|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
OP
|
$7,535.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$305.19 |
| Max. Negotiated Rate |
$6,781.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,521.00
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$3,390.75
|
| Rate for Payer: Cash Price |
$3,390.75
|
| Rate for Payer: Cash Price |
$3,390.75
|
| Rate for Payer: Cash Price |
$3,390.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,028.00
|
| Rate for Payer: Cigna of CA PPO |
$5,575.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$6,404.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,521.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,781.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,651.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Innovage PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,025.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,507.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$5,651.25
|
| Rate for Payer: Networks By Design Commercial |
$4,897.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,404.75
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,521.00
|
| Rate for Payer: Riverside University Health MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,521.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,767.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,767.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,767.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,767.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
OP
|
$7,535.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$305.19 |
| Max. Negotiated Rate |
$6,781.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$305.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,521.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,739.52
|
| Rate for Payer: Blue Shield of California EPN |
$3,684.62
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$3,390.75
|
| Rate for Payer: Cash Price |
$3,390.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,028.00
|
| Rate for Payer: Cigna of CA HMO |
$4,822.40
|
| Rate for Payer: Cigna of CA PPO |
$5,575.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$6,404.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,521.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,781.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,651.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: IEHP medi-cal |
$503.56
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Innovage PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,025.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,507.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$5,651.25
|
| Rate for Payer: Networks By Design Commercial |
$4,897.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,404.75
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,521.00
|
| Rate for Payer: Riverside University Health MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,521.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,521.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,767.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,767.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,767.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,767.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
IP
|
$7,535.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,507.00 |
| Max. Negotiated Rate |
$6,781.50 |
| Rate for Payer: Cash Price |
$3,390.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,028.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,014.00
|
| Rate for Payer: Galaxy Health WC |
$6,404.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,521.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,781.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,025.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,507.00
|
| Rate for Payer: Multiplan Commercial |
$5,651.25
|
| Rate for Payer: Networks By Design Commercial |
$4,897.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,404.75
|
|
|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
IP
|
$7,535.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,507.00 |
| Max. Negotiated Rate |
$6,781.50 |
| Rate for Payer: Cash Price |
$3,390.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,028.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,014.00
|
| Rate for Payer: Galaxy Health WC |
$6,404.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,521.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,781.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,025.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,507.00
|
| Rate for Payer: Multiplan Commercial |
$5,651.25
|
| Rate for Payer: Networks By Design Commercial |
$4,897.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,404.75
|
|
|
HC PROCEDURE ANUS
|
Facility
IP
|
$1,730.00
|
|
|
Service Code
|
CPT 46999
|
| Hospital Charge Code |
900501653
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$346.00 |
| Max. Negotiated Rate |
$1,557.00 |
| Rate for Payer: Cash Price |
$778.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,384.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$692.00
|
| Rate for Payer: Galaxy Health WC |
$1,470.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,038.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,557.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,153.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$346.00
|
| Rate for Payer: Multiplan Commercial |
$1,297.50
|
| Rate for Payer: Networks By Design Commercial |
$1,124.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,470.50
|
|
|
HC PROCEDURE ANUS
|
Facility
OP
|
$1,730.00
|
|
|
Service Code
|
CPT 46999
|
| Hospital Charge Code |
900501653
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$346.00 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,038.00
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$778.50
|
| Rate for Payer: Cash Price |
$778.50
|
| Rate for Payer: Cash Price |
$778.50
|
| Rate for Payer: Cash Price |
$778.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,384.00
|
| Rate for Payer: Cigna of CA PPO |
