|
HC S-ICD GEN&LEAD TEST POST IMPL
|
Facility
|
OP
|
$5,022.00
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
906811490
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$448.30 |
| Max. Negotiated Rate |
$8,136.21 |
| Rate for Payer: Adventist Health Commercial |
$1,004.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$661.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,268.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,762.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,766.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$2,259.90
|
| Rate for Payer: Cash Price |
$2,259.90
|
| Rate for Payer: Cash Price |
$2,259.90
|
| Rate for Payer: Cash Price |
$2,259.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,017.60
|
| Rate for Payer: Cigna of CA HMO |
$3,214.08
|
| Rate for Payer: Cigna of CA PPO |
$3,716.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,268.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,268.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,268.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,515.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,008.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,008.80
|
| Rate for Payer: Galaxy Health WC |
$4,268.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,013.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,519.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$448.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,188.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$495.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,962.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,004.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,515.40
|
| Rate for Payer: Multiplan Commercial |
$3,766.50
|
| Rate for Payer: Networks By Design Commercial |
$3,264.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,268.70
|
| Rate for Payer: Riverside University Health System MISP |
$2,008.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,013.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,013.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,268.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,268.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,268.70
|
|
|
HC SICKLE CELL SCREEN
|
Facility
|
OP
|
$59.00
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
900910034
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.46 |
| Max. Negotiated Rate |
$55.97 |
| Rate for Payer: Adventist Health Commercial |
$11.80
|
| Rate for Payer: Adventist Health Commercial |
$19.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.51
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$40.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.97
|
| Rate for Payer: Blue Shield of California Commercial |
$60.48
|
| Rate for Payer: Blue Shield of California Commercial |
$37.17
|
| Rate for Payer: Blue Shield of California EPN |
$38.11
|
| Rate for Payer: Blue Shield of California EPN |
$23.42
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$26.55
|
| Rate for Payer: Cash Price |
$26.55
|
| Rate for Payer: Central Health Plan Commercial |
$47.20
|
| Rate for Payer: Central Health Plan Commercial |
$76.80
|
| Rate for Payer: Cigna of CA HMO |
$61.44
|
| Rate for Payer: Cigna of CA HMO |
$37.76
|
| Rate for Payer: Cigna of CA PPO |
$71.04
|
| Rate for Payer: Cigna of CA PPO |
$43.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.51
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$41.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.09
|
| Rate for Payer: EPIC Health Plan Senior |
$6.06
|
| Rate for Payer: EPIC Health Plan Senior |
$6.06
|
| Rate for Payer: Galaxy Health WC |
$81.60
|
| Rate for Payer: Galaxy Health WC |
$50.15
|
| Rate for Payer: Global Benefits Group Commercial |
$57.60
|
| Rate for Payer: Global Benefits Group Commercial |
$35.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$86.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.04
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$37.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7.38
|
| Rate for Payer: Multiplan Commercial |
$72.00
|
| Rate for Payer: Multiplan Commercial |
$44.25
|
| Rate for Payer: Networks By Design Commercial |
$38.35
|
| Rate for Payer: Networks By Design Commercial |
$62.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.51
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.51
|
| Rate for Payer: Prime Health Services Commercial |
$81.60
|
| Rate for Payer: Prime Health Services Commercial |
$50.15
|
| Rate for Payer: Prime Health Services Medicare |
$5.84
|
| Rate for Payer: Prime Health Services Medicare |
$5.84
|
| Rate for Payer: Riverside University Health System MISP |
$6.06
|
| Rate for Payer: Riverside University Health System MISP |
$6.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.46
|
| Rate for Payer: United Healthcare All Other HMO |
$4.46
|
| Rate for Payer: United Healthcare All Other HMO |
$4.46
|
| Rate for Payer: United Healthcare HMO Rider |
$4.46
|
| Rate for Payer: United Healthcare HMO Rider |
$4.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.51
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.06
|
| Rate for Payer: Vantage Medical Group Senior |
$5.51
|
| Rate for Payer: Vantage Medical Group Senior |
$5.51
|
|
|
HC SICKLE CELL SCREEN
|
Facility
|
IP
|
$96.00
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
900910034
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$86.40 |
| Rate for Payer: Adventist Health Commercial |
$19.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Central Health Plan Commercial |
$76.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.40
|
| Rate for Payer: EPIC Health Plan Senior |
$38.40
|
| Rate for Payer: Galaxy Health WC |
$81.60
|
| Rate for Payer: Global Benefits Group Commercial |
$57.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$86.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Multiplan Commercial |
$72.00
|
| Rate for Payer: Networks By Design Commercial |
$62.40
|
| Rate for Payer: Prime Health Services Commercial |
$81.60
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
|
IP
|
$4,910.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$982.00 |
| Max. Negotiated Rate |
$4,419.00 |
| Rate for Payer: Adventist Health Commercial |
$982.00
|
| Rate for Payer: Cash Price |
$2,209.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,928.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,437.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,964.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,964.00
|
| Rate for Payer: Galaxy Health WC |
