|
HC PROCEDURE, FEMUR OR KNEE
|
Facility
|
IP
|
$2,280.00
|
|
|
Service Code
|
CPT 27599
|
| Hospital Charge Code |
909007599
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$456.00 |
| Max. Negotiated Rate |
$2,052.00 |
| Rate for Payer: Adventist Health Commercial |
$456.00
|
| Rate for Payer: Cash Price |
$1,026.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,824.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$912.00
|
| Rate for Payer: EPIC Health Plan Senior |
$912.00
|
| Rate for Payer: Galaxy Health WC |
$1,938.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,368.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,052.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,520.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$868.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,411.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$456.00
|
| Rate for Payer: Multiplan Commercial |
$1,710.00
|
| Rate for Payer: Networks By Design Commercial |
$1,482.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,938.00
|
|
|
HC PROCEDURE NOSE
|
Facility
|
IP
|
$1,056.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
900501667
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$211.20 |
| Max. Negotiated Rate |
$950.40 |
| Rate for Payer: Adventist Health Commercial |
$211.20
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Central Health Plan Commercial |
$844.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$422.40
|
| Rate for Payer: EPIC Health Plan Senior |
$422.40
|
| Rate for Payer: Galaxy Health WC |
$897.60
|
| Rate for Payer: Global Benefits Group Commercial |
$633.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$950.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$704.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$402.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$653.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$211.20
|
| Rate for Payer: Multiplan Commercial |
$792.00
|
| Rate for Payer: Networks By Design Commercial |
$686.40
|
| Rate for Payer: Prime Health Services Commercial |
$897.60
|
|
|
HC PROCEDURE NOSE
|
Facility
|
OP
|
$1,056.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
900501667
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$211.20 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$211.20
|
| 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 |
$442.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$470.13
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Central Health Plan Commercial |
$844.80
|
| Rate for Payer: Cigna of CA HMO |
$675.84
|
| Rate for Payer: Cigna of CA PPO |
$781.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$442.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$295.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$398.33
|
| Rate for Payer: EPIC Health Plan Senior |
$295.06
|
| Rate for Payer: Galaxy Health WC |
$897.60
|
| Rate for Payer: Global Benefits Group Commercial |
$633.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$950.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$295.06
|
| Rate for Payer: InnovAge PACE Commercial |
$442.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$704.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$295.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$211.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$395.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$395.38
|
| Rate for Payer: Multiplan Commercial |
$792.00
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$686.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$295.06
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$897.60
|
| Rate for Payer: Prime Health Services Medicare |
$312.76
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$324.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$633.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$528.00
|
| Rate for Payer: United Healthcare All Other HMO |
$528.00
|
| Rate for Payer: United Healthcare HMO Rider |
$528.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$528.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$295.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Vantage Medical Group Senior |
$295.06
|
|
|
HC PROC PHARYNX ADENOIDS
|
Facility
|
OP
|
$5,494.00
|
|
|
Service Code
|
CPT 42999
|
| Hospital Charge Code |
900501360
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$295.06 |
| Max. Negotiated Rate |
$4,944.60 |
| Rate for Payer: Adventist Health Commercial |
$1,098.80
|
| 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 |
$442.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$295.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$470.13
|
| Rate for Payer: Cash Price |
$2,472.30
|
| Rate for Payer: Cash Price |
$2,472.30
|
| Rate for Payer: Cash Price |
$2,472.30
|
| Rate for Payer: Cash Price |
$2,472.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,395.20
|
| Rate for Payer: Cigna of CA HMO |
$3,516.16
|
| Rate for Payer: Cigna of CA PPO |
$4,065.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$442.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$324.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$295.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$398.33
|
| Rate for Payer: EPIC Health Plan Senior |
$295.06
|
| Rate for Payer: Galaxy Health WC |
$4,669.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,296.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,944.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$295.06
|
| Rate for Payer: InnovAge PACE Commercial |
$442.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,664.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$295.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,098.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$395.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$395.38
|
| Rate for Payer: Multiplan Commercial |
$4,120.50
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: Networks By Design Commercial |
$3,571.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$295.06
|
| Rate for Payer: Preferred Health Network WC |
$479.72
|
| Rate for Payer: Prime Health Services Commercial |
$4,669.90
|
| Rate for Payer: Prime Health Services Medicare |
$312.76
|
| Rate for Payer: Prime Health Services WC |
$465.33
|
| Rate for Payer: Riverside University Health System MISP |
$324.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,296.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,747.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,747.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,747.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,747.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$295.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$442.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.57
