|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
OP
|
$1,019.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$79.40 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$247.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$611.40
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$247.49
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Central Health Plan Commercial |
$815.20
|
| Rate for Payer: Cigna of CA HMO |
$652.16
|
| Rate for Payer: Cigna of CA PPO |
$754.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: Dignity Health Media |
$247.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$247.49
|
| Rate for Payer: Galaxy Health WC |
$866.15
|
| Rate for Payer: Global Benefits Group Commercial |
$611.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$917.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$764.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$405.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$408.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$247.49
|
| Rate for Payer: InnovAge PACE Commercial |
$371.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$679.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$417.79
|
| 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 |
$764.25
|
| Rate for Payer: Networks By Design Commercial |
$662.35
|
| Rate for Payer: Prime Health Services Commercial |
$866.15
|
| Rate for Payer: Prime Health Services Medicare |
$262.34
|
| Rate for Payer: Riverside University Health System MISP |
$272.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$611.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$296.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
IP
|
$1,019.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
516
|
| 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: Kaiser Permanente of CA Medi-Cal |
$388.24
|
| 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
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
OP
|
$1,019.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$79.40 |
| 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: Alpha Care Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$611.40
|
| Rate for Payer: Caremore Medicare Advantage |
$247.49
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Central Health Plan Commercial |
$815.20
|
| Rate for Payer: Cigna of CA PPO |
$754.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: Dignity Health Media |
$247.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$247.49
|
| Rate for Payer: Galaxy Health WC |
$866.15
|
| Rate for Payer: Global Benefits Group Commercial |
$611.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$917.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$764.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$405.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$247.49
|
| Rate for Payer: InnovAge PACE Commercial |
$371.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$679.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$331.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.64
|
| Rate for Payer: Multiplan Commercial |
$764.25
|
| Rate for Payer: Networks By Design Commercial |
$662.35
|
| Rate for Payer: Prime Health Services Commercial |
$866.15
|
| Rate for Payer: Prime Health Services Medicare |
$262.34
|
| Rate for Payer: Riverside University Health System MISP |
$272.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$611.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.50
|
| Rate for Payer: United Healthcare All Other HMO |
$509.50
|
| Rate for Payer: United Healthcare HMO Rider |
$509.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$509.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC NASOPHARYNGOSCOPY W/ENDOSCOPE
|
Facility
|
OP
|
$1,019.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
905601701
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$79.40 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$247.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$611.40
|
| Rate for Payer: Blue Shield of California Commercial |
$640.95
|
| Rate for Payer: Blue Shield of California EPN |
$498.29
|
| Rate for Payer: Caremore Medicare Advantage |
$247.49
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Central Health Plan Commercial |
$815.20
|
| Rate for Payer: Cigna of CA HMO |
$652.16
|
| Rate for Payer: Cigna of CA PPO |
$754.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: Dignity Health Media |
$247.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$247.49
|
| Rate for Payer: Galaxy Health WC |
$866.15
|
| Rate for Payer: Global Benefits Group Commercial |
$611.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$917.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$764.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$405.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$408.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$247.49
|
| Rate for Payer: InnovAge PACE Commercial |
$371.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$679.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$331.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.64
|
| Rate for Payer: Multiplan Commercial |
$764.25
|
| Rate for Payer: Networks By Design Commercial |
$662.35
|
| Rate for Payer: Prime Health Services Commercial |
$866.15
|
| Rate for Payer: Prime Health Services Medicare |
$262.34
|
| Rate for Payer: Riverside University Health System MISP |
$272.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$611.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$611.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$509.50
|
| Rate for Payer: United Healthcare All Other HMO |
$509.50
|
| Rate for Payer: United Healthcare HMO Rider |