$4,173.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,946.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,419.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,117.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,896.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$982.00
|
| Rate for Payer: Multiplan Commercial |
$3,682.50
|
| Rate for Payer: Networks By Design Commercial |
$3,191.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,173.50
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
|
IP
|
$4,910.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$982.00 |
| Max. Negotiated Rate |
$4,419.00 |
| Rate for Payer: Adventist Health Commercial |
$982.00
|
| Rate for Payer: Cash Price |
$2,209.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,928.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,437.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,964.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,964.00
|
| Rate for Payer: Galaxy Health WC |
$4,173.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,946.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,419.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,117.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,896.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$982.00
|
| Rate for Payer: Multiplan Commercial |
$3,682.50
|
| Rate for Payer: Networks By Design Commercial |
$3,191.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,173.50
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
|
OP
|
$4,910.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$94.14 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$982.00
|
| Rate for Payer: Adventist Health Commercial |
$579.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$363.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$363.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,837.97
|
| Rate for Payer: Blue Shield of California Commercial |
$3,112.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,959.09
|
| Rate for Payer: Blue Shield of California EPN |
$1,156.70
|
| Rate for Payer: Cash Price |
$1,304.55
|
| Rate for Payer: Cash Price |
$2,209.50
|
| Rate for Payer: Cash Price |
$2,209.50
|
| Rate for Payer: Cash Price |
$2,209.50
|
| Rate for Payer: Cash Price |
$1,304.55
|
| Rate for Payer: Cash Price |
$1,304.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,928.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,319.20
|
| Rate for Payer: Cigna of CA HMO |
$1,855.36
|
| Rate for Payer: Cigna of CA HMO |
$3,142.40
|
| Rate for Payer: Cigna of CA PPO |
$2,145.26
|
| Rate for Payer: Cigna of CA PPO |
$3,633.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,437.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,029.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$2,464.15
|
| Rate for Payer: Galaxy Health WC |
$4,173.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,946.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,739.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,419.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,609.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$94.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$94.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,117.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,840.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$103.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$103.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$579.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$982.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$2,174.25
|
| Rate for Payer: Multiplan Commercial |
$3,682.50
|
| Rate for Payer: Networks By Design Commercial |
$1,884.35
|
| Rate for Payer: Networks By Design Commercial |
$3,191.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Prime Health Services Commercial |
$2,464.15
|
| Rate for Payer: Prime Health Services Commercial |
$4,173.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,946.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,739.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,739.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,946.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,455.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,449.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,455.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,449.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,449.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,455.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,455.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,449.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
|
OP
|
$4,910.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$94.14 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$982.00
|
| Rate for Payer: Adventist Health Commercial |
$579.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,209.50
|
| Rate for Payer: Cash Price |
$2,209.50
|
| Rate for Payer: Cash Price |
$1,304.55
|
| Rate for Payer: Cash Price |
$2,209.50
|
| Rate for Payer: Cash Price |
$1,304.55
|
| Rate for Payer: Cash Price |
$1,304.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,319.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,928.00
|
| Rate for Payer: Cigna of CA HMO |
$1,855.36
|
| Rate for Payer: Cigna of CA HMO |
$3,142.40
|
| Rate for Payer: Cigna of CA PPO |
$3,633.40
|
| Rate for Payer: Cigna of CA PPO |
$2,145.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,029.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,437.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$4,173.50
|
| Rate for Payer: Galaxy Health WC |
$2,464.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,739.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,946.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,609.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,419.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$94.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$94.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,840.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,117.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$103.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$103.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$982.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$579.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$3,682.50
|
| Rate for Payer: Multiplan Commercial |
$2,174.25
|
| Rate for Payer: Networks By Design Commercial |
$3,191.50
|
| Rate for Payer: Networks By Design Commercial |
$1,884.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Prime Health Services Commercial |
$2,464.15
|
| Rate for Payer: Prime Health Services Commercial |
