|
HC SIGMDSCPY W TUMOR ABLATION
|
Facility
|
IP
|
$3,544.00
|
|
|
Service Code
|
CPT 45346
|
| Hospital Charge Code |
906745346
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$708.80 |
| Max. Negotiated Rate |
$3,189.60 |
| Rate for Payer: Adventist Health Commercial |
$708.80
|
| Rate for Payer: Cash Price |
$1,594.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,835.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,480.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,417.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,417.60
|
| Rate for Payer: Galaxy Health WC |
$3,012.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,126.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,189.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,250.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,090.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$708.80
|
| Rate for Payer: Multiplan Commercial |
$2,658.00
|
| Rate for Payer: Networks By Design Commercial |
$2,303.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,012.40
|
|
|
HC SIGMDSCPY W TUMOR ABLATION
|
Facility
|
OP
|
$3,544.00
|
|
|
Service Code
|
CPT 45346
|
| Hospital Charge Code |
906745346
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$708.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$708.80
|
| Rate for Payer: Adventist Health Commercial |
$450.00
|
| 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 |
$1,594.80
|
| Rate for Payer: Cash Price |
$1,012.50
|
| Rate for Payer: Cash Price |
$1,012.50
|
| Rate for Payer: Cash Price |
$1,012.50
|
| Rate for Payer: Cash Price |
$1,594.80
|
| Rate for Payer: Cash Price |
$1,594.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,800.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,835.20
|
| Rate for Payer: Cigna of CA HMO |
$2,268.16
|
| Rate for Payer: Cigna of CA HMO |
$1,440.00
|
| Rate for Payer: Cigna of CA PPO |
$2,622.56
|
| Rate for Payer: Cigna of CA PPO |
$1,665.00
|
| 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 |
$2,480.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,575.00
|
| 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 |
$3,012.40
|
| Rate for Payer: Galaxy Health WC |
$1,912.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,126.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,350.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,025.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,189.60
|
| 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) 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 |
$2,250.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,428.75
|
| 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 |
$450.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$708.80
|
| 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 |
$1,687.50
|
| Rate for Payer: Multiplan Commercial |
$2,658.00
|
| Rate for Payer: Networks By Design Commercial |
$2,303.60
|
| Rate for Payer: Networks By Design Commercial |
$1,462.50
|
| 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 |
$3,012.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,912.50
|
| 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 |
$1,350.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,126.40
|
| 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 |
$1,772.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,125.00
|
| 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 TUMOR SNARE RMVL
|
Facility
|
OP
|
$3,894.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
906745338
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$246.54 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$778.80
|
| Rate for Payer: Adventist Health Commercial |
$494.60
|
| 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 |
$1,752.30
|
| Rate for Payer: Cash Price |
$1,752.30
|
| Rate for Payer: Cash Price |
$1,112.85
|
| Rate for Payer: Cash Price |
$1,752.30
|
| Rate for Payer: Cash Price |
$1,112.85
|
| Rate for Payer: Cash Price |
$1,112.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,978.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,115.20
|
| Rate for Payer: Cigna of CA HMO |
$1,582.72
|
| Rate for Payer: Cigna of CA HMO |
$2,492.16
|
| Rate for Payer: Cigna of CA PPO |
$2,881.56
|
| Rate for Payer: Cigna of CA PPO |
$1,830.02
|
| 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 |
$1,731.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,725.80
|
| 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 |
$3,309.90
|
| Rate for Payer: Galaxy Health WC |
$2,102.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,483.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,336.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,225.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,504.60
|
| 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 |
$246.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$246.54
|
| 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 |
$1,570.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,472.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$272.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$272.35
|
| 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 |
$778.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$494.60
|
| 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 |
$2,920.50
|
| Rate for Payer: Multiplan Commercial |
$1,854.75
|
| Rate for Payer: Networks By Design Commercial |
$2,531.10
|
| Rate for Payer: Networks By Design Commercial |
$1,607.45
|
| 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 |
$2,102.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,309.90
|
| 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 |
$1,483.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,336.40
|
| 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 |
$1,947.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,236.50
|
| 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 TUMOR SNARE RMVL
|
Facility
|
IP
|
$3,894.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
906745338