$509.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$509.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC 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: Kaiser Permanente of CA Medi-Cal |
$388.24
|
| 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
|
|
|
HC NASOPHARYNGOSCOPY W ENDOSCOPE MCAL
|
Facility
|
OP
|
$1,019.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
907000031
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$79.40 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$247.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$611.40
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$247.49
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Cash Price |
$458.55
|
| Rate for Payer: Central Health Plan Commercial |
$815.20
|
| Rate for Payer: Cigna of CA HMO |
$652.16
|
| Rate for Payer: Cigna of CA PPO |
$754.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$371.24
|
| Rate for Payer: Dignity Health Media |
$247.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$272.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$334.11
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$247.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$247.49
|
| Rate for Payer: Galaxy Health WC |
$866.15
|
| Rate for Payer: Global Benefits Group Commercial |
$611.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$917.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$764.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$405.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$408.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$247.49
|
| Rate for Payer: InnovAge PACE Commercial |
$371.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$679.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$247.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$417.79
|
| 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 |
$764.25
|
| Rate for Payer: Networks By Design Commercial |
$662.35
|
| Rate for Payer: Prime Health Services Commercial |
$866.15
|
| Rate for Payer: Prime Health Services Medicare |
$262.34
|
| Rate for Payer: Riverside University Health System MISP |
$272.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$611.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$296.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$371.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$272.24
|
| Rate for Payer: Vantage Medical Group Senior |
$247.49
|
|
|
HC NASOPHARYNGOSCOPY W ENDOSCOPE MCAL
|
Facility
|
IP
|
$1,019.00
|
|
|
Service Code
|
CPT 92511
|
| Hospital Charge Code |
907000031
|
|
Hospital Revenue Code
|
440
|
| 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: Kaiser Permanente of CA Medi-Cal |
$388.24
|
| 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
|
|
|
HC NASOTRACHEAL SUCTIONING
|
Facility
|
OP
|
$345.00
|
|
|
Service Code
|
CPT 31720
|
| Hospital Charge Code |
900800380
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$69.00 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$266.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$399.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$293.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$266.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$207.00
|
| Rate for Payer: Blue Shield of California Commercial |
$217.00
|
| Rate for Payer: Blue Shield of California EPN |
$168.70
|
| Rate for Payer: Caremore Medicare Advantage |
$266.49
|
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Central Health Plan Commercial |
$276.00
|
| Rate for Payer: Cigna of CA HMO |
$220.80
|
| Rate for Payer: Cigna of CA PPO |
$255.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$399.74
|
| Rate for Payer: Dignity Health Media |
$266.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$293.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$359.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$266.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$266.49
|
| Rate for Payer: Galaxy Health WC |
$293.25
|
| Rate for Payer: Global Benefits Group Commercial |
$207.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$310.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$258.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$437.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$439.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$266.49
|
| Rate for Payer: InnovAge PACE Commercial |
$399.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$230.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$266.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$357.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$357.10
|
| Rate for Payer: Multiplan Commercial |
$258.75
|
| Rate for Payer: Networks By Design Commercial |
$224.25
|
| Rate for Payer: Prime Health Services Commercial |
$293.25
|
| Rate for Payer: Prime Health Services Medicare |
$282.48
|
| Rate for Payer: Riverside University Health System MISP |
$293.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$207.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$207.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$172.50
|
| Rate for Payer: United Healthcare All Other HMO |
$172.50
|
| Rate for Payer: United Healthcare HMO Rider |
$172.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$172.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$399.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$293.14
|
| Rate for Payer: Vantage Medical Group Senior |
$266.49
|
|
|
HC NASOTRACHEAL SUCTIONING
|
Facility
|
IP
|
$345.00
|
|
|
Service Code
|
CPT 31720
|
| Hospital Charge Code |
900800380
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$69.00 |
| Max. Negotiated Rate |
$310.50 |
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Central Health Plan Commercial |
$276.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$138.00
|
| Rate for Payer: Galaxy Health WC |