$1,280.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$1,470.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,038.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,557.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,297.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,153.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$346.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,297.50
|
| Rate for Payer: Networks By Design Commercial |
$1,124.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,470.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,038.00
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,038.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$865.00
|
| Rate for Payer: United Healthcare All Other HMO |
$865.00
|
| Rate for Payer: United Healthcare HMO Rider |
$865.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$865.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC PROCEDURE CARDIAC SURG
|
Facility
IP
|
$1,160.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
900501696
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$232.00 |
| Max. Negotiated Rate |
$1,044.00 |
| Rate for Payer: Cash Price |
$522.00
|
| Rate for Payer: Central Health Plan Commercial |
$928.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$464.00
|
| Rate for Payer: Galaxy Health WC |
$986.00
|
| Rate for Payer: Global Benefits Group Commercial |
$696.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,044.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$773.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.00
|
| Rate for Payer: Multiplan Commercial |
$870.00
|
| Rate for Payer: Networks By Design Commercial |
$754.00
|
| Rate for Payer: Prime Health Services Commercial |
$986.00
|
|
|
HC PROCEDURE CARDIAC SURG
|
Facility
OP
|
$1,160.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
900501696
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$232.00 |
| 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: AlphaCare Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$784.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$696.00
|
| Rate for Payer: Caremore Medicare Advantage |
$784.90
|
| Rate for Payer: Cash Price |
$522.00
|
| Rate for Payer: Cash Price |
$522.00
|
| Rate for Payer: Cash Price |
$522.00
|
| Rate for Payer: Cash Price |
$522.00
|
| Rate for Payer: Central Health Plan Commercial |
$928.00
|
| Rate for Payer: Cigna of CA PPO |
$858.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.90
|
| Rate for Payer: Galaxy Health WC |
$986.00
|
| Rate for Payer: Global Benefits Group Commercial |
$696.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,044.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$870.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,287.24
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$784.90
|
| Rate for Payer: Innovage PACE Commercial |
$1,177.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$773.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$232.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.77
|
| Rate for Payer: Multiplan Commercial |
$870.00
|
| Rate for Payer: Networks By Design Commercial |
$754.00
|
| Rate for Payer: Prime Health Services Commercial |
$986.00
|
| Rate for Payer: Prime Health Services Medicare |
$831.99
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$696.00
|
| Rate for Payer: Riverside University Health MISP |
$863.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$696.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$580.00
|
| Rate for Payer: United Healthcare All Other HMO |
$580.00
|
| Rate for Payer: United Healthcare HMO Rider |
$580.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$580.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Vantage Medical Group Senior |
$784.90
|
|
|
HC PROCEDURE, FEMUR OR KNEE
|
Facility
OP
|
$1,724.00
|
|
|
Service Code
|
CPT 27599
|
| Hospital Charge Code |
909007599
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$294.64 |
| Max. Negotiated Rate |
$3,079.84 |
| Rate for Payer: Adventist Health Medi-Cal |
$294.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$294.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$834.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,018.54
|
| Rate for Payer: BCBS Transplant Transplant |
$1,034.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$294.64
|
| Rate for Payer: Cash Price |
$775.80
|
| Rate for Payer: Cash Price |
$775.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,379.20
|
| Rate for Payer: Cigna of CA PPO |
$1,275.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$441.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.76
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$294.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$294.64
|
| Rate for Payer: Galaxy Health WC |
$1,465.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,034.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,551.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,293.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$483.21
|
| Rate for Payer: IEHP medi-cal |
$486.16
|
| Rate for Payer: IEHP Medicare Advantage |
$294.64
|
| Rate for Payer: Innovage PACE Commercial |
$441.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,149.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$294.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$344.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.82
|
| Rate for Payer: Multiplan Commercial |
$1,293.00
|
| Rate for Payer: Networks By Design Commercial |
$1,120.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,465.40
|
| Rate for Payer: Prime Health Services Medicare |
$312.32
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,034.40
|
| Rate for Payer: Riverside University Health MISP |
$324.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,034.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$441.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$324.10
|
| Rate for Payer: Vantage Medical Group Senior |
$294.64
|
|
|
HC PROCEDURE, FEMUR OR KNEE
|
Facility
IP
|
$1,724.00
|
|
|
Service Code
|
CPT 27599
|
| Hospital Charge Code |
909007599
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$344.80 |
| Max. Negotiated Rate |
$1,551.60 |
| Rate for Payer: Blue Shield of California Commercial |