|
| Rate for Payer: Vantage Medical Group Senior |
$295.06
|
|
|
HC PROC PHARYNX ADENOIDS
|
Facility
|
IP
|
$5,494.00
|
|
|
Service Code
|
CPT 42999
|
| Hospital Charge Code |
900501360
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,098.80 |
| Max. Negotiated Rate |
$4,944.60 |
| Rate for Payer: Adventist Health Commercial |
$1,098.80
|
| Rate for Payer: Cash Price |
$2,472.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,395.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,197.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,197.60
|
| Rate for Payer: Galaxy Health WC |
$4,669.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,296.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,944.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,664.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,093.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,400.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,098.80
|
| Rate for Payer: Multiplan Commercial |
$4,120.50
|
| Rate for Payer: Networks By Design Commercial |
$3,571.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,669.90
|
|
|
HC PROC RECTUM
|
Facility
|
IP
|
$2,070.00
|
|
|
Service Code
|
CPT 45999
|
| Hospital Charge Code |
900501387
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$414.00 |
| Max. Negotiated Rate |
$1,863.00 |
| Rate for Payer: Adventist Health Commercial |
$414.00
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,656.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$828.00
|
| Rate for Payer: EPIC Health Plan Senior |
$828.00
|
| Rate for Payer: Galaxy Health WC |
$1,759.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,242.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,863.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,380.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$788.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,281.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.00
|
| Rate for Payer: Multiplan Commercial |
$1,552.50
|
| Rate for Payer: Networks By Design Commercial |
$1,345.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,759.50
|
|
|
HC PROC RECTUM
|
Facility
|
IP
|
$2,070.00
|
|
|
Service Code
|
CPT 45999
|
| Hospital Charge Code |
900501387
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$414.00 |
| Max. Negotiated Rate |
$1,863.00 |
| Rate for Payer: Adventist Health Commercial |
$414.00
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,656.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$828.00
|
| Rate for Payer: EPIC Health Plan Senior |
$828.00
|
| Rate for Payer: Galaxy Health WC |
$1,759.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,242.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,863.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,380.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$788.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,281.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.00
|
| Rate for Payer: Multiplan Commercial |
$1,552.50
|
| Rate for Payer: Networks By Design Commercial |
$1,345.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,759.50
|
|
|
HC PROC RECTUM
|
Facility
|
OP
|
$2,070.00
|
|
|
Service Code
|
CPT 45999
|
| Hospital Charge Code |
900501387
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$2,696.00 |
| Rate for Payer: Adventist Health Commercial |
$414.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,845.73
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,656.00
|
| Rate for Payer: Cigna of CA HMO |
$1,324.80
|
| Rate for Payer: Cigna of CA PPO |
$1,531.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$1,759.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,242.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,863.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,380.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$1,552.50
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: Networks By Design Commercial |
$1,345.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Preferred Health Network WC |
$1,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,759.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Prime Health Services WC |
$1,826.90
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,242.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,035.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,035.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,035.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,035.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC PROC RECTUM
|
Facility
|
OP
|
$2,070.00
|
|
|
Service Code
|
CPT 45999
|
| Hospital Charge Code |
900501387
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$848.70
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,257.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,845.73
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,656.00
|
| Rate for Payer: Cigna of CA HMO |
$1,324.80
|
| Rate for Payer: Cigna of CA PPO |
$1,531.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$1,759.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,242.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,863.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,380.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$1,552.50
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: Networks By Design Commercial |
$1,345.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Preferred Health Network WC |
$1,883.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,759.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Prime Health Services WC |
$1,826.90
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,242.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,242.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC PROC SK MUC MEMB & SUB
|
Facility
|
IP
|
$1,551.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
900501051
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$310.20 |
| Max. Negotiated Rate |
$1,395.90 |
| Rate for Payer: Adventist Health Commercial |
$310.20
|
| Rate for Payer: Cash Price |
$697.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,240.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$620.40
|
| Rate for Payer: EPIC Health Plan Senior |
$620.40
|
| Rate for Payer: Galaxy Health WC |
$1,318.35
|
| Rate for Payer: Global Benefits Group Commercial |
$930.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,395.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,034.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$590.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$960.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.20
|
| Rate for Payer: Multiplan Commercial |
$1,163.25
|
| Rate for Payer: Networks By Design Commercial |