$293.25
|
| Rate for Payer: Global Benefits Group Commercial |
$207.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$310.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$230.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$131.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.00
|
| Rate for Payer: Multiplan Commercial |
$258.75
|
| Rate for Payer: Networks By Design Commercial |
$224.25
|
| Rate for Payer: Prime Health Services Commercial |
$293.25
|
|
|
HC N BLOCK,SPHENOPALATINE GANGLIN
|
Facility
|
OP
|
$1,382.00
|
|
|
Service Code
|
CPT 64505
|
| Hospital Charge Code |
900501686
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$115.29 |
| 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: Alpha Care Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$370.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$829.20
|
| Rate for Payer: Caremore Medicare Advantage |
$370.06
|
| Rate for Payer: Cash Price |
$621.90
|
| Rate for Payer: Cash Price |
$621.90
|
| Rate for Payer: Cash Price |
$621.90
|
| Rate for Payer: Cash Price |
$621.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,105.60
|
| Rate for Payer: Cigna of CA PPO |
$1,022.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: Dignity Health Media |
$370.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$370.06
|
| Rate for Payer: Galaxy Health WC |
$1,174.70
|
| Rate for Payer: Global Benefits Group Commercial |
$829.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,243.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,036.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$606.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$370.06
|
| Rate for Payer: InnovAge PACE Commercial |
$555.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$921.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$115.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$495.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$495.88
|
| Rate for Payer: Multiplan Commercial |
$1,036.50
|
| Rate for Payer: Networks By Design Commercial |
$898.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,174.70
|
| Rate for Payer: Prime Health Services Medicare |
$392.26
|
| Rate for Payer: Riverside University Health System MISP |
$407.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$829.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$691.00
|
| Rate for Payer: United Healthcare All Other HMO |
$691.00
|
| Rate for Payer: United Healthcare HMO Rider |
$691.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$691.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC N BLOCK,SPHENOPALATINE GANGLIN
|
Facility
|
IP
|
$1,382.00
|
|
|
Service Code
|
CPT 64505
|
| Hospital Charge Code |
900501686
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$276.40 |
| Max. Negotiated Rate |
$1,243.80 |
| Rate for Payer: Cash Price |
$621.90
|
| Rate for Payer: Central Health Plan Commercial |
$1,105.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$552.80
|
| Rate for Payer: Galaxy Health WC |
$1,174.70
|
| Rate for Payer: Global Benefits Group Commercial |
$829.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,243.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$921.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$526.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$276.40
|
| Rate for Payer: Multiplan Commercial |
$1,036.50
|
| Rate for Payer: Networks By Design Commercial |
$898.30
|
| Rate for Payer: Prime Health Services Commercial |
$1,174.70
|
|
|
HC N-CARDIAC VASC FLOW IMAG
|
Facility
|
IP
|
$1,927.00
|
|
|
Service Code
|
CPT 78445
|
| Hospital Charge Code |
909301349
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$385.40 |
| Max. Negotiated Rate |
$1,734.30 |
| Rate for Payer: Cash Price |
$867.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,541.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$770.80
|
| Rate for Payer: Galaxy Health WC |
$1,637.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,156.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,734.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,285.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$734.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$385.40
|
| Rate for Payer: Multiplan Commercial |
$1,445.25
|
| Rate for Payer: Networks By Design Commercial |
$1,252.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,637.95
|
|
|
HC N-CARDIAC VASC FLOW IMAG
|
Facility
|
OP
|
$1,927.00
|
|
|
Service Code
|
CPT 78445
|
| Hospital Charge Code |
909301349
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$229.58 |
| Max. Negotiated Rate |
$1,734.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$515.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$828.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$515.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$384.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,138.47
|
| Rate for Payer: Blue Distinction Transplant |
$1,156.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,190.89
|
| Rate for Payer: Blue Shield of California EPN |
$936.52
|
| Rate for Payer: Caremore Medicare Advantage |
$515.32
|
| Rate for Payer: Cash Price |
$867.15
|
| Rate for Payer: Cash Price |
$867.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,541.60
|
| Rate for Payer: Cigna of CA HMO |
$1,233.28
|
| Rate for Payer: Cigna of CA PPO |
$1,425.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$772.98
|
| Rate for Payer: Dignity Health Media |
$515.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$566.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$695.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$515.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$515.32
|
| Rate for Payer: Galaxy Health WC |