$4,173.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,739.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,946.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,455.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,449.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| 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 HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC SIGMDSCPY FLEX W POLYPECTOMY
|
Facility
|
IP
|
$5,348.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
906745333
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,069.60 |
| Max. Negotiated Rate |
$4,813.20 |
| Rate for Payer: Adventist Health Commercial |
$1,069.60
|
| Rate for Payer: Cash Price |
$2,406.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,278.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,743.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,139.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,139.20
|
| Rate for Payer: Galaxy Health WC |
$4,545.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,208.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,813.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,395.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,155.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,069.60
|
| Rate for Payer: Multiplan Commercial |
$4,011.00
|
| Rate for Payer: Networks By Design Commercial |
$3,476.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,545.80
|
|
|
HC SIGMDSCPY FLEX W POLYPECTOMY
|
Facility
|
OP
|
$5,348.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
906745333
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$182.51 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,069.60
|
| Rate for Payer: Adventist Health Commercial |
$679.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,406.60
|
| Rate for Payer: Cash Price |
$2,406.60
|
| Rate for Payer: Cash Price |
$1,528.20
|
| Rate for Payer: Cash Price |
$2,406.60
|
| Rate for Payer: Cash Price |
$1,528.20
|
| Rate for Payer: Cash Price |
$1,528.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,716.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,278.40
|
| Rate for Payer: Cigna of CA HMO |
$2,173.44
|
| Rate for Payer: Cigna of CA HMO |
$3,422.72
|
| Rate for Payer: Cigna of CA PPO |
$3,957.52
|
| Rate for Payer: Cigna of CA PPO |
$2,513.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,377.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,743.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$4,545.80
|
| Rate for Payer: Galaxy Health WC |
$2,886.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,037.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,208.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,056.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,813.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$182.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$182.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,156.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,395.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$201.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$201.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,069.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$679.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$4,011.00
|
| Rate for Payer: Multiplan Commercial |
$2,547.00
|
| Rate for Payer: Networks By Design Commercial |
$3,476.20
|
| Rate for Payer: Networks By Design Commercial |
$2,207.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Prime Health Services Commercial |
$2,886.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,545.80
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,037.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,208.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,674.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,698.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| 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 HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC SIGMDSCPY W BLLN DILATION
|
Facility
|
OP
|
$3,334.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
906745340
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$611.55 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$666.80
|
| Rate for Payer: Adventist Health Commercial |
$423.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,500.30
|
| Rate for Payer: Cash Price |
$1,500.30
|
| Rate for Payer: Cash Price |
$952.20
|
| Rate for Payer: Cash Price |
$1,500.30
|
| Rate for Payer: Cash Price |
$952.20
|
| Rate for Payer: Cash Price |
$952.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,692.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,667.20
|
| Rate for Payer: Cigna of CA HMO |
$1,354.24
|
| Rate for Payer: Cigna of CA HMO |
$2,133.76
|
| Rate for Payer: Cigna of CA PPO |
$2,467.16
|
| Rate for Payer: Cigna of CA PPO |
$1,565.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,481.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,333.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$2,833.90
|
| Rate for Payer: Galaxy Health WC |
$1,798.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,269.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,000.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,904.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,000.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$611.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$611.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,343.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,117.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$675.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$675.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$666.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$423.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$2,500.50
|
| Rate for Payer: Multiplan Commercial |
$1,587.00
|
| Rate for Payer: Networks By Design Commercial |
$2,167.10
|
| Rate for Payer: Networks By Design Commercial |
$1,375.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Prime Health Services Commercial |
$1,798.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,833.90
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,269.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,000.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,667.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,058.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC SIGMDSCPY W BLLN DILATION
|
Facility
|
IP
|
$3,334.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
906745340
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$666.80 |
| Max. Negotiated Rate |