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$778.80 |
| Max. Negotiated Rate |
$3,504.60 |
| Rate for Payer: Adventist Health Commercial |
$778.80
|
| Rate for Payer: Cash Price |
$1,752.30
|
| Rate for Payer: Central Health Plan Commercial |
$3,115.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,725.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,557.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,557.60
|
| Rate for Payer: Galaxy Health WC |
$3,309.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,336.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,504.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,472.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,297.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$778.80
|
| Rate for Payer: Multiplan Commercial |
$2,920.50
|
| Rate for Payer: Networks By Design Commercial |
$2,531.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,309.90
|
|
|
HC SIGMOIDOSCOPY W ENDO MCSL RESC
|
Facility
|
IP
|
$2,332.00
|
|
|
Service Code
|
CPT 45349
|
| Hospital Charge Code |
906745349
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$466.40 |
| Max. Negotiated Rate |
$2,098.80 |
| Rate for Payer: Adventist Health Commercial |
$466.40
|
| Rate for Payer: Cash Price |
$1,049.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,865.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,632.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$932.80
|
| Rate for Payer: EPIC Health Plan Senior |
$932.80
|
| Rate for Payer: Galaxy Health WC |
$1,982.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,399.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,098.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,480.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,375.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$466.40
|
| Rate for Payer: Multiplan Commercial |
$1,749.00
|
| Rate for Payer: Networks By Design Commercial |
$1,515.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,982.20
|
|
|
HC SIGMOIDOSCOPY W ENDO MCSL RESC
|
Facility
|
OP
|
$2,332.00
|
|
|
Service Code
|
CPT 45349
|
| Hospital Charge Code |
906745349
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$466.40 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$466.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,569.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,569.96
|
| 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: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,049.40
|
| Rate for Payer: Cash Price |
$1,049.40
|
| Rate for Payer: Cash Price |
$1,049.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,865.60
|
| Rate for Payer: Cigna of CA HMO |
$1,492.48
|
| Rate for Payer: Cigna of CA PPO |
$1,725.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,926.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,569.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,632.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,890.43
|
| Rate for Payer: EPIC Health Plan Senior |
$3,926.96
|
| Rate for Payer: Galaxy Health WC |
$1,982.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,399.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,098.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,854.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,480.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,997.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$466.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,783.75
|
| Rate for Payer: Multiplan Commercial |
$1,749.00
|
| Rate for Payer: Networks By Design Commercial |
$1,515.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Prime Health Services Commercial |
$1,982.20
|
| Rate for Payer: Prime Health Services Medicare |
$3,784.16
|
| Rate for Payer: Riverside University Health System MISP |
$3,926.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,399.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,283.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,166.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,569.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,569.96
|
|
|
HC SIGMOIDOSCOPY W STENT PLCMNT
|
Facility
|
IP
|
$6,969.00
|
|
|
Service Code
|
CPT 45347
|
| Hospital Charge Code |
906745347
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,393.80 |
| Max. Negotiated Rate |
$6,272.10 |
| Rate for Payer: Adventist Health Commercial |
$1,393.80
|
| Rate for Payer: Cash Price |
$3,136.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,575.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,878.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,787.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,787.60
|
| Rate for Payer: Galaxy Health WC |
$5,923.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,181.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,272.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,425.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,111.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,393.80
|
| Rate for Payer: Multiplan Commercial |
$5,226.75
|
| Rate for Payer: Networks By Design Commercial |
$4,529.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,923.65
|
|
|
HC SIGMOIDOSCOPY W STENT PLCMNT
|
Facility
|
OP
|
$6,969.00
|
|
|
Service Code
|
CPT 45347
|
| Hospital Charge Code |
906745347
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,393.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,393.80
|
| Rate for Payer: Adventist Health Commercial |
$884.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,808.19
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,808.19
|
| 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 |
$11,712.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,808.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,808.19
|
| 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 |
$3,136.05
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cash Price |
$1,990.80
|
| Rate for Payer: Cash Price |
$3,136.05
|
| Rate for Payer: Cash Price |
$3,136.05
|
| Rate for Payer: Central Health Plan Commercial |