$1,637.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,156.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,734.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,445.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$845.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$850.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$515.32
|
| Rate for Payer: InnovAge PACE Commercial |
$772.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,285.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$229.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$515.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$385.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$690.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$690.53
|
| Rate for Payer: Multiplan Commercial |
$1,445.25
|
| Rate for Payer: Networks By Design Commercial |
$1,252.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,637.95
|
| Rate for Payer: Prime Health Services Medicare |
$546.24
|
| Rate for Payer: Riverside University Health System MISP |
$566.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,156.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,156.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.46
|
| Rate for Payer: United Healthcare All Other HMO |
$396.46
|
| Rate for Payer: United Healthcare HMO Rider |
$396.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$396.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Vantage Medical Group Senior |
$515.32
|
|
|
HC NECK SOFT TISSUE
|
Facility
|
IP
|
$657.00
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
909001201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$131.40 |
| Max. Negotiated Rate |
$591.30 |
| Rate for Payer: Cash Price |
$295.65
|
| Rate for Payer: Central Health Plan Commercial |
$525.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$262.80
|
| Rate for Payer: Galaxy Health WC |
$558.45
|
| Rate for Payer: Global Benefits Group Commercial |
$394.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$591.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$438.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$250.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.40
|
| Rate for Payer: Multiplan Commercial |
$492.75
|
| Rate for Payer: Networks By Design Commercial |
$427.05
|
| Rate for Payer: Prime Health Services Commercial |
$558.45
|
|
|
HC NECK SOFT TISSUE
|
Facility
|
OP
|
$657.00
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
909001201
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.87 |
| Max. Negotiated Rate |
$591.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$113.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$107.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.89
|
| Rate for Payer: Blue Distinction Transplant |
$394.20
|
| Rate for Payer: Blue Shield of California Commercial |
$406.03
|
| Rate for Payer: Blue Shield of California EPN |
$319.30
|
| Rate for Payer: Caremore Medicare Advantage |
$113.54
|
| Rate for Payer: Cash Price |
$295.65
|
| Rate for Payer: Cash Price |
$295.65
|
| Rate for Payer: Central Health Plan Commercial |
$525.60
|
| Rate for Payer: Cigna of CA HMO |
$420.48
|
| Rate for Payer: Cigna of CA PPO |
$486.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Media |
$113.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| 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 |
$558.45
|
| Rate for Payer: Global Benefits Group Commercial |
$394.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$591.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$492.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$186.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$187.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.54
|
| Rate for Payer: InnovAge PACE Commercial |
$170.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$438.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$113.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.40
|
| 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 |
$492.75
|
| Rate for Payer: Networks By Design Commercial |
$427.05
|
| Rate for Payer: Prime Health Services Commercial |
$558.45
|
| Rate for Payer: Prime Health Services Medicare |
$120.35
|
| Rate for Payer: Riverside University Health System MISP |
$124.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$394.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$394.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: 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 NEDL BARD TRANS-SEPTAL
|
Facility
|
OP
|
$1,012.00
|
|
| Hospital Charge Code |
906812363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$910.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$614.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$860.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$556.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$556.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$490.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$597.89
|
| Rate for Payer: Blue Distinction Transplant |
$607.20
|
| Rate for Payer: Blue Shield of California Commercial |
$636.55
|
| Rate for Payer: Blue Shield of California EPN |
$494.87
|
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Central Health Plan Commercial |
$809.60
|
| Rate for Payer: Cigna of CA HMO |
$647.68
|
| Rate for Payer: Cigna of CA PPO |
$748.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$860.20
|
| Rate for Payer: Dignity Health Media |
$860.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$860.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$910.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$759.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$354.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.40
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
