer: Cigna of CA PPO |
$453.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$746.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$497.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$497.82
|
| Rate for Payer: Galaxy Health WC |
$521.05
|
| Rate for Payer: Global Benefits Group Commercial |
$367.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$551.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$459.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$816.42
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$497.82
|
| Rate for Payer: Innovage PACE Commercial |
$746.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$408.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$497.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.08
|
| Rate for Payer: Multiplan Commercial |
$459.75
|
| Rate for Payer: Networks By Design Commercial |
$398.45
|
| Rate for Payer: Prime Health Services Commercial |
$521.05
|
| Rate for Payer: Prime Health Services Medicare |
$527.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$367.80
|
| Rate for Payer: Riverside University Health MISP |
$547.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$367.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$306.50
|
| Rate for Payer: United Healthcare All Other HMO |
$306.50
|
| Rate for Payer: United Healthcare HMO Rider |
$306.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$306.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: Vantage Medical Group Senior |
$497.82
|
|
|
HC NASO/ORGSTRC TUBE PLCM FS GDNC
|
Facility
IP
|
$613.00
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
906743752
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$122.60 |
| Max. Negotiated Rate |
$551.70 |
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Central Health Plan Commercial |
$490.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$245.20
|
| Rate for Payer: Galaxy Health WC |
$521.05
|
| Rate for Payer: Global Benefits Group Commercial |
$367.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$551.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$408.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.60
|
| Rate for Payer: Multiplan Commercial |
$459.75
|
| Rate for Payer: Networks By Design Commercial |
$398.45
|
| Rate for Payer: Prime Health Services Commercial |
$521.05
|
|
|
HC NASO/ORGSTRC TUBE PLCM FS GDNC
|
Facility
OP
|
$613.00
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
906743752
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$122.60 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$497.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$497.82
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$367.80
|
| 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 |
$497.82
|
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Cash Price |
$275.85
|
| Rate for Payer: Central Health Plan Commercial |
$490.40
|
| Rate for Payer: Cigna of CA PPO |
$453.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$746.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$672.06
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$497.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$497.82
|
| Rate for Payer: Galaxy Health WC |
$521.05
|
| Rate for Payer: Global Benefits Group Commercial |
$367.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$551.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$459.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$816.42
|
| Rate for Payer: IEHP medi-cal |
$821.40
|
| Rate for Payer: IEHP Medicare Advantage |
$497.82
|
| Rate for Payer: Innovage PACE Commercial |
$746.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$408.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$497.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$667.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$667.08
|
| Rate for Payer: Multiplan Commercial |
$459.75
|
| Rate for Payer: Networks By Design Commercial |
$398.45
|
| Rate for Payer: Prime Health Services Commercial |
$521.05
|
| Rate for Payer: Prime Health Services Medicare |
$527.69
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$367.80
|
| Rate for Payer: Riverside University Health MISP |
$547.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$367.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$746.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$547.60
|
| Rate for Payer: Vantage Medical Group Senior |
$497.82
|
|
|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
IP
|
$752.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$150.40 |
| Max. Negotiated Rate |
$676.80 |
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Central Health Plan Commercial |
$601.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$300.80
|
| Rate for Payer: Galaxy Health WC |
$639.20
|
| Rate for Payer: Global Benefits Group Commercial |
$451.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$676.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$501.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.40
|
| Rate for Payer: Multiplan Commercial |
$564.00
|
| Rate for Payer: Networks By Design Commercial |
$488.80
|
| Rate for Payer: Prime Health Services Commercial |
$639.20
|
|
|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
OP
|
$752.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$150.40 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$392.17
|
| 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: BCBS Transplant Transplant |
