|
HC PELVIC EXAM UNDER ANESTHESIA
|
Facility
|
IP
|
$7,849.00
|
|
|
Service Code
|
CPT 57410
|
| Hospital Charge Code |
900501650
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,569.80 |
| Max. Negotiated Rate |
$7,064.10 |
| Rate for Payer: Cash Price |
$3,532.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,279.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,139.60
|
| Rate for Payer: Galaxy Health WC |
$6,671.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,709.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,064.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,235.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,990.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,569.80
|
| Rate for Payer: Multiplan Commercial |
$5,886.75
|
| Rate for Payer: Networks By Design Commercial |
$5,101.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,671.65
|
|
|
HC PELVIC EXAM UNDER ANESTHESIA
|
Facility
|
IP
|
$7,849.00
|
|
|
Service Code
|
CPT 57410
|
| Hospital Charge Code |
900501650
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,569.80 |
| Max. Negotiated Rate |
$7,064.10 |
| Rate for Payer: Cash Price |
$3,532.05
|
| Rate for Payer: Central Health Plan Commercial |
$6,279.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,139.60
|
| Rate for Payer: Galaxy Health WC |
$6,671.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,709.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,064.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,235.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,990.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,569.80
|
| Rate for Payer: Multiplan Commercial |
$5,886.75
|
| Rate for Payer: Networks By Design Commercial |
$5,101.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,671.65
|
|
|
HC PELVIC SLING
|
Facility
|
OP
|
$1,430.00
|
|
|
Service Code
|
CPT L2580
|
| Hospital Charge Code |
905352580
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$500.50 |
| Max. Negotiated Rate |
$1,287.00 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,215.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$786.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$786.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$692.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$844.84
|
| Rate for Payer: Blue Distinction Transplant |
$858.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,072.50
|
| Rate for Payer: Blue Shield of California EPN |
$777.92
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,144.00
|
| Rate for Payer: Cigna of CA HMO |
$1,001.00
|
| Rate for Payer: Cigna of CA PPO |
$1,001.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,215.50
|
| Rate for Payer: Dignity Health Media |
$1,215.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,215.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$572.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$572.00
|
| Rate for Payer: Galaxy Health WC |
$1,215.50
|
| Rate for Payer: Global Benefits Group Commercial |
$858.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,287.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,072.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$500.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$953.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$586.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$586.30
|
| Rate for Payer: Multiplan Commercial |
$1,072.50
|
| Rate for Payer: Networks By Design Commercial |
$715.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,215.50
|
| Rate for Payer: Riverside University Health System MISP |
$572.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$858.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$858.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$715.00
|
| Rate for Payer: United Healthcare All Other HMO |
$715.00
|
| Rate for Payer: United Healthcare HMO Rider |
$715.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$715.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,215.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,215.50
|
|
|
HC PELVIC SLING
|
Facility
|
IP
|
$1,430.00
|
|
|
Service Code
|
CPT L2580
|
| Hospital Charge Code |
905352580
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$286.00 |
| Max. Negotiated Rate |
$1,287.00 |
| Rate for Payer: Blue Shield of California EPN |
$763.62
|
| Rate for Payer: Cash Price |
$643.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,144.00
|
| Rate for Payer: Cigna of CA HMO |
$1,001.00
|
| Rate for Payer: Cigna of CA PPO |
$1,001.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$572.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$572.00
|
| Rate for Payer: Galaxy Health WC |
$1,215.50
|
| Rate for Payer: Global Benefits Group Commercial |
$858.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,287.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$953.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$544.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$286.00
|
| Rate for Payer: Multiplan Commercial |
$1,072.50
|
| Rate for Payer: Networks By Design Commercial |
$715.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,215.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$539.97
|
| Rate for Payer: United Healthcare All Other HMO |
$527.38
|
| Rate for Payer: United Healthcare HMO Rider |
$515.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$471.90
|
|
|
HC PELVIS 1 OR 2 VIEWS
|
Facility
|
OP
|
$827.00
|
|
|
Service Code
|
CPT 72170
|
| Hospital Charge Code |
909001339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$41.08 |
| Max. Negotiated Rate |
$744.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$137.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$100.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$108.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.50
|
| Rate for Payer: Blue Distinction Transplant |
$496.20
|
| Rate for Payer: Blue Shield of California Commercial |
$511.09
|
| Rate for Payer: Blue Shield of California EPN |
$401.92
|
| Rate for Payer: Caremore Medicare Advantage |
$137.36
|
| Rate for Payer: Cash Price |
$372.15
|
| Rate for Payer: Cash Price |
$372.15
|
| Rate for Payer: Central Health Plan Commercial |