$1,293.00
|
| Rate for Payer: Cash Price |
$775.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,379.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$689.60
|
| Rate for Payer: Galaxy Health WC |
$1,465.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,034.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,551.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,149.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$344.80
|
| Rate for Payer: Multiplan Commercial |
$1,293.00
|
| Rate for Payer: Networks By Design Commercial |
$1,120.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,465.40
|
|
|
HC PROCEDURE NOSE
|
Facility
IP
|
$798.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
900501667
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$718.20 |
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Central Health Plan Commercial |
$638.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$319.20
|
| Rate for Payer: Galaxy Health WC |
$678.30
|
| Rate for Payer: Global Benefits Group Commercial |
$478.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$718.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$532.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.60
|
| Rate for Payer: Multiplan Commercial |
$598.50
|
| Rate for Payer: Networks By Design Commercial |
$518.70
|
| Rate for Payer: Prime Health Services Commercial |
$678.30
|
|
|
HC PROCEDURE NOSE
|
Facility
OP
|
$798.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
900501667
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.60 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$478.80
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Central Health Plan Commercial |
$638.40
|
| Rate for Payer: Cigna of CA PPO |
$590.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$678.30
|
| Rate for Payer: Global Benefits Group Commercial |
$478.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$718.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$598.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Innovage PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$532.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$598.50
|
| Rate for Payer: Networks By Design Commercial |
$518.70
|
| Rate for Payer: Prime Health Services Commercial |
$678.30
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$478.80
|
| Rate for Payer: Riverside University Health MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$478.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$399.00
|
| Rate for Payer: United Healthcare All Other HMO |
$399.00
|
| Rate for Payer: United Healthcare HMO Rider |
$399.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$399.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC PROC PHARYNX ADENOIDS
|
Facility
OP
|
$4,154.00
|
|
|
Service Code
|
CPT 42999
|
| Hospital Charge Code |
900501360
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$305.19 |
| Max. Negotiated Rate |
$3,738.60 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$305.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,492.40
|
| Rate for Payer: Caremore Medicare Advantage |
$305.19
|
| Rate for Payer: Cash Price |
$1,869.30
|
| Rate for Payer: Cash Price |
$1,869.30
|
| Rate for Payer: Cash Price |
$1,869.30
|
| Rate for Payer: Cash Price |
$1,869.30
|
| Rate for Payer: Central Health Plan Commercial |
$3,323.20
|
| Rate for Payer: Cigna of CA PPO |
$3,073.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$457.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$412.01
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$305.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$305.19
|
| Rate for Payer: Galaxy Health WC |
$3,530.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,492.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,738.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,115.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$500.51
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$305.19
|
| Rate for Payer: Innovage PACE Commercial |
$457.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,770.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$305.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$830.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$408.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$408.95
|
| Rate for Payer: Multiplan Commercial |
$3,115.50
|
| Rate for Payer: Networks By Design Commercial |
$2,700.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,530.90
|
| Rate for Payer: Prime Health Services Medicare |
$323.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,492.40
|
| Rate for Payer: Riverside University Health MISP |
$335.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,492.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,077.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,077.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,077.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,077.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$457.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.71
|
| Rate for Payer: Vantage Medical Group Senior |
$305.19
|
|
|
HC PROC PHARYNX ADENOIDS
|
Facility
IP
|
$4,154.00
|
|
|
Service Code
|
CPT 42999
|
| Hospital Charge Code |
900501360
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$830.80 |
| Max. Negotiated Rate |
$3,738.60 |
| Rate for Payer: Cash Price |
$1,869.30
|
| Rate for Payer: Central Health Plan Commercial |
$3,323.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,661.60
|
| Rate for Payer: Galaxy Health WC |
$3,530.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,492.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,738.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,770.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$830.80
|
| Rate for Payer: Multiplan Commercial |
$3,115.50
|
| Rate for Payer: Networks By Design Commercial |
$2,700.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,530.90
|
|
|
HC PROC RECTUM
|
Facility
OP
|
$1,565.00
|
|
|
Service Code
|
CPT 45999
|
| Hospital Charge Code |
900501387
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$313.00 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$950.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$939.00