$451.20
|
| Rate for Payer: Blue Shield of California Commercial |
$473.01
|
| Rate for Payer: Blue Shield of California EPN |
$367.73
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Central Health Plan Commercial |
$601.60
|
| Rate for Payer: Cigna of CA HMO |
$481.28
|
| Rate for Payer: Cigna of CA PPO |
$556.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$392.17
|
| Rate for Payer: Galaxy Health WC |
$639.20
|
| Rate for Payer: Global Benefits Group Commercial |
$451.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$676.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$564.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: IEHP medi-cal |
$647.08
|
| Rate for Payer: IEHP Medicare Advantage |
$392.17
|
| Rate for Payer: Innovage PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$501.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.51
|
| Rate for Payer: Multiplan Commercial |
$564.00
|
| Rate for Payer: Networks By Design Commercial |
$488.80
|
| Rate for Payer: Prime Health Services Commercial |
$639.20
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$451.20
|
| Rate for Payer: Riverside University Health MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$451.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$451.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$376.00
|
| Rate for Payer: United Healthcare All Other HMO |
$376.00
|
| Rate for Payer: United Healthcare HMO Rider |
$376.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$376.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
OP
|
$752.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$150.40 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$392.17
|
| 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: BCBS Transplant Transplant |
$451.20
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Central Health Plan Commercial |
$601.60
|
| Rate for Payer: Cigna of CA PPO |
$556.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$392.17
|
| Rate for Payer: Galaxy Health WC |
$639.20
|
| Rate for Payer: Global Benefits Group Commercial |
$451.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$676.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$564.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$392.17
|
| Rate for Payer: Innovage PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$501.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.51
|
| Rate for Payer: Multiplan Commercial |
$564.00
|
| Rate for Payer: Networks By Design Commercial |
$488.80
|
| Rate for Payer: Prime Health Services Commercial |
$639.20
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$451.20
|
| Rate for Payer: Riverside University Health MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$451.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$376.00
|
| Rate for Payer: United Healthcare All Other HMO |
$376.00
|
| Rate for Payer: United Healthcare HMO Rider |
$376.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$376.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
IP
|
$752.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$150.40 |
| Max. Negotiated Rate |
$676.80 |
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Central Health Plan Commercial |
$601.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$300.80
|
| Rate for Payer: Galaxy Health WC |
$639.20
|
| Rate for Payer: Global Benefits Group Commercial |
$451.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$676.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$501.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.40
|
| Rate for Payer: Multiplan Commercial |
$564.00
|
| Rate for Payer: Networks By Design Commercial |
$488.80
|
| Rate for Payer: Prime Health Services Commercial |
$639.20
|
|
|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
IP
|
$752.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$150.40 |
| Max. Negotiated Rate |
$676.80 |
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Central Health Plan Commercial |
$601.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$300.80
|
| Rate for Payer: Galaxy Health WC |
$639.20
|
| Rate for Payer: Global Benefits Group Commercial |
$451.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$676.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$501.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.40
|
| Rate for Payer: Multiplan Commercial |
$564.00
|
| Rate for Payer: Networks By Design Commercial |
$488.80
|
| Rate for Payer: Prime Health Services Commercial |
$639.20
|
|
|
HC NASO/OROGASTRIC TUBE PLACEMENT
|
Facility
OP
|
$752.00
|
|
|
Service Code
|
CPT 43753
|
| Hospital Charge Code |
900501188
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$150.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$392.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$392.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$451.20
|
| Rate for Payer: Blue Shield of California Commercial |
$473.01
|
| Rate for Payer: Blue Shield of California EPN |
$367.73
|
| Rate for Payer: Caremore Medicare Advantage |
$392.17
|
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Central Health Plan Commercial |
$601.60
|
| Rate for Payer: Cigna of CA HMO |
$481.28
|
| Rate for Payer: Cigna of CA PPO |
$556.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$588.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$392.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$392.17