$661.60
|
| Rate for Payer: Cigna of CA HMO |
$529.28
|
| Rate for Payer: Cigna of CA PPO |
$611.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$702.95
|
| Rate for Payer: Global Benefits Group Commercial |
$496.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$744.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$620.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$225.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$226.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: InnovAge PACE Commercial |
$206.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$551.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$620.25
|
| Rate for Payer: Networks By Design Commercial |
$537.55
|
| Rate for Payer: Prime Health Services Commercial |
$702.95
|
| Rate for Payer: Prime Health Services Medicare |
$145.60
|
| Rate for Payer: Riverside University Health System MISP |
$151.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$496.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$496.20
|
| 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 |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC PELVIS 1 OR 2 VIEWS
|
Facility
|
IP
|
$827.00
|
|
|
Service Code
|
CPT 72170
|
| Hospital Charge Code |
909001339
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$165.40 |
| Max. Negotiated Rate |
$744.30 |
| Rate for Payer: Cash Price |
$372.15
|
| Rate for Payer: Central Health Plan Commercial |
$661.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$330.80
|
| Rate for Payer: Galaxy Health WC |
$702.95
|
| Rate for Payer: Global Benefits Group Commercial |
$496.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$744.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$551.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$315.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$165.40
|
| Rate for Payer: Multiplan Commercial |
$620.25
|
| Rate for Payer: Networks By Design Commercial |
$537.55
|
| Rate for Payer: Prime Health Services Commercial |
$702.95
|
|
|
HC PELVIS COMPLETE MIN 3 VIEWS
|
Facility
|
OP
|
$1,325.00
|
|
|
Service Code
|
CPT 72190
|
| Hospital Charge Code |
909001342
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$59.94 |
| Max. Negotiated Rate |
$1,192.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$137.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$172.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$139.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.14
|
| Rate for Payer: Blue Distinction Transplant |
$795.00
|
| Rate for Payer: Blue Shield of California Commercial |
$818.85
|
| Rate for Payer: Blue Shield of California EPN |
$643.95
|
| Rate for Payer: Caremore Medicare Advantage |
$137.36
|
| Rate for Payer: Cash Price |
$596.25
|
| Rate for Payer: Cash Price |
$596.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,060.00
|
| Rate for Payer: Cigna of CA HMO |
$848.00
|
| Rate for Payer: Cigna of CA PPO |
$980.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$1,126.25
|
| Rate for Payer: Global Benefits Group Commercial |
$795.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,192.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$993.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$225.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$226.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: InnovAge PACE Commercial |
$206.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$883.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$265.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$993.75
|
| Rate for Payer: Networks By Design Commercial |
$861.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,126.25
|
| Rate for Payer: Prime Health Services Medicare |
$145.60
|
| Rate for Payer: Riverside University Health System MISP |
$151.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$795.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$795.00
|
| 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 |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC PELVIS COMPLETE MIN 3 VIEWS
|
Facility
|
IP
|
$1,325.00
|
|
|
Service Code
|
CPT 72190
|
| Hospital Charge Code |
909001342
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$265.00 |
| Max. Negotiated Rate |
$1,192.50 |
| Rate for Payer: Cash Price |
$596.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,060.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$530.00
|
| Rate for Payer: Galaxy Health WC |
$1,126.25
|
| Rate for Payer: Global Benefits Group Commercial |
$795.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,192.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$883.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$504.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$265.00
|
| Rate for Payer: Multiplan Commercial |
$993.75
|
| Rate for Payer: Networks By Design Commercial |
$861.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,126.25
|
|
|
HC PENILE INJECTION
|
Facility
|
IP
|
$1,764.00
|
|
|
Service Code
|
CPT 54235
|
| Hospital Charge Code |
900501609
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$352.80 |
| Max. Negotiated Rate |
$1,587.60 |
| Rate for Payer: Cash Price |
$793.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,411.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$705.60
|
| Rate for Payer: Galaxy Health WC |
$1,499.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,058.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,587.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,176.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$672.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$352.80
|
| Rate for Payer: Multiplan Commercial |
$1,323.00
|
| Rate for Payer: Networks By Design Commercial |
$1,146.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,499.40
|
|
|
HC PENILE INJECTION
|
Facility
|
OP
|
$1,764.00
|
|
|
Service Code
|
CPT 54235
|
| Hospital Charge Code |
900501609
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$308.79 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$463.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$308.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,058.40
|
| Rate for Payer: Caremore Medicare Advantage |
$308.79
|