$3,539.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,575.20
|
| Rate for Payer: Cigna of CA HMO |
$4,460.16
|
| Rate for Payer: Cigna of CA HMO |
$2,831.36
|
| Rate for Payer: Cigna of CA PPO |
$5,157.06
|
| Rate for Payer: Cigna of CA PPO |
$3,273.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,589.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,589.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,808.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,808.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,878.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,096.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,883.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,883.51
|
| Rate for Payer: EPIC Health Plan Senior |
$8,589.01
|
| Rate for Payer: EPIC Health Plan Senior |
$8,589.01
|
| Rate for Payer: Galaxy Health WC |
$5,923.65
|
| Rate for Payer: Galaxy Health WC |
$3,760.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,181.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,654.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,981.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,272.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,805.43
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,805.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,425.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,809.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,931.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,931.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$884.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,393.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,462.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,462.97
|
| Rate for Payer: Multiplan Commercial |
$3,318.00
|
| Rate for Payer: Multiplan Commercial |
$5,226.75
|
| Rate for Payer: Networks By Design Commercial |
$4,529.85
|
| Rate for Payer: Networks By Design Commercial |
$2,875.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,808.19
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Prime Health Services Commercial |
$5,923.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,760.40
|
| Rate for Payer: Prime Health Services Medicare |
$8,276.68
|
| Rate for Payer: Prime Health Services Medicare |
$8,276.68
|
| Rate for Payer: Riverside University Health System MISP |
$8,589.01
|
| Rate for Payer: Riverside University Health System MISP |
$8,589.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,654.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,181.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,369.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,369.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,484.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,212.00
|
| 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 |
$7,808.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,808.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Vantage Medical Group Senior |
$7,808.19
|
| Rate for Payer: Vantage Medical Group Senior |
$7,808.19
|
|
|
HC SIGMOIDOSCOPY W SUBMUC INJ
|
Facility
|
OP
|
$2,700.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
906745335
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$263.83 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$540.00
|
| Rate for Payer: Adventist Health Commercial |
$277.60
|
| 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 |
$1,215.00
|
| Rate for Payer: Cash Price |
$1,215.00
|
| Rate for Payer: Cash Price |
$624.60
|
| Rate for Payer: Cash Price |
$1,215.00
|
| Rate for Payer: Cash Price |
$624.60
|
| Rate for Payer: Cash Price |
$624.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,110.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,160.00
|
| Rate for Payer: Cigna of CA HMO |
$888.32
|
| Rate for Payer: Cigna of CA HMO |
$1,728.00
|
| Rate for Payer: Cigna of CA PPO |
$1,998.00
|
| Rate for Payer: Cigna of CA PPO |
$1,027.12
|
| 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 |
$971.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,890.00
|
| 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 |
$2,295.00
|
| Rate for Payer: Galaxy Health WC |
$1,179.80
|
| Rate for Payer: Global Benefits Group Commercial |
$832.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,620.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,249.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,430.00
|
| 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 |
$263.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.83
|
| 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 |
$881.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,714.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$291.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$291.44
|
| 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 |
$540.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$277.60
|
| 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 |
$2,025.00
|
| Rate for Payer: Multiplan Commercial |
$1,041.00
|
| Rate for Payer: Networks By Design Commercial |
$1,755.00
|
| Rate for Payer: Networks By Design Commercial |
$902.20
|
| 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 |
$1,179.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,295.00
|
| 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 |
$832.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,620.00
|
| 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 |
$1,350.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$694.00
|
| 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 SIGMOIDOSCOPY W SUBMUC INJ
|
Facility
|
IP
|
$2,700.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
906745335
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$540.00 |
| Max. Negotiated Rate |
$2,430.00 |
| Rate for Payer: Adventist Health Commercial |
$540.00
|
| Rate for Payer: Cash Price |
$1,215.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,160.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,890.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,080.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,080.00