$1,008.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,318.35
|
|
|
HC PROC SK MUC MEMB & SUB
|
Facility
|
OP
|
$1,551.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
900501051
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$252.47 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$310.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$252.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$750.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$910.90
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$402.27
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$697.95
|
| Rate for Payer: Cash Price |
$697.95
|
| Rate for Payer: Cash Price |
$697.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,240.80
|
| Rate for Payer: Cigna of CA HMO |
$992.64
|
| Rate for Payer: Cigna of CA PPO |
$1,147.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$1,318.35
|
| Rate for Payer: Global Benefits Group Commercial |
$930.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,395.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: InnovAge PACE Commercial |
$378.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,034.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$338.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$1,163.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$1,008.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$252.47
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$1,318.35
|
| Rate for Payer: Prime Health Services Medicare |
$267.62
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$277.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$930.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC PROC SK MUC MEMB & SUB
|
Facility
|
OP
|
$1,551.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
900501051
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$252.47 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$310.20
|
| 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 |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$402.27
|
| Rate for Payer: Cash Price |
$697.95
|
| Rate for Payer: Cash Price |
$697.95
|
| Rate for Payer: Cash Price |
$697.95
|
| Rate for Payer: Cash Price |
$697.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,240.80
|
| Rate for Payer: Cigna of CA HMO |
$992.64
|
| Rate for Payer: Cigna of CA PPO |
$1,147.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$1,318.35
|
| Rate for Payer: Global Benefits Group Commercial |
$930.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,395.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: InnovAge PACE Commercial |
$378.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,034.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$338.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$1,163.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$1,008.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$252.47
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$1,318.35
|
| Rate for Payer: Prime Health Services Medicare |
$267.62
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$277.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$930.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$775.50
|
| Rate for Payer: United Healthcare All Other HMO |
$775.50
|
| Rate for Payer: United Healthcare HMO Rider |
$775.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$775.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC PROC SK MUC MEMB & SUB
|
Facility
|
IP
|
$1,551.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
900501051
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$310.20 |
| Max. Negotiated Rate |
$1,395.90 |
| Rate for Payer: Adventist Health Commercial |
$310.20
|
| Rate for Payer: Cash Price |
$697.95
|
| Rate for Payer: Central Health Plan Commercial |
$1,240.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$620.40
|
| Rate for Payer: EPIC Health Plan Senior |
$620.40
|
| Rate for Payer: Galaxy Health WC |
$1,318.35
|
| Rate for Payer: Global Benefits Group Commercial |
$930.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,395.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,034.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$590.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$960.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$310.20
|
| Rate for Payer: Multiplan Commercial |
$1,163.25
|
| Rate for Payer: Networks By Design Commercial |
$1,008.15
|
| Rate for Payer: Prime Health Services Commercial |
$1,318.35
|
|
|
HC PROCTOSIGMODISOCPY W REMOVAL
|
Facility
|
IP
|
$2,742.00
|
|
|
Service Code
|
CPT 45309
|
| Hospital Charge Code |
906745309
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$548.40 |
| Max. Negotiated Rate |
$2,467.80 |
| Rate for Payer: Adventist Health Commercial |
$548.40
|
| Rate for Payer: Cash Price |
$1,233.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,193.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,096.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,096.80
|
| Rate for Payer: Galaxy Health WC |
$2,330.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,645.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,467.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,828.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,044.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,697.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$548.40
|
| Rate for Payer: Multiplan Commercial |
$2,056.50
|
| Rate for Payer: Networks By Design Commercial |
$1,782.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,330.70
|
|
|
HC PROCTOSIGMODISOCPY W REMOVAL
|
Facility
|
OP
|
$1,741.00
|
|
|
Service Code
|
CPT 45309
|
| Hospital Charge Code |
906745309
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$169.06 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$348.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,498.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$783.45
|
| Rate for Payer: Cash Price |
$783.45
|
| Rate for Payer: Cash Price |
$783.45
|
| Rate for Payer: Central Health Plan Commercial |
$1,392.80
|
| Rate for Payer: Cigna of CA HMO |
$1,114.24
|
| Rate for Payer: Cigna of CA PPO |
$1,288.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$1,479.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,044.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,566.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$169.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: InnovAge PACE Commercial |
$2,247.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,161.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$186.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$348.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,007.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$1,305.75
|