| Rate for Payer: Cash Price |
$793.80
|
| Rate for Payer: Cash Price |
$793.80
|
| Rate for Payer: Cash Price |
$793.80
|
| Rate for Payer: Cash Price |
$793.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,411.20
|
| Rate for Payer: Cigna of CA PPO |
$1,305.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$463.18
|
| Rate for Payer: Dignity Health Media |
$308.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$339.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$416.87
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$308.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$308.79
|
| Rate for Payer: Galaxy Health WC |
$1,499.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,058.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,587.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,323.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$506.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$308.79
|
| Rate for Payer: InnovAge PACE Commercial |
$463.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,176.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$672.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$308.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$352.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$413.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$413.78
|
| Rate for Payer: Multiplan Commercial |
$1,323.00
|
| Rate for Payer: Networks By Design Commercial |
$1,146.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,499.40
|
| Rate for Payer: Prime Health Services Medicare |
$327.32
|
| Rate for Payer: Riverside University Health System MISP |
$339.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,058.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$882.00
|
| Rate for Payer: United Healthcare All Other HMO |
$882.00
|
| Rate for Payer: United Healthcare HMO Rider |
$882.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$882.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$463.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$339.67
|
| Rate for Payer: Vantage Medical Group Senior |
$308.79
|
|
|
HC PENILE VASC STUDIES COMPLETE
|
Facility
|
OP
|
$1,549.00
|
|
|
Service Code
|
CPT 93980
|
| Hospital Charge Code |
908100111
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$1,507.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$137.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$687.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$790.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$915.15
|
| Rate for Payer: Blue Distinction Transplant |
$929.40
|
| Rate for Payer: Blue Shield of California Commercial |
$957.28
|
| Rate for Payer: Blue Shield of California EPN |
$752.81
|
| Rate for Payer: Caremore Medicare Advantage |
$137.36
|
| Rate for Payer: Cash Price |
$697.05
|
| Rate for Payer: Cash Price |
$697.05
|
| Rate for Payer: Cash Price |
$697.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,239.20
|
| Rate for Payer: Cigna of CA HMO |
$991.36
|
| Rate for Payer: Cigna of CA PPO |
$1,146.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$1,316.65
|
| Rate for Payer: Global Benefits Group Commercial |
$929.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,394.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,161.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$225.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$226.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: InnovAge PACE Commercial |
$206.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,033.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$314.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$309.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$1,161.75
|
| Rate for Payer: Networks By Design Commercial |
$1,006.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,316.65
|
| Rate for Payer: Prime Health Services Medicare |
$145.60
|
| Rate for Payer: Riverside University Health System MISP |
$151.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$929.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$929.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,507.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,228.00
|
| Rate for Payer: United Healthcare HMO Rider |
$931.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$851.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC PENILE VASC STUDIES COMPLETE
|
Facility
|
IP
|
$1,549.00
|
|
|
Service Code
|
CPT 93980
|
| Hospital Charge Code |
908100111
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$309.80 |
| Max. Negotiated Rate |
$1,394.10 |
| Rate for Payer: Cash Price |
$697.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,239.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$619.60
|
| Rate for Payer: Galaxy Health WC |
$1,316.65
|
| Rate for Payer: Global Benefits Group Commercial |
$929.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,394.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,033.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$590.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$309.80
|
| Rate for Payer: Multiplan Commercial |
$1,161.75
|
| Rate for Payer: Networks By Design Commercial |
$1,006.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,316.65
|
|
|
HC PERC BILIARY DRAINAGE EXT
|
Facility
|
IP
|
$14,416.00
|
|
|
Service Code
|
CPT 47533
|
| Hospital Charge Code |
909000145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,883.20 |
| Max. Negotiated Rate |
$12,974.40 |
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Central Health Plan Commercial |
$11,532.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,766.40
|
| Rate for Payer: Galaxy Health WC |
$12,253.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8,649.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,974.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,615.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,492.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,883.20
|
| Rate for Payer: Multiplan Commercial |
$10,812.00
|
| Rate for Payer: Networks By Design Commercial |
$9,370.40
|
| Rate for Payer: Prime Health Services Commercial |
$12,253.60
|
|
|
HC PERC BILIARY DRAINAGE EXT
|
Facility
|
OP
|
$14,416.00