|
| Rate for Payer: Galaxy Health WC |
$2,295.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,620.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,430.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,714.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,593.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$540.00
|
| Rate for Payer: Multiplan Commercial |
$2,025.00
|
| Rate for Payer: Networks By Design Commercial |
$1,755.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,295.00
|
|
|
HC SIGMOIDOSCOPY W SUBMUC INJ
|
Facility
|
OP
|
$2,700.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
906745335
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$263.83 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$540.00
|
| Rate for Payer: Adventist Health Commercial |
$277.60
|
| 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 |
$533.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$533.56
|
| 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 |
$879.99
|
| Rate for Payer: Blue Shield of California Commercial |
$1,711.80
|
| Rate for Payer: Blue Shield of California EPN |
$1,077.30
|
| Rate for Payer: Blue Shield of California EPN |
$553.81
|
| Rate for Payer: Cash Price |
$624.60
|
| Rate for Payer: Cash Price |
$1,215.00
|
| Rate for Payer: Cash Price |
$1,215.00
|
| Rate for Payer: Cash Price |
$1,215.00
|
| Rate for Payer: Cash Price |
$624.60
|
| Rate for Payer: Cash Price |
$624.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,160.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,110.40
|
| Rate for Payer: Cigna of CA HMO |
$888.32
|
| Rate for Payer: Cigna of CA HMO |
$1,728.00
|
| Rate for Payer: Cigna of CA PPO |
$1,027.12
|
| Rate for Payer: Cigna of CA PPO |
$1,998.00
|
| 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 |
$1,890.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$971.60
|
| 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 |
$1,179.80
|
| Rate for Payer: Galaxy Health WC |
$2,295.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,620.00
|
| Rate for Payer: Global Benefits Group Commercial |
$832.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,430.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,249.20
|
| 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 |
$263.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.83
|
| 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 |
$1,714.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$881.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$291.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$291.44
|
| 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 |
$277.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$540.00
|
| 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 |
$1,041.00
|
| Rate for Payer: Multiplan Commercial |
$2,025.00
|
| Rate for Payer: Networks By Design Commercial |
$902.20
|
| Rate for Payer: Networks By Design Commercial |
$1,755.00
|
| 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 |
$1,179.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,295.00
|
| 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 |
$1,620.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$832.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$832.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,620.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,350.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$694.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,350.00
|
| Rate for Payer: United Healthcare All Other HMO |
$694.00
|
| Rate for Payer: United Healthcare HMO Rider |
$694.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,350.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,350.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$694.00
|
| 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 SIGMOIDOSCOPY W SUBMUC INJ
|
Facility
|
IP
|
$2,700.00
|
|
|
Service Code
|
CPT 45335
|
| Hospital Charge Code |
906745335
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$540.00 |
| Max. Negotiated Rate |
$2,430.00 |
| Rate for Payer: Adventist Health Commercial |
$540.00
|
| Rate for Payer: Cash Price |
$1,215.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,160.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,890.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,080.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,080.00
|
| Rate for Payer: Galaxy Health WC |
$2,295.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,620.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,430.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,714.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,593.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$540.00
|
| Rate for Payer: Multiplan Commercial |
$2,025.00
|
| Rate for Payer: Networks By Design Commercial |
$1,755.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,295.00
|
|
|
HC SIGMOIDSCPY FLX DIAG W BND LIG
|
Facility
|
OP
|
$2,200.00
|
|
|
Service Code
|
CPT 45350
|
| Hospital Charge Code |
906745350
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$440.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$440.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,539.08
|
| 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 Medi-Cal |
$1,692.99
|
| 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 HMO/PPO |
$5,523.00
|
| 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: Cash Price |
$990.00
|
| Rate for Payer: Cash Price |
$990.00
|
| Rate for Payer: Cash Price |
$990.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,760.00
|
| Rate for Payer: Cigna of CA HMO |
$1,408.00
|
| Rate for Payer: Cigna of CA PPO |
$1,628.00
|
| 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 Medicare Advantage |
$1,539.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,540.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,539.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1,692.99
|
| Rate for Payer: Galaxy Health WC |