| Rate for Payer: Networks By Design Commercial |
$1,131.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,479.85
|
| Rate for Payer: Prime Health Services Medicare |
$1,588.03
|
| Rate for Payer: Riverside University Health System MISP |
$1,647.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,044.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC PROCTOSIGMOIDOSCOPY RIGID/DIL
|
Facility
|
OP
|
$1,603.00
|
|
|
Service Code
|
CPT 45303
|
| Hospital Charge Code |
906745303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$70.43 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$320.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,498.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$2,387.03
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$721.35
|
| Rate for Payer: Cash Price |
$721.35
|
| Rate for Payer: Cash Price |
$721.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,282.40
|
| Rate for Payer: Cigna of CA HMO |
$1,025.92
|
| Rate for Payer: Cigna of CA PPO |
$1,186.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$1,362.55
|
| Rate for Payer: Global Benefits Group Commercial |
$961.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,442.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$70.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: InnovAge PACE Commercial |
$2,247.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,069.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$320.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,007.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$1,202.25
|
| Rate for Payer: Multiplan WC |
$2,387.03
|
| Rate for Payer: Networks By Design Commercial |
$1,041.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Preferred Health Network WC |
$2,435.74
|
| Rate for Payer: Prime Health Services Commercial |
$1,362.55
|
| Rate for Payer: Prime Health Services Medicare |
$1,588.03
|
| Rate for Payer: Prime Health Services WC |
$2,362.67
|
| Rate for Payer: Riverside University Health System MISP |
$1,647.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$961.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC PROCTOSIGMOIDOSCOPY RIGID/DIL
|
Facility
|
IP
|
$2,524.00
|
|
|
Service Code
|
CPT 45303
|
| Hospital Charge Code |
906745303
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$504.80 |
| Max. Negotiated Rate |
$2,271.60 |
| Rate for Payer: Adventist Health Commercial |
$504.80
|
| Rate for Payer: Cash Price |
$1,135.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,019.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,009.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,009.60
|
| Rate for Payer: Galaxy Health WC |
$2,145.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,514.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,271.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,683.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$961.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,562.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$504.80
|
| Rate for Payer: Multiplan Commercial |
$1,893.00
|
| Rate for Payer: Networks By Design Commercial |
$1,640.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,145.40
|
|
|
HC PROCTOSIGMOIDOSCOPY RIGID/DIL
|
Facility
|
OP
|
$1,603.00
|
|
|
Service Code
|
CPT 45303
|
| Hospital Charge Code |
906745303
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$70.43 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$320.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,498.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$721.35
|
| Rate for Payer: Cash Price |
$721.35
|
| Rate for Payer: Cash Price |
$721.35
|
| Rate for Payer: Central Health Plan Commercial |
$1,282.40
|
| Rate for Payer: Cigna of CA HMO |
$1,025.92
|
| Rate for Payer: Cigna of CA PPO |
$1,186.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$1,362.55
|
| Rate for Payer: Global Benefits Group Commercial |
$961.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,442.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$70.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: InnovAge PACE Commercial |
$2,247.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,069.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$77.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$320.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,007.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$1,202.25
|
| Rate for Payer: Networks By Design Commercial |
$1,041.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,362.55
|
| Rate for Payer: Prime Health Services Medicare |
$1,588.03
|
| Rate for Payer: Riverside University Health System MISP |
$1,647.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$961.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC PROCTOSIGMOIDOSCOPY RIGID/DIL
|
Facility
|
IP
|
$2,524.00
|
|
|
Service Code
|
CPT 45303
|
| Hospital Charge Code |
906745303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$504.80 |
| Max. Negotiated Rate |
$2,271.60 |
| Rate for Payer: Adventist Health Commercial |
$504.80
|
| Rate for Payer: Cash Price |
$1,135.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,019.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,009.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,009.60
|
| Rate for Payer: Galaxy Health WC |
$2,145.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,514.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,271.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,683.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$961.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,562.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$504.80
|
| Rate for Payer: Multiplan Commercial |
$1,893.00
|
| Rate for Payer: Networks By Design Commercial |
$1,640.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,145.40
|
|
|
HC PROCTOSIGMOIDOSCOPY W FB RMVL
|
Facility
|
OP
|
$3,732.00
|
|
|
Service Code
|
CPT 45307
|
| Hospital Charge Code |
906745307
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$133.20 |
| Max. Negotiated Rate |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$746.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,484.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,484.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,679.40
|
| Rate for Payer: Cash Price |
$1,679.40
|
| Rate for Payer: Cash Price |
$1,679.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,985.60
|
| Rate for Payer: Cigna of CA HMO |
$2,388.48
|
| Rate for Payer: Cigna of CA PPO |
$2,761.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,832.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,484.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,704.05
|
| Rate for Payer: EPIC Health Plan Senior |
$3,484.48
|
| Rate for Payer: Galaxy Health WC |