|
|
|
Service Code
|
CPT 47533
|
| Hospital Charge Code |
909000145
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,328.66 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,322.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,322.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,649.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$4,322.62
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Central Health Plan Commercial |
$11,532.80
|
| Rate for Payer: Cigna of CA PPO |
$10,667.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Dignity Health Media |
$4,322.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,754.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,835.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,322.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,322.62
|
| Rate for Payer: Galaxy Health WC |
$12,253.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8,649.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,974.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,812.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,089.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,132.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,322.62
|
| Rate for Payer: InnovAge PACE Commercial |
$6,483.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,615.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,328.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,322.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,883.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,792.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,792.31
|
| Rate for Payer: Multiplan Commercial |
$10,812.00
|
| Rate for Payer: Networks By Design Commercial |
$9,370.40
|
| Rate for Payer: Prime Health Services Commercial |
$12,253.60
|
| Rate for Payer: Prime Health Services Medicare |
$4,581.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,754.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,649.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,322.62
|
|
|
HC PERC BILIARY DRAIN INT & EX
|
Facility
|
OP
|
$14,197.00
|
|
|
Service Code
|
CPT 47534
|
| Hospital Charge Code |
909000146
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,839.40 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,322.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,322.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,518.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$4,322.62
|
| Rate for Payer: Cash Price |
$6,388.65
|
| Rate for Payer: Cash Price |
$6,388.65
|
| Rate for Payer: Central Health Plan Commercial |
$11,357.60
|
| Rate for Payer: Cigna of CA PPO |
$10,505.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Dignity Health Media |
$4,322.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,754.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,835.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,322.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,322.62
|
| Rate for Payer: Galaxy Health WC |
$12,067.45
|
| Rate for Payer: Global Benefits Group Commercial |
$8,518.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,777.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,647.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,089.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,132.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,322.62
|
| Rate for Payer: InnovAge PACE Commercial |
$6,483.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,469.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,864.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,322.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,839.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,792.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,792.31
|
| Rate for Payer: Multiplan Commercial |
$10,647.75
|
| Rate for Payer: Networks By Design Commercial |
$9,228.05
|
| Rate for Payer: Prime Health Services Commercial |
$12,067.45
|
| Rate for Payer: Prime Health Services Medicare |
$4,581.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,754.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,518.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,322.62
|
|
|
HC PERC BILIARY DRAIN INT & EX
|
Facility
|
IP
|
$14,197.00
|
|
|
Service Code
|
CPT 47534
|
| Hospital Charge Code |
909000146
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,839.40 |
| Max. Negotiated Rate |
$12,777.30 |
| Rate for Payer: Cash Price |
$6,388.65
|
| Rate for Payer: Central Health Plan Commercial |
$11,357.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,678.80
|
| Rate for Payer: Galaxy Health WC |
$12,067.45
|
| Rate for Payer: Global Benefits Group Commercial |
$8,518.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,777.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,469.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,409.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,839.40
|
| Rate for Payer: Multiplan Commercial |
$10,647.75
|
| Rate for Payer: Networks By Design Commercial |
$9,228.05
|
| Rate for Payer: Prime Health Services Commercial |
$12,067.45
|
|
|
HC PERC CECOSTOMY TUBE PLACEMENT
|
Facility
|
IP
|
$8,126.00
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
909000215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,625.20 |
| Max. Negotiated Rate |
$7,313.40 |
| Rate for Payer: Cash Price |
$3,656.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,500.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,250.40
|
| Rate for Payer: Galaxy Health WC |
$6,907.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,875.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,313.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,420.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,096.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,625.20
|
| Rate for Payer: Multiplan Commercial |
$6,094.50
|
| Rate for Payer: Networks By Design Commercial |
$5,281.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,907.10
|
|
|
HC PERC CECOSTOMY TUBE PLACEMENT
|
Facility
|
OP
|
$8,126.00
|
|
|
Service Code
|
CPT 49442
|
| Hospital Charge Code |
909000215
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,474.42 |