$1,870.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,320.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,980.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,524.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,397.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,154.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$1,650.00
|
| Rate for Payer: Networks By Design Commercial |
$1,430.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Prime Health Services Commercial |
$1,870.00
|
| Rate for Payer: Prime Health Services Medicare |
$1,631.42
|
| Rate for Payer: Riverside University Health System MISP |
$1,692.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,320.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,846.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,100.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,539.08
|
| 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 Senior |
$1,539.08
|
|
|
HC SIGMOIDSCPY FLX DIAG W BND LIG
|
Facility
|
IP
|
$2,200.00
|
|
|
Service Code
|
CPT 45350
|
| Hospital Charge Code |
906745350
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$440.00 |
| Max. Negotiated Rate |
$1,980.00 |
| Rate for Payer: Adventist Health Commercial |
$440.00
|
| Rate for Payer: Cash Price |
$990.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,760.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,540.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$880.00
|
| Rate for Payer: EPIC Health Plan Senior |
$880.00
|
| Rate for Payer: Galaxy Health WC |
$1,870.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,320.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,980.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,397.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,298.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.00
|
| Rate for Payer: Multiplan Commercial |
$1,650.00
|
| Rate for Payer: Networks By Design Commercial |
$1,430.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,870.00
|
|
|
HC SILVERBIRCHE
|
Facility
|
OP
|
$7.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913721
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.48 |
| Max. Negotiated Rate |
$159.88 |
| Rate for Payer: Adventist Health Commercial |
$1.48
|
| Rate for Payer: Adventist Health Commercial |
$1.77
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.88
|
| Rate for Payer: Blue Shield of California Commercial |
$5.59
|
| Rate for Payer: Blue Shield of California Commercial |
$4.66
|
| Rate for Payer: Blue Shield of California EPN |
$3.52
|
| Rate for Payer: Blue Shield of California EPN |
$2.93
|
| Rate for Payer: Cash Price |
$3.99
|
| Rate for Payer: Cash Price |
$3.99
|
| Rate for Payer: Cash Price |
$3.33
|
| Rate for Payer: Cash Price |
$3.33
|
| Rate for Payer: Central Health Plan Commercial |
$5.91
|
| Rate for Payer: Central Health Plan Commercial |
$7.10
|
| Rate for Payer: Cigna of CA HMO |
$5.68
|
| Rate for Payer: Cigna of CA HMO |
$4.73
|
| Rate for Payer: Cigna of CA PPO |
$6.56
|
| Rate for Payer: Cigna of CA PPO |
$5.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.61
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: EPIC Health Plan Senior |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$7.54
|
| Rate for Payer: Galaxy Health WC |
$6.28
|
| Rate for Payer: Global Benefits Group Commercial |
$5.32
|
| Rate for Payer: Global Benefits Group Commercial |
$4.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.65
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$6.65
|
| Rate for Payer: Multiplan Commercial |
$5.54
|
| Rate for Payer: Networks By Design Commercial |
$4.80
|
| Rate for Payer: Networks By Design Commercial |
$5.77
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.22
|
| Rate for Payer: Prime Health Services Commercial |
$7.54
|
| Rate for Payer: Prime Health Services Commercial |
$6.28
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Upland Medical Group Pediatric |
$5.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC SILVERBIRCHE
|
Facility
|
IP
|
$8.87
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913721
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.77 |
| Max. Negotiated Rate |
$7.98 |
| Rate for Payer: Adventist Health Commercial |
$1.77
|
| Rate for Payer: Cash Price |
$3.99
|
| Rate for Payer: Central Health Plan Commercial |
$7.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.55
|
| Rate for Payer: EPIC Health Plan Senior |
$3.55
|
| Rate for Payer: Galaxy Health WC |
$7.54
|
| Rate for Payer: Global Benefits Group Commercial |
$5.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.77
|
| Rate for Payer: Multiplan Commercial |
$6.65
|
| Rate for Payer: Networks By Design Commercial |
$5.77
|
| Rate for Payer: Prime Health Services Commercial |
$7.54
|
|
|
HC SILVERHAWK THROMB CATH
|
Facility
|
IP
|
$4,125.00
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909080046
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$825.00 |
| Max. Negotiated Rate |
$3,712.50 |
| Rate for Payer: Adventist Health Commercial |
$825.00
|
| Rate for Payer: Cash Price |
$1,856.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,300.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,887.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,650.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,650.00
|
| Rate for Payer: Galaxy Health WC |
$3,506.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,475.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,712.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,619.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,433.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$825.00
|
| Rate for Payer: Multiplan Commercial |
$3,093.75
|
| Rate for Payer: Networks By Design Commercial |
$2,681.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,506.25
|
|
|
HC SILVERHAWK THROMB CATH
|
Facility
|
OP
|
$4,125.00
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909080046
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$825.00 |
| Max. Negotiated Rate |
$23,685.15 |
| Rate for Payer: Adventist Health Commercial |