$3,000.60 |
| Rate for Payer: Adventist Health Commercial |
$666.80
|
| Rate for Payer: Cash Price |
$1,500.30
|
| Rate for Payer: Central Health Plan Commercial |
$2,667.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,333.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,333.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,333.60
|
| Rate for Payer: Galaxy Health WC |
$2,833.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,000.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,000.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,117.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,967.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$666.80
|
| Rate for Payer: Multiplan Commercial |
$2,500.50
|
| Rate for Payer: Networks By Design Commercial |
$2,167.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,833.90
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
|
IP
|
$5,767.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,153.40 |
| Max. Negotiated Rate |
$5,190.30 |
| Rate for Payer: Adventist Health Commercial |
$1,153.40
|
| Rate for Payer: Cash Price |
$2,595.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,613.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,036.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,306.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,306.80
|
| Rate for Payer: Galaxy Health WC |
$4,901.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,460.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,190.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,662.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,402.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,153.40
|
| Rate for Payer: Multiplan Commercial |
$4,325.25
|
| Rate for Payer: Networks By Design Commercial |
$3,748.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,901.95
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
|
OP
|
$5,767.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$124.24 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,153.40
|
| Rate for Payer: Adventist Health Commercial |
$732.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$440.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$440.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,321.07
|
| Rate for Payer: Blue Shield of California Commercial |
$3,656.28
|
| Rate for Payer: Blue Shield of California EPN |
$2,301.03
|
| Rate for Payer: Blue Shield of California EPN |
$1,460.74
|
| Rate for Payer: Cash Price |
$1,647.45
|
| Rate for Payer: Cash Price |
$2,595.15
|
| Rate for Payer: Cash Price |
$2,595.15
|
| Rate for Payer: Cash Price |
$2,595.15
|
| Rate for Payer: Cash Price |
$1,647.45
|
| Rate for Payer: Cash Price |
$1,647.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,613.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,928.80
|
| Rate for Payer: Cigna of CA HMO |
$2,343.04
|
| Rate for Payer: Cigna of CA HMO |
$3,690.88
|
| Rate for Payer: Cigna of CA PPO |
$2,709.14
|
| Rate for Payer: Cigna of CA PPO |
$4,267.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,036.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,562.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$3,111.85
|
| Rate for Payer: Galaxy Health WC |
$4,901.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,460.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,196.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,190.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,294.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$124.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$124.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,662.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,324.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$137.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$137.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$732.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,153.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$2,745.75
|
| Rate for Payer: Multiplan Commercial |
$4,325.25
|
| Rate for Payer: Networks By Design Commercial |
$2,379.65
|
| Rate for Payer: Networks By Design Commercial |
$3,748.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Prime Health Services Commercial |
$3,111.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,901.95
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,460.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,196.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,196.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,460.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,883.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,830.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,883.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,830.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,830.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,883.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,883.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,830.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
|
OP
|
$5,767.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$124.24 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,153.40
|
| Rate for Payer: Adventist Health Commercial |
$732.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,595.15
|
| Rate for Payer: Cash Price |
$2,595.15
|
| Rate for Payer: Cash Price |
$1,647.45
|
| Rate for Payer: Cash Price |
$2,595.15
|
| Rate for Payer: Cash Price |
$1,647.45
|
| Rate for Payer: Cash Price |
$1,647.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,928.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,613.60
|
| Rate for Payer: Cigna of CA HMO |
$2,343.04
|
| Rate for Payer: Cigna of CA HMO |
$3,690.88
|
| Rate for Payer: Cigna of CA PPO |
$4,267.58
|
| Rate for Payer: Cigna of CA PPO |
$2,709.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,562.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,036.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$4,901.95
|
| Rate for Payer: Galaxy Health WC |
$3,111.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,196.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,460.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,294.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,190.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$124.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$124.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,324.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,662.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$137.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$137.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,153.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$732.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$4,325.25