|
| Rate for Payer: Blue Shield of California Commercial |
$984.38
|
| Rate for Payer: Blue Shield of California EPN |
$765.28
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$704.25
|
| Rate for Payer: Cash Price |
$704.25
|
| Rate for Payer: Cash Price |
$704.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.00
|
| Rate for Payer: Cigna of CA HMO |
$1,001.60
|
| Rate for Payer: Cigna of CA PPO |
$1,158.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$1,330.25
|
| Rate for Payer: Global Benefits Group Commercial |
$939.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,408.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,173.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$1,884.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,043.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,173.75
|
| Rate for Payer: Networks By Design Commercial |
$1,017.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,330.25
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$939.00
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$939.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$939.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$782.50
|
| Rate for Payer: United Healthcare All Other HMO |
$782.50
|
| Rate for Payer: United Healthcare HMO Rider |
$782.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$782.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC PROC RECTUM
|
Facility
IP
|
$1,565.00
|
|
|
Service Code
|
CPT 45999
|
| Hospital Charge Code |
900501387
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$313.00 |
| Max. Negotiated Rate |
$1,408.50 |
| Rate for Payer: Cash Price |
$704.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$626.00
|
| Rate for Payer: Galaxy Health WC |
$1,330.25
|
| Rate for Payer: Global Benefits Group Commercial |
$939.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,408.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,043.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.00
|
| Rate for Payer: Multiplan Commercial |
$1,173.75
|
| Rate for Payer: Networks By Design Commercial |
$1,017.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,330.25
|
|
|
HC PROC RECTUM
|
Facility
IP
|
$1,565.00
|
|
|
Service Code
|
CPT 45999
|
| Hospital Charge Code |
900501387
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$313.00 |
| Max. Negotiated Rate |
$1,408.50 |
| Rate for Payer: Cash Price |
$704.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$626.00
|
| Rate for Payer: Galaxy Health WC |
$1,330.25
|
| Rate for Payer: Global Benefits Group Commercial |
$939.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,408.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,043.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.00
|
| Rate for Payer: Multiplan Commercial |
$1,173.75
|
| Rate for Payer: Networks By Design Commercial |
$1,017.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,330.25
|
|
|
HC PROC RECTUM
|
Facility
OP
|
$1,565.00
|
|
|
Service Code
|
CPT 45999
|
| Hospital Charge Code |
900501387
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$313.00 |
| 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: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$939.00
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$704.25
|
| Rate for Payer: Cash Price |
$704.25
|
| Rate for Payer: Cash Price |
$704.25
|
| Rate for Payer: Cash Price |
$704.25
|
| Rate for Payer: Central Health Plan Commercial |
$1,252.00
|
| Rate for Payer: Cigna of CA PPO |
$1,158.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$1,330.25
|
| Rate for Payer: Global Benefits Group Commercial |
$939.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,408.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,173.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,043.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$313.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$1,173.75
|
| Rate for Payer: Networks By Design Commercial |
$1,017.25
|
| Rate for Payer: Prime Health Services Commercial |
$1,330.25
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$939.00
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$939.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$782.50
|
| Rate for Payer: United Healthcare All Other HMO |
$782.50
|
| Rate for Payer: United Healthcare HMO Rider |
$782.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$782.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC PROC SK MUC MEMB & SUB
|
Facility
IP
|
$1,420.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
900501051
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$284.00 |
| Max. Negotiated Rate |
$1,278.00 |
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,136.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$568.00
|
| Rate for Payer: Galaxy Health WC |
$1,207.00
|
| Rate for Payer: Global Benefits Group Commercial |
$852.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,278.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$947.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$284.00
|
| Rate for Payer: Multiplan Commercial |
$1,065.00
|
| Rate for Payer: Networks By Design Commercial |
$923.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,207.00
|
|
|
HC PROC SK MUC MEMB & SUB
|
Facility
OP
|
$1,420.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
900501051
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$250.14 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$687.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$838.94
|
| Rate for Payer: BCBS Transplant Transplant |
$852.00
|
| 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 |
$250.14
|
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,136.00
|
| Rate for Payer: Cigna of CA PPO |
$1,050.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$1,207.00
|
| Rate for Payer: Global Benefits Group Commercial |
$852.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,278.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,065.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: IEHP medi-cal |
$412.73
|
| Rate for Payer: IEHP Medicare Advantage |
$250.14
|