$825.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23,685.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,506.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,268.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,093.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,997.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,399.51
|
| Rate for Payer: Blue Shield of California Commercial |
$2,615.25
|
| Rate for Payer: Blue Shield of California EPN |
$1,645.88
|
| Rate for Payer: Cash Price |
$1,856.25
|
| Rate for Payer: Cash Price |
$1,856.25
|
| Rate for Payer: Central Health Plan Commercial |
$3,300.00
|
| Rate for Payer: Cigna of CA HMO |
$2,640.00
|
| Rate for Payer: Cigna of CA PPO |
$3,052.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,506.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,506.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,506.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,887.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,650.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,650.00
|
| Rate for Payer: Galaxy Health WC |
$3,506.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,475.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,712.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,619.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,497.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,433.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$825.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,887.50
|
| Rate for Payer: Multiplan Commercial |
$3,093.75
|
| Rate for Payer: Networks By Design Commercial |
$2,681.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,506.25
|
| Rate for Payer: Riverside University Health System MISP |
$1,650.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,475.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,475.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,062.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,062.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,062.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,062.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,506.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,506.25
|
| Rate for Payer: Vantage Medical Group Senior |
$3,506.25
|
|
|
HC SIMP REP SUP WND 12.6-20.0 CM
|
Facility
|
IP
|
$2,758.00
|
|
|
Service Code
|
CPT 12005
|
| Hospital Charge Code |
900501023
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$551.60 |
| Max. Negotiated Rate |
$2,482.20 |
| Rate for Payer: Adventist Health Commercial |
$551.60
|
| Rate for Payer: Cash Price |
$1,241.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,206.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,930.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,103.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,103.20
|
| Rate for Payer: Galaxy Health WC |
$2,344.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,654.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,482.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,751.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,627.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$551.60
|
| Rate for Payer: Multiplan Commercial |
$2,068.50
|
| Rate for Payer: Networks By Design Commercial |
$1,792.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,344.30
|
|
|
HC SIMP REP SUP WND 12.6-20.0 CM
|
Facility
|
OP
|
$2,758.00
|
|
|
Service Code
|
CPT 12005
|
| Hospital Charge Code |
900501023
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$305.92 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$551.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Cash Price |
$1,241.10
|
| Rate for Payer: Cash Price |
$1,241.10
|
| Rate for Payer: Cash Price |
$1,241.10
|
| Rate for Payer: Cash Price |
$1,241.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,206.40
|
| Rate for Payer: Cigna of CA HMO |
$1,765.12
|
| Rate for Payer: Cigna of CA PPO |
$2,040.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,930.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$2,344.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,654.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,482.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,751.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$305.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$551.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$2,068.50
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$1,792.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,344.30
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,654.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,379.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,379.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,379.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,379.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC SIMP REP SUP WND 12.6-20.0 CM
|
Facility
|
OP
|
$2,758.00
|
|
|
Service Code
|
CPT 12005
|
| Hospital Charge Code |
900501023
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$305.92 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$1,130.78
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$612.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Cash Price |
$1,241.10
|
| Rate for Payer: Cash Price |
$1,241.10
|
| Rate for Payer: Cash Price |
$1,241.10
|
| Rate for Payer: Cash Price |
$1,241.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,206.40
|
| Rate for Payer: Cigna of CA HMO |
$1,765.12
|
| Rate for Payer: Cigna of CA PPO |
$2,040.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,930.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$2,344.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,654.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,482.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,751.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$305.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$551.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$2,068.50