$3,172.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,239.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,358.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,714.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$133.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,484.48
|
| Rate for Payer: InnovAge PACE Commercial |
$5,226.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,489.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$147.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,484.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$746.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,669.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,669.20
|
| Rate for Payer: Multiplan Commercial |
$2,799.00
|
| Rate for Payer: Networks By Design Commercial |
$2,425.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,484.48
|
| Rate for Payer: Prime Health Services Commercial |
$3,172.20
|
| Rate for Payer: Prime Health Services Medicare |
$3,693.55
|
| Rate for Payer: Riverside University Health System MISP |
$3,832.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,239.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,181.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,484.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,226.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,832.93
|
| Rate for Payer: Vantage Medical Group Senior |
$3,484.48
|
|
|
HC PROCTOSIGMOIDOSCOPY W FB RMVL
|
Facility
|
IP
|
$7,347.00
|
|
|
Service Code
|
CPT 45307
|
| Hospital Charge Code |
906745307
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,469.40 |
| Max. Negotiated Rate |
$6,612.30 |
| Rate for Payer: Adventist Health Commercial |
$1,469.40
|
| Rate for Payer: Cash Price |
$3,306.15
|
| Rate for Payer: Central Health Plan Commercial |
$5,877.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,938.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,938.80
|
| Rate for Payer: Galaxy Health WC |
$6,244.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,408.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,612.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,900.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,799.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,547.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,469.40
|
| Rate for Payer: Multiplan Commercial |
$5,510.25
|
| Rate for Payer: Networks By Design Commercial |
$4,775.55
|
| Rate for Payer: Prime Health Services Commercial |
$6,244.95
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
OP
|
$2,724.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
906745300
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$544.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,158.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,225.80
|
| Rate for Payer: Cash Price |
$1,225.80
|
| Rate for Payer: Cash Price |
$1,225.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,179.20
|
| Rate for Payer: Cigna of CA HMO |
$1,743.36
|
| Rate for Payer: Cigna of CA PPO |
$2,015.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$2,315.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,634.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,451.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$62.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,816.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$544.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,043.00
|
| Rate for Payer: Networks By Design Commercial |
$1,770.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Prime Health Services Commercial |
$2,315.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,634.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
IP
|
$5,070.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
900501380
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$1,014.00 |
| Max. Negotiated Rate |
$4,563.00 |
| Rate for Payer: Adventist Health Commercial |
$1,014.00
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,056.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,028.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,028.00
|
| Rate for Payer: Galaxy Health WC |
$4,309.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,042.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,563.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,381.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,931.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,138.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,014.00
|
| Rate for Payer: Multiplan Commercial |
$3,802.50
|
| Rate for Payer: Networks By Design Commercial |
$3,295.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,309.50
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
IP
|
$5,070.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
900501380
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,014.00 |
| Max. Negotiated Rate |
$4,563.00 |
| Rate for Payer: Adventist Health Commercial |
$1,014.00
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,056.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,028.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,028.00
|
| Rate for Payer: Galaxy Health WC |
$4,309.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,042.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,563.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,381.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,931.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,138.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,014.00
|
| Rate for Payer: Multiplan Commercial |
$3,802.50
|
| Rate for Payer: Networks By Design Commercial |
$3,295.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,309.50
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
IP
|
$5,070.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
900501380
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,014.00 |
| Max. Negotiated Rate |
$4,563.00 |
| Rate for Payer: Adventist Health Commercial |
$1,014.00
|
| Rate for Payer: Cash Price |
$2,281.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,056.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,028.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,028.00
|
| Rate for Payer: Galaxy Health WC |
$4,309.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,042.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,563.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,381.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,931.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,138.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,014.00
|
| Rate for Payer: Multiplan Commercial |
$3,802.50
|
| Rate for Payer: Networks By Design Commercial |
$3,295.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,309.50
|
|