|
| Rate for Payer: Multiplan Commercial |
$2,745.75
|
| Rate for Payer: Networks By Design Commercial |
$3,748.55
|
| Rate for Payer: Networks By Design Commercial |
$2,379.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Prime Health Services Commercial |
$3,111.85
|
| Rate for Payer: Prime Health Services Commercial |
$4,901.95
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,196.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,460.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,883.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,830.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| 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 HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
|
IP
|
$5,767.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,153.40 |
| Max. Negotiated Rate |
$5,190.30 |
| Rate for Payer: Adventist Health Commercial |
$1,153.40
|
| Rate for Payer: Cash Price |
$2,595.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,613.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,036.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,306.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,306.80
|
| Rate for Payer: Galaxy Health WC |
$4,901.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,460.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,190.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,662.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,402.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,153.40
|
| Rate for Payer: Multiplan Commercial |
$4,325.25
|
| Rate for Payer: Networks By Design Commercial |
$3,748.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,901.95
|
|
|
HC SIGMDSCPY W CNTRL BLEEDING
|
Facility
|
OP
|
$4,868.00
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
906745334
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$211.96 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$973.60
|
| Rate for Payer: Adventist Health Commercial |
$618.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,190.60
|
| Rate for Payer: Cash Price |
$2,190.60
|
| Rate for Payer: Cash Price |
$1,390.95
|
| Rate for Payer: Cash Price |
$2,190.60
|
| Rate for Payer: Cash Price |
$1,390.95
|
| Rate for Payer: Cash Price |
$1,390.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,472.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,894.40
|
| Rate for Payer: Cigna of CA HMO |
$1,978.24
|
| Rate for Payer: Cigna of CA HMO |
$3,115.52
|
| Rate for Payer: Cigna of CA PPO |
$3,602.32
|
| Rate for Payer: Cigna of CA PPO |
$2,287.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,163.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,407.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$4,137.80
|
| Rate for Payer: Galaxy Health WC |
$2,627.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,854.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,920.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,781.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,381.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$211.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$211.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,962.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,091.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$234.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$234.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$973.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$618.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$3,651.00
|
| Rate for Payer: Multiplan Commercial |
$2,318.25
|
| Rate for Payer: Networks By Design Commercial |
$3,164.20
|
| Rate for Payer: Networks By Design Commercial |
$2,009.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Prime Health Services Commercial |
$2,627.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,137.80
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,854.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,920.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,434.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,545.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC SIGMDSCPY W CNTRL BLEEDING
|
Facility
|
IP
|
$4,868.00
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
906745334
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$973.60 |
| Max. Negotiated Rate |
$4,381.20 |
| Rate for Payer: Adventist Health Commercial |
$973.60
|
| Rate for Payer: Cash Price |
$2,190.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,894.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,407.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,947.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,947.20
|
| Rate for Payer: Galaxy Health WC |
$4,137.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,920.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,381.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,091.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,872.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$973.60
|
| Rate for Payer: Multiplan Commercial |
$3,651.00
|
| Rate for Payer: Networks By Design Commercial |
$3,164.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,137.80
|
|
|
HC SIGMDSCPY W DECMPRS
|
Facility
|
IP
|
$6,810.00
|
|
|
Service Code
|
CPT 45337
|
| Hospital Charge Code |
906745337
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,362.00 |
| Max. Negotiated Rate |
$6,129.00 |
| Rate for Payer: Adventist Health Commercial |
$1,362.00
|
| Rate for Payer: Cash Price |
$3,064.50
|
| Rate for Payer: Central Health Plan Commercial |
$5,448.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,767.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,724.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,724.00
|
| Rate for Payer: Galaxy Health WC |
$5,788.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,086.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,129.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,324.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,017.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,362.00
|
| Rate for Payer: Multiplan Commercial |
$5,107.50
|
| Rate for Payer: Networks By Design Commercial |
$4,426.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,788.50
|
|
|
HC SIGMDSCPY W DECMPRS
|
Facility
|
OP
|
$6,810.00
|
|
|
Service Code
|
CPT 45337
|
| Hospital Charge Code |
906745337
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$214.52 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,362.00
|