| Rate for Payer: Riverside University Health System MISP |
$404.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$506.00
|
| Rate for Payer: United Healthcare HMO Rider |
$506.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$506.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$860.20
|
| Rate for Payer: Vantage Medical Group Senior |
$860.20
|
|
|
HC NEDL BARD TRANS-SEPTAL
|
Facility
|
IP
|
$1,012.00
|
|
| Hospital Charge Code |
906812363
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$202.40 |
| Max. Negotiated Rate |
$910.80 |
| Rate for Payer: Cash Price |
$455.40
|
| Rate for Payer: Central Health Plan Commercial |
$809.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$404.80
|
| Rate for Payer: Galaxy Health WC |
$860.20
|
| Rate for Payer: Global Benefits Group Commercial |
$607.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$910.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$675.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$385.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.40
|
| Rate for Payer: Multiplan Commercial |
$759.00
|
| Rate for Payer: Networks By Design Commercial |
$657.80
|
| Rate for Payer: Prime Health Services Commercial |
$860.20
|
|
|
HC NEDL BAYLIS RF TRANSEPTAL
|
Facility
|
OP
|
$2,277.00
|
|
| Hospital Charge Code |
906812470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$455.40 |
| Max. Negotiated Rate |
$2,049.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,382.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,935.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,252.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,252.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,102.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,345.25
|
| Rate for Payer: Blue Distinction Transplant |
$1,366.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,432.23
|
| Rate for Payer: Blue Shield of California EPN |
$1,113.45
|
| Rate for Payer: Cash Price |
$1,024.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,821.60
|
| Rate for Payer: Cigna of CA HMO |
$1,457.28
|
| Rate for Payer: Cigna of CA PPO |
$1,684.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,935.45
|
| Rate for Payer: Dignity Health Media |
$1,935.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,935.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$910.80
|
| Rate for Payer: Galaxy Health WC |
$1,935.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,366.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,049.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,707.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$796.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,518.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$867.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$455.40
|
| Rate for Payer: Multiplan Commercial |
$1,707.75
|
| Rate for Payer: Networks By Design Commercial |
$1,480.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,935.45
|
| Rate for Payer: Riverside University Health System MISP |
$910.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,366.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,366.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,138.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,138.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,138.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,138.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,935.45
|
| Rate for Payer: Vantage Medical Group Senior |
$1,935.45
|
|
|
HC NEDL BAYLIS RF TRANSEPTAL
|
Facility
|
IP
|
$2,277.00
|
|
| Hospital Charge Code |
906812470
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$455.40 |
| Max. Negotiated Rate |
$2,049.30 |
| Rate for Payer: Cash Price |
$1,024.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,821.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$910.80
|
| Rate for Payer: Galaxy Health WC |
$1,935.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,366.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,049.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,518.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$867.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$455.40
|
| Rate for Payer: Multiplan Commercial |
$1,707.75
|
| Rate for Payer: Networks By Design Commercial |
$1,480.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,935.45
|
|
|
HC NEDL COOK TRANSSEPTAL
|
Facility
|
OP
|
$288.00
|
|
| Hospital Charge Code |
906811779
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$174.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$158.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.15
|
| Rate for Payer: Blue Distinction Transplant |
$172.80
|
| Rate for Payer: Blue Shield of California Commercial |
$181.15
|
| Rate for Payer: Blue Shield of California EPN |
$140.83
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.80
|
| Rate for Payer: Dignity Health Media |
$244.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$216.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$100.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Riverside University Health System MISP |
$115.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.00
|
| Rate for Payer: United Healthcare All Other HMO |
$144.00
|
| Rate for Payer: United Healthcare HMO Rider |
$144.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.80
|
| Rate for Payer: Vantage Medical Group Senior |
$244.80
|
|
|
HC NEDL COOK TRANSSEPTAL
|
Facility
|
IP
|
$288.00
|
|
| Hospital Charge Code |
906811779
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$259.20 |
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Central Health Plan Commercial |
$230.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$259.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$192.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$109.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$57.60