|
| Rate for Payer: Galaxy Health WC |
$639.20
|
| Rate for Payer: Global Benefits Group Commercial |
$451.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$676.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$564.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$643.16
|
| Rate for Payer: IEHP medi-cal |
$647.08
|
| Rate for Payer: IEHP Medicare Advantage |
$392.17
|
| Rate for Payer: Innovage PACE Commercial |
$588.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$501.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$525.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.51
|
| Rate for Payer: Multiplan Commercial |
$564.00
|
| Rate for Payer: Networks By Design Commercial |
$488.80
|
| Rate for Payer: Prime Health Services Commercial |
$639.20
|
| Rate for Payer: Prime Health Services Medicare |
$415.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$451.20
|
| Rate for Payer: Riverside University Health MISP |
$431.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$451.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$451.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$376.00
|
| Rate for Payer: United Healthcare All Other HMO |
$376.00
|
| Rate for Payer: United Healthcare HMO Rider |
$376.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$376.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$588.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.39
|
| Rate for Payer: Vantage Medical Group Senior |
$392.17
|
|
|
HC NASOPHARYNGOGRAM
|
Facility
OP
|
$797.00
|
|
|
Service Code
|
CPT 70370
|
| Hospital Charge Code |
909001253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$113.54 |
| Max. Negotiated Rate |
$717.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$113.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$369.61
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$271.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$330.78
|
| Rate for Payer: BCBS Transplant Transplant |
$478.20
|
| Rate for Payer: Blue Shield of California Commercial |
$492.55
|
| Rate for Payer: Blue Shield of California EPN |
$387.34
|
| Rate for Payer: Caremore Medicare Advantage |
$113.54
|
| Rate for Payer: Cash Price |
$358.65
|
| Rate for Payer: Cash Price |
$358.65
|
| Rate for Payer: Central Health Plan Commercial |
$637.60
|
| Rate for Payer: Cigna of CA HMO |
$510.08
|
| Rate for Payer: Cigna of CA PPO |
$589.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$153.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$113.54
|
| Rate for Payer: Galaxy Health WC |
$677.45
|
| Rate for Payer: Global Benefits Group Commercial |
$478.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$717.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$597.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$186.21
|
| Rate for Payer: IEHP medi-cal |
$187.34
|
| Rate for Payer: IEHP Medicare Advantage |
$113.54
|
| Rate for Payer: Innovage PACE Commercial |
$170.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$531.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$113.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$152.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$152.14
|
| Rate for Payer: Multiplan Commercial |
$597.75
|
| Rate for Payer: Networks By Design Commercial |
$518.05
|
| Rate for Payer: Prime Health Services Commercial |
$677.45
|
| Rate for Payer: Prime Health Services Medicare |
$120.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$478.20
|
| Rate for Payer: Riverside University Health MISP |
$124.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$478.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$478.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.63
|
| Rate for Payer: United Healthcare All Other HMO |
$225.63
|
| Rate for Payer: United Healthcare HMO Rider |
$225.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC NASOPHARYNGOGRAM
|
Facility
IP
|
$797.00
|
|
|
Service Code
|
CPT 70370
|
| Hospital Charge Code |
909001253
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$159.40 |
| Max. Negotiated Rate |
$717.30 |
| Rate for Payer: Cash Price |
$358.65
|
| Rate for Payer: Central Health Plan Commercial |
$637.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$318.80
|
| Rate for Payer: Galaxy Health WC |
$677.45
|
| Rate for Payer: Global Benefits Group Commercial |
$478.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$717.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$531.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.40
|
| Rate for Payer: Multiplan Commercial |
$597.75
|
| Rate for Payer: Networks By Design Commercial |
$518.05
|
| Rate for Payer: Prime Health Services Commercial |
$677.45
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
IP
|
$1,019.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$203.80 |
| Max. Negotiated Rate |
$917.10 |
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Central Health Plan Commercial |
$815.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$407.60
|
| Rate for Payer: Galaxy Health WC |
$866.15
|
| Rate for Payer: Global Benefits Group Commercial |
$611.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$917.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$679.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.80
|
| Rate for Payer: Multiplan Commercial |
$764.25
|
| Rate for Payer: Networks By Design Commercial |
$662.35
|
| Rate for Payer: Prime Health Services Commercial |
$866.15
|
|