| Rate for Payer: Adventist Health Commercial |
$864.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$3,064.50
|
| Rate for Payer: Cash Price |
$3,064.50
|
| Rate for Payer: Cash Price |
$1,945.80
|
| Rate for Payer: Cash Price |
$3,064.50
|
| Rate for Payer: Cash Price |
$1,945.80
|
| Rate for Payer: Cash Price |
$1,945.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,459.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,448.00
|
| Rate for Payer: Cigna of CA HMO |
$2,767.36
|
| Rate for Payer: Cigna of CA HMO |
$4,358.40
|
| Rate for Payer: Cigna of CA PPO |
$5,039.40
|
| Rate for Payer: Cigna of CA PPO |
$3,199.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,026.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,767.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$5,788.50
|
| Rate for Payer: Galaxy Health WC |
$3,675.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,594.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,086.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,891.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,129.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$214.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$214.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,745.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,324.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$236.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$236.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,362.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$864.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$5,107.50
|
| Rate for Payer: Multiplan Commercial |
$3,243.00
|
| Rate for Payer: Networks By Design Commercial |
$4,426.50
|
| Rate for Payer: Networks By Design Commercial |
$2,810.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Prime Health Services Commercial |
$3,675.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,788.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,594.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,086.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,405.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,162.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC SIGMDSCPY W ENDO US
|
Facility
|
IP
|
$5,276.00
|
|
|
Service Code
|
CPT 45341
|
| Hospital Charge Code |
906745341
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,055.20 |
| Max. Negotiated Rate |
$4,748.40 |
| Rate for Payer: Adventist Health Commercial |
$1,055.20
|
| Rate for Payer: Cash Price |
$2,374.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,220.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,693.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,110.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,110.40
|
| Rate for Payer: Galaxy Health WC |
$4,484.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,165.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,748.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,350.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,112.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,055.20
|
| Rate for Payer: Multiplan Commercial |
$3,957.00
|
| Rate for Payer: Networks By Design Commercial |
$3,429.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,484.60
|
|
|
HC SIGMDSCPY W ENDO US
|
Facility
|
OP
|
$5,276.00
|
|
|
Service Code
|
CPT 45341
|
| Hospital Charge Code |
906745341
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$297.13 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,055.20
|
| Rate for Payer: Adventist Health Commercial |
$572.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,196.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,374.20
|
| Rate for Payer: Cash Price |
$2,374.20
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cash Price |
$2,374.20
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,291.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,220.80
|
| Rate for Payer: Cigna of CA HMO |
$1,832.96
|
| Rate for Payer: Cigna of CA HMO |
$3,376.64
|
| Rate for Payer: Cigna of CA PPO |
$3,904.24
|
| Rate for Payer: Cigna of CA PPO |
$2,119.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,004.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,693.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,973.53
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: EPIC Health Plan Senior |
$1,315.69
|
| Rate for Payer: Galaxy Health WC |
$4,484.60
|
| Rate for Payer: Galaxy Health WC |
$2,434.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,718.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,165.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,577.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,748.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,961.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$297.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$297.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,818.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,350.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$328.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$328.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,674.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,055.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$572.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$3,957.00
|
| Rate for Payer: Multiplan Commercial |
$2,148.00
|
| Rate for Payer: Networks By Design Commercial |
$3,429.40
|
| Rate for Payer: Networks By Design Commercial |
$1,861.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Prime Health Services Commercial |
$2,434.40
|
| Rate for Payer: Prime Health Services Commercial |
$4,484.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Prime Health Services Medicare |
$1,267.84
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Riverside University Health System MISP |
$1,315.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,718.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,165.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,435.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,638.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,432.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC SIGMDSCPY W FB RMVL
|
Facility
|
OP
|
$5,458.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
906745332
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$161.37 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,091.60
|
| Rate for Payer: Adventist Health Commercial |
$554.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,456.10
|
| Rate for Payer: Cash Price |
$2,456.10
|
| Rate for Payer: Cash Price |
$1,247.85
|
| Rate for Payer: Cash Price |
$2,456.10
|