| Rate for Payer: Innovage PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$947.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$284.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$1,065.00
|
| Rate for Payer: Networks By Design Commercial |
$923.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,207.00
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$852.00
|
| Rate for Payer: Riverside University Health MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$852.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC PROC SK MUC MEMB & SUB
|
Facility
IP
|
$1,420.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
900501051
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$284.00 |
| Max. Negotiated Rate |
$1,278.00 |
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,136.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$568.00
|
| Rate for Payer: Galaxy Health WC |
$1,207.00
|
| Rate for Payer: Global Benefits Group Commercial |
$852.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,278.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$947.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$284.00
|
| Rate for Payer: Multiplan Commercial |
$1,065.00
|
| Rate for Payer: Networks By Design Commercial |
$923.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,207.00
|
|
|
HC PROC SK MUC MEMB & SUB
|
Facility
OP
|
$1,420.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
900501051
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$250.14 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$852.00
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Cash Price |
$639.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,136.00
|
| Rate for Payer: Cigna of CA PPO |
$1,050.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$1,207.00
|
| Rate for Payer: Global Benefits Group Commercial |
$852.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,278.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,065.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$250.14
|
| Rate for Payer: Innovage PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$947.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$284.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$1,065.00
|
| Rate for Payer: Networks By Design Commercial |
$923.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,207.00
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$852.00
|
| Rate for Payer: Riverside University Health MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$852.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$710.00
|
| Rate for Payer: United Healthcare All Other HMO |
$710.00
|
| Rate for Payer: United Healthcare HMO Rider |
$710.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$710.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC PROCTOSIGMODISOCPY W REMOVAL
|
Facility
OP
|
$2,048.00
|
|
|
Service Code
|
CPT 45309
|
| Hospital Charge Code |
906745309
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$409.60 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,228.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Cash Price |
$921.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,638.40
|
| Rate for Payer: Cigna of CA PPO |
$1,515.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| 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 |
$1,740.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,228.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,843.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,536.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: 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 |
$1,366.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$409.60
|
| 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 |
$1,536.00
|
| Rate for Payer: Networks By Design Commercial |
$1,331.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,740.80
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,621.86
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,228.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| 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 PROCTOSIGMODISOCPY W REMOVAL
|
Facility
IP
|
$3,226.00
|
|
|
Service Code
|
CPT 45309
|
| Hospital Charge Code |
906745309
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$645.20 |
| Max. Negotiated Rate |
$2,903.40 |
| Rate for Payer: Cash Price |
$1,451.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,580.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,290.40
|
| Rate for Payer: Galaxy Health WC |
$2,742.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,935.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,903.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,151.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$645.20
|
| Rate for Payer: Multiplan Commercial |
$2,419.50
|
| Rate for Payer: Networks By Design Commercial |
$2,096.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,742.10
|
|
|
HC PROCTOSIGMOIDOSCOPY RIGID/DIL
|
Facility
OP
|
$1,886.00
|
|
|
Service Code
|
CPT 45303
|
| Hospital Charge Code |
906745303
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$377.20 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,131.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$848.70
|
| Rate for Payer: Cash Price |
$848.70
|
| Rate for Payer: Cash Price |
$848.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,508.80
|
| Rate for Payer: Cigna of CA PPO |
$1,395.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| 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 |
$1,603.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,131.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,697.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,414.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: 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 |
$1,257.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$377.20
|
| 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 |
$1,414.50
|
| Rate for Payer: Networks By Design Commercial |
$1,225.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,603.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,131.60
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,131.60
|
| 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
|
|