| Max. Negotiated Rate |
$7,313.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,875.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$3,656.70
|
| Rate for Payer: Cash Price |
$3,656.70
|
| Rate for Payer: Central Health Plan Commercial |
$6,500.80
|
| Rate for Payer: Cigna of CA PPO |
$6,013.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Media |
$1,474.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$6,907.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,875.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,313.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,094.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,432.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: InnovAge PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,420.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,693.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,625.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$6,094.50
|
| Rate for Payer: Networks By Design Commercial |
$5,281.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,907.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Riverside University Health System MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,875.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC PERC DRAINAGE W CATH PLACEMENT
|
Facility
|
IP
|
$2,187.00
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
906601707
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$437.40 |
| Max. Negotiated Rate |
$1,968.30 |
| Rate for Payer: Cash Price |
$984.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,749.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$874.80
|
| Rate for Payer: Galaxy Health WC |
$1,858.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,312.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,968.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,458.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$833.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$437.40
|
| Rate for Payer: Multiplan Commercial |
$1,640.25
|
| Rate for Payer: Networks By Design Commercial |
$1,421.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,858.95
|
|
|
HC PERC DRAINAGE W CATH PLACEMENT
|
Facility
|
OP
|
$2,187.00
|
|
|
Service Code
|
CPT 75989
|
| Hospital Charge Code |
906601707
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$198.59 |
| Max. Negotiated Rate |
$2,364.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,858.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,202.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,202.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$651.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,292.08
|
| Rate for Payer: Blue Distinction Transplant |
$1,312.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,351.57
|
| Rate for Payer: Blue Shield of California EPN |
$1,062.88
|
| Rate for Payer: Cash Price |
$984.15
|
| Rate for Payer: Cash Price |
$984.15
|
| Rate for Payer: Central Health Plan Commercial |
$1,749.60
|
| Rate for Payer: Cigna of CA HMO |
$1,399.68
|
| Rate for Payer: Cigna of CA PPO |
$1,618.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,858.95
|
| Rate for Payer: Dignity Health Media |
$1,858.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,858.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$874.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$874.80
|
| Rate for Payer: Galaxy Health WC |
$1,858.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,312.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,968.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,640.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$765.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,458.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$437.40
|
| Rate for Payer: Multiplan Commercial |
$1,640.25
|
| Rate for Payer: Networks By Design Commercial |
$1,421.55
|
| Rate for Payer: Prime Health Services Commercial |
$1,858.95
|
| Rate for Payer: Riverside University Health System MISP |
$874.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,312.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,312.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,093.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,093.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,093.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,858.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,858.95
|
|
|
HC PERC HC TRANSCATH ABLTN PULM ARTERIES RH CATH
|
Facility
|
OP
|
$48,705.00
|
|
|
Service Code
|
CPT 0793T
|
| Hospital Charge Code |
906819786
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$43,834.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23,582.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,774.91
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,952.68
|
| Rate for Payer: Blue Distinction Transplant |
$29,223.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$21,917.25
|
| Rate for Payer: Cash Price |
$21,917.25
|
| Rate for Payer: Cash Price |
$21,917.25
|
| Rate for Payer: Central Health Plan Commercial |
$38,964.00
|
| Rate for Payer: Cigna of CA PPO |
$36,041.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Dignity Health Media |
$21,908.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,099.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,577.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,908.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$21,908.96
|
| Rate for Payer: Galaxy Health WC |
$41,399.25
|
| Rate for Payer: Global Benefits Group Commercial |
$29,223.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$43,834.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$36,528.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35,930.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36,149.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,908.96
|
| Rate for Payer: InnovAge PACE Commercial |
$32,863.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,486.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,556.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,741.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,358.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,358.01
|