| Rate for Payer: Cash Price |
$1,247.85
|
| Rate for Payer: Cash Price |
$1,247.85
|
| Rate for Payer: Central Health Plan Commercial |
$2,218.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,366.40
|
| Rate for Payer: Cigna of CA HMO |
$1,774.72
|
| Rate for Payer: Cigna of CA HMO |
$3,493.12
|
| Rate for Payer: Cigna of CA PPO |
$4,038.92
|
| Rate for Payer: Cigna of CA PPO |
$2,052.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,941.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,820.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$4,639.30
|
| Rate for Payer: Galaxy Health WC |
$2,357.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,663.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,274.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,495.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,912.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$161.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$161.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,760.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,465.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$178.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$178.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,091.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$554.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$4,093.50
|
| Rate for Payer: Multiplan Commercial |
$2,079.75
|
| Rate for Payer: Networks By Design Commercial |
$3,547.70
|
| Rate for Payer: Networks By Design Commercial |
$1,802.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Prime Health Services Commercial |
$2,357.05
|
| Rate for Payer: Prime Health Services Commercial |
$4,639.30
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,663.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,274.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,729.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,386.50
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC SIGMDSCPY W FB RMVL
|
Facility
|
IP
|
$5,458.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
906745332
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,091.60 |
| Max. Negotiated Rate |
$4,912.20 |
| Rate for Payer: Adventist Health Commercial |
$1,091.60
|
| Rate for Payer: Cash Price |
$2,456.10
|
| Rate for Payer: Central Health Plan Commercial |
$4,366.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,820.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,183.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,183.20
|
| Rate for Payer: Galaxy Health WC |
$4,639.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,274.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,912.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,465.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,220.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,091.60
|
| Rate for Payer: Multiplan Commercial |
$4,093.50
|
| Rate for Payer: Networks By Design Commercial |
$3,547.70
|
| Rate for Payer: Prime Health Services Commercial |
$4,639.30
|
|
|
HC SIGMDSCPY W TRNS-EN US
|
Facility
|
OP
|
$4,287.00
|
|
|
Service Code
|
CPT 45342
|
| Hospital Charge Code |
906745342
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$341.32 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$857.40
|
| Rate for Payer: Adventist Health Commercial |
$521.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,929.15
|
| Rate for Payer: Cash Price |
$1,929.15
|
| Rate for Payer: Cash Price |
$1,172.70
|
| Rate for Payer: Cash Price |
$1,929.15
|
| Rate for Payer: Cash Price |
$1,172.70
|
| Rate for Payer: Cash Price |
$1,172.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,084.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,429.60
|
| Rate for Payer: Cigna of CA HMO |
$1,667.84
|
| Rate for Payer: Cigna of CA HMO |
$2,743.68
|
| Rate for Payer: Cigna of CA PPO |
$3,172.38
|
| Rate for Payer: Cigna of CA PPO |
$1,928.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,824.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,000.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$3,643.95
|
| Rate for Payer: Galaxy Health WC |
$2,215.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,563.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,572.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,345.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,858.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$341.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$341.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,654.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,722.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$377.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$377.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$857.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$521.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$3,215.25
|
| Rate for Payer: Multiplan Commercial |
$1,954.50
|
| Rate for Payer: Networks By Design Commercial |
$2,786.55
|
| Rate for Payer: Networks By Design Commercial |
$1,693.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Prime Health Services Commercial |
$2,215.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,643.95
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,563.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,572.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,143.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,303.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| 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 HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC SIGMDSCPY W TRNS-EN US
|
Facility
|
IP
|
$4,287.00
|
|
|
Service Code
|
CPT 45342
|
| Hospital Charge Code |
906745342
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$857.40 |
| Max. Negotiated Rate |
$3,858.30 |
| Rate for Payer: Adventist Health Commercial |
$857.40
|
| Rate for Payer: Cash Price |
$1,929.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,429.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,000.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,714.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,714.80
|
| Rate for Payer: Galaxy Health WC |
$3,643.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,572.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,858.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,722.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,529.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$857.40
|
| Rate for Payer: Multiplan Commercial |
$3,215.25
|
| Rate for Payer: Networks By Design Commercial |
$2,786.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,643.95
|
|