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
|
|
HC NEDL PD ACCESS DOPPLER
|
Facility
|
OP
|
$551.00
|
|
| Hospital Charge Code |
906811790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$495.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$334.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$468.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$303.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$303.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$266.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$325.53
|
| Rate for Payer: Blue Distinction Transplant |
$330.60
|
| Rate for Payer: Blue Shield of California Commercial |
$346.58
|
| Rate for Payer: Blue Shield of California EPN |
$269.44
|
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Central Health Plan Commercial |
$440.80
|
| Rate for Payer: Cigna of CA HMO |
$352.64
|
| Rate for Payer: Cigna of CA PPO |
$407.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$468.35
|
| Rate for Payer: Dignity Health Media |
$468.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$468.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$495.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$413.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$192.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.20
|
| Rate for Payer: Multiplan Commercial |
$413.25
|
| Rate for Payer: Networks By Design Commercial |
$358.15
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
| Rate for Payer: Riverside University Health System MISP |
$220.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$330.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$330.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$275.50
|
| Rate for Payer: United Healthcare All Other HMO |
$275.50
|
| Rate for Payer: United Healthcare HMO Rider |
$275.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$275.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$468.35
|
| Rate for Payer: Vantage Medical Group Senior |
$468.35
|
|
|
HC NEDL PD ACCESS DOPPLER
|
Facility
|
IP
|
$551.00
|
|
| Hospital Charge Code |
906811790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$495.90 |
| Rate for Payer: Cash Price |
$247.95
|
| Rate for Payer: Central Health Plan Commercial |
$440.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.40
|
| Rate for Payer: Galaxy Health WC |
$468.35
|
| Rate for Payer: Global Benefits Group Commercial |
$330.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$495.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$367.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.20
|
| Rate for Payer: Multiplan Commercial |
$413.25
|
| Rate for Payer: Networks By Design Commercial |
$358.15
|
| Rate for Payer: Prime Health Services Commercial |
$468.35
|
|
|
HC NEDL PERI-CARD CENTISIS COOK
|
Facility
|
OP
|
$527.56
|
|
| Hospital Charge Code |
906811776
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.51 |
| Max. Negotiated Rate |
$474.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$320.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$448.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$290.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$290.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$255.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$311.68
|
| Rate for Payer: Blue Distinction Transplant |
$316.54
|
| Rate for Payer: Blue Shield of California Commercial |
$331.84
|
| Rate for Payer: Blue Shield of California EPN |
$257.98
|
| Rate for Payer: Cash Price |
$237.40
|
| Rate for Payer: Central Health Plan Commercial |
$422.05
|
| Rate for Payer: Cigna of CA HMO |
$337.64
|
| Rate for Payer: Cigna of CA PPO |
$390.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$448.43
|
| Rate for Payer: Dignity Health Media |
$448.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$448.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.02
|
| Rate for Payer: EPIC Health Plan Transplant |
$211.02
|
| Rate for Payer: Galaxy Health WC |
$448.43
|
| Rate for Payer: Global Benefits Group Commercial |
$316.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$474.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$395.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$184.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.51
|
| Rate for Payer: Multiplan Commercial |
$395.67
|
| Rate for Payer: Networks By Design Commercial |
$342.91
|
| Rate for Payer: Prime Health Services Commercial |
$448.43
|
| Rate for Payer: Riverside University Health System MISP |
$211.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$316.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$316.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$263.78
|
| Rate for Payer: United Healthcare All Other HMO |
$263.78
|
| Rate for Payer: United Healthcare HMO Rider |
$263.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$448.43
|
| Rate for Payer: Vantage Medical Group Senior |
$448.43
|
|
|
HC NEDL PERI-CARD CENTISIS COOK
|
Facility
|
IP
|
$527.56
|
|
| Hospital Charge Code |
906811776
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.51 |
| Max. Negotiated Rate |
$474.80 |
| Rate for Payer: Cash Price |
$237.40
|
| Rate for Payer: Central Health Plan Commercial |
$422.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$211.02
|
| Rate for Payer: Galaxy Health WC |
$448.43
|
| Rate for Payer: Global Benefits Group Commercial |
$316.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$474.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.51
|
| Rate for Payer: Multiplan Commercial |
$395.67
|
| Rate for Payer: Networks By Design Commercial |
$342.91
|
| Rate for Payer: Prime Health Services Commercial |
$448.43
|
|