| Rate for Payer: Multiplan Commercial |
$36,528.75
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: Networks By Design Commercial |
$31,658.25
|
| Rate for Payer: Preferred Health Network WC |
$30,563.96
|
| Rate for Payer: Prime Health Services Commercial |
$41,399.25
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Prime Health Services WC |
$29,647.04
|
| Rate for Payer: Riverside University Health System MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29,223.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$24,352.50
|
| Rate for Payer: United Healthcare All Other HMO |
$24,352.50
|
| Rate for Payer: United Healthcare HMO Rider |
$24,352.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24,352.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Vantage Medical Group Senior |
$21,908.96
|
|
|
HC PERC HC TRANSCATH ABLTN PULM ARTERIES RH CATH
|
Facility
|
IP
|
$48,705.00
|
|
|
Service Code
|
CPT 0793T
|
| Hospital Charge Code |
906819786
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,741.00 |
| Max. Negotiated Rate |
$43,834.50 |
| Rate for Payer: Cash Price |
$21,917.25
|
| Rate for Payer: Central Health Plan Commercial |
$38,964.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,482.00
|
| Rate for Payer: Galaxy Health WC |
$41,399.25
|
| Rate for Payer: Global Benefits Group Commercial |
$29,223.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$43,834.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,486.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,556.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,741.00
|
| Rate for Payer: Multiplan Commercial |
$36,528.75
|
| Rate for Payer: Networks By Design Commercial |
$31,658.25
|
| Rate for Payer: Prime Health Services Commercial |
$41,399.25
|
|
|
HC PERC PLCMNT FIDUCIAL MRKR
|
Facility
|
IP
|
$3,119.00
|
|
|
Service Code
|
CPT 32553
|
| Hospital Charge Code |
900832553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$623.80 |
| Max. Negotiated Rate |
$2,807.10 |
| Rate for Payer: Cash Price |
$1,403.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,495.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,247.60
|
| Rate for Payer: Galaxy Health WC |
$2,651.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,871.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,807.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,080.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,188.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$623.80
|
| Rate for Payer: Multiplan Commercial |
$2,339.25
|
| Rate for Payer: Networks By Design Commercial |
$2,027.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,651.15
|
|
|
HC PERC PLCMNT FIDUCIAL MRKR
|
Facility
|
OP
|
$3,119.00
|
|
|
Service Code
|
CPT 32553
|
| Hospital Charge Code |
900832553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$623.80 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,731.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,596.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,904.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,731.24
|
| 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 |
$1,871.40
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$1,731.24
|
| Rate for Payer: Cash Price |
$1,403.55
|
| Rate for Payer: Cash Price |
$1,403.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,495.20
|
| Rate for Payer: Cigna of CA PPO |
$2,308.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,596.86
|
| Rate for Payer: Dignity Health Media |
$1,731.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,904.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,337.17
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,731.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,731.24
|
| Rate for Payer: Galaxy Health WC |
$2,651.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,871.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,807.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,339.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,839.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,856.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,731.24
|
| Rate for Payer: InnovAge PACE Commercial |
$2,596.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,080.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$986.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,731.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$623.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,319.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,319.86
|
| Rate for Payer: Multiplan Commercial |
$2,339.25
|
| Rate for Payer: Networks By Design Commercial |
$2,027.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,651.15
|
| Rate for Payer: Prime Health Services Medicare |
$1,835.11
|
| Rate for Payer: Riverside University Health System MISP |
$1,904.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,871.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,596.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,904.36
|
| Rate for Payer: Vantage Medical Group Senior |
$1,731.24
|
|
|
HC PERC PULM ART STENT ABN BI
|
Facility
|
OP
|
$31,065.00
|
|
|
Service Code
|
CPT 33903
|
| Hospital Charge Code |
906820326
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: Blue Distinction Transplant |
$18,639.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Central Health Plan Commercial |
$24,852.00
|
| Rate for Payer: Cigna of CA PPO |
$22,988.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$26,405.25
|
| Rate for Payer: Global Benefits Group Commercial |
$18,639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,958.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$23,298.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,679.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: InnovAge PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,720.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,213.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$23,298.75
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$20,192.25
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$26,405.25
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,639.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