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$1,792.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,344.30
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,654.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,654.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC SIMP REP SUP WND 12.6-20.0 CM
|
Facility
|
IP
|
$2,758.00
|
|
|
Service Code
|
CPT 12005
|
| Hospital Charge Code |
900501023
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$551.60 |
| Max. Negotiated Rate |
$2,482.20 |
| Rate for Payer: Adventist Health Commercial |
$551.60
|
| Rate for Payer: Cash Price |
$1,241.10
|
| Rate for Payer: Central Health Plan Commercial |
$2,206.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,930.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,103.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,103.20
|
| Rate for Payer: Galaxy Health WC |
$2,344.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,654.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,482.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,751.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,627.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$551.60
|
| Rate for Payer: Multiplan Commercial |
$2,068.50
|
| Rate for Payer: Networks By Design Commercial |
$1,792.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,344.30
|
|
|
HC SIMP REP SUP WND 20.1-30.0 CM
|
Facility
|
OP
|
$3,444.00
|
|
|
Service Code
|
CPT 12006
|
| Hospital Charge Code |
900501408
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$261.73 |
| Max. Negotiated Rate |
$6,587.00 |
| Rate for Payer: Adventist Health Commercial |
$688.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,696.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$522.85
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$808.84
|
| Rate for Payer: Cash Price |
$1,549.80
|
| Rate for Payer: Cash Price |
$1,549.80
|
| Rate for Payer: Cash Price |
$1,549.80
|
| Rate for Payer: Cash Price |
$1,549.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,755.20
|
| Rate for Payer: Cigna of CA HMO |
$2,204.16
|
| Rate for Payer: Cigna of CA PPO |
$2,548.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$575.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$522.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,410.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$862.70
|
| Rate for Payer: EPIC Health Plan Senior |
$575.13
|
| Rate for Payer: Galaxy Health WC |
$2,927.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,066.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,099.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$857.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$522.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,186.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$261.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$562.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$688.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$700.62
|
| Rate for Payer: Multiplan Commercial |
$2,583.00
|
| Rate for Payer: Multiplan WC |
$808.84
|
| Rate for Payer: Networks By Design Commercial |
$2,238.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$522.85
|
| Rate for Payer: Preferred Health Network WC |
$825.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,927.40
|
| Rate for Payer: Prime Health Services Medicare |
$554.22
|
| Rate for Payer: Prime Health Services WC |
$800.59
|
| Rate for Payer: Riverside University Health System MISP |
$575.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,066.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,722.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,722.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,722.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,722.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$522.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$575.13
|
| Rate for Payer: Vantage Medical Group Senior |
$522.85
|
|
|
HC SIMP REP SUP WND 20.1-30.0 CM
|
Facility
|
IP
|
$3,444.00
|
|
|
Service Code
|
CPT 12006
|
| Hospital Charge Code |
900501408
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$688.80 |
| Max. Negotiated Rate |
$3,099.60 |
| Rate for Payer: Adventist Health Commercial |
$688.80
|
| Rate for Payer: Cash Price |
$1,549.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,755.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,410.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,377.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,377.60
|
| Rate for Payer: Galaxy Health WC |
$2,927.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,066.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,099.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,186.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,031.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$688.80
|
| Rate for Payer: Multiplan Commercial |
$2,583.00
|
| Rate for Payer: Networks By Design Commercial |
$2,238.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,927.40
|
|
|
HC SIMP REP SUP WND 2.6 - 5.0 CM
|
Facility
|
IP
|
$2,399.00
|
|
|
Service Code
|
CPT 12013
|
| Hospital Charge Code |
900501026
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$479.80 |
| Max. Negotiated Rate |
$2,159.10 |
| Rate for Payer: Adventist Health Commercial |
$479.80
|
| Rate for Payer: Cash Price |
$1,079.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,919.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,679.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$959.60
|
| Rate for Payer: EPIC Health Plan Senior |
$959.60
|
| Rate for Payer: Galaxy Health WC |
$2,039.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,439.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,159.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,523.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,415.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$479.80
|
| Rate for Payer: Multiplan Commercial |
$1,799.25
|
| Rate for Payer: Networks By Design Commercial |
$1,559.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,039.15
|
|
