|
HC S-ICD GEN&LEAD TEST POST IMPL
|
Facility
|
IP
|
$4,367.00
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
906820024
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$873.40 |
| Max. Negotiated Rate |
$3,930.30 |
| Rate for Payer: Adventist Health Commercial |
$873.40
|
| Rate for Payer: Cash Price |
$2,401.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,493.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,746.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,746.80
|
| Rate for Payer: Galaxy Health WC |
$3,711.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,620.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,930.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,912.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,663.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,703.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$873.40
|
| Rate for Payer: Multiplan Commercial |
$3,275.25
|
| Rate for Payer: Networks By Design Commercial |
$2,838.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,711.95
|
|
|
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 |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$1,004.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,049.86
|
| 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 |
$2,431.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,949.42
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$2,762.10
|
| Rate for Payer: Cash Price |
$2,762.10
|
| Rate for Payer: Cash Price |
$2,762.10
|
| 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: 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: InnovAge PACE Commercial |
$2,511.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,349.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$495.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,108.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,004.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,515.40
|
| Rate for Payer: Molina Healthcare of CA 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 S-ICD GEN&LEAD TEST POST IMPL
|
Facility
|
IP
|
$5,022.00
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
906811490
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1,004.40 |
| Max. Negotiated Rate |
$4,519.80 |
| Rate for Payer: Adventist Health Commercial |
$1,004.40
|
| Rate for Payer: Cash Price |
$2,762.10
|
| Rate for Payer: Central Health Plan Commercial |
$4,017.60
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$3,349.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,913.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,108.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,004.40
|
| 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
|
|
|
HC S-ICD GEN&LEAD TEST POST IMPL
|
Facility
|
OP
|
$4,367.00
|
|
|
Service Code
|
CPT 93644
|
| Hospital Charge Code |
906820024
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$448.30 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$873.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,652.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,711.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,401.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,275.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,114.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,564.74
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$2,401.85
|
| Rate for Payer: Cash Price |
$2,401.85
|
| Rate for Payer: Cash Price |
$2,401.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,493.60
|
| Rate for Payer: Cigna of CA HMO |
$2,794.88
|
| Rate for Payer: Cigna of CA PPO |
$3,231.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,711.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,711.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,711.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,746.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,746.80
|
| Rate for Payer: Galaxy Health WC |
$3,711.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,620.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,930.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$448.30
|
| Rate for Payer: InnovAge PACE Commercial |
$2,183.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,912.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$495.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,703.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$873.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,056.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,056.90
|
| Rate for Payer: Multiplan Commercial |
$3,275.25
|
| Rate for Payer: Networks By Design Commercial |
$2,838.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,711.95
|
| Rate for Payer: Riverside University Health System MISP |
$1,746.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,620.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,620.20
|
| 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 |
$3,711.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,711.95
|
| Rate for Payer: Vantage Medical Group Senior |
$3,711.95
|
|
|
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 |
$53.10 |
| Rate for Payer: Adventist Health Commercial |
$11.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$5.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$35.83
|
| 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 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 HMO/PPO |
$8.17
|
| Rate for Payer: Blue Shield of California Commercial |
$35.81
|
| Rate for Payer: Blue Shield of California EPN |
$23.42
|
| Rate for Payer: Cash Price |
$32.45
|
| Rate for Payer: Cash Price |
$32.45
|
| Rate for Payer: Central Health Plan Commercial |
$47.20
|
| Rate for Payer: Cigna of CA HMO |
$37.76
|
| Rate for Payer: Cigna of CA PPO |
$43.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.44
|
| Rate for Payer: EPIC Health Plan Senior |
$5.51
|
| Rate for Payer: Galaxy Health WC |
$50.15
|
| Rate for Payer: Global Benefits Group Commercial |
$35.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.10
|
| 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) Medicare Advantage |
$5.51
|
| Rate for Payer: InnovAge PACE Commercial |
$8.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.38
|
| Rate for Payer: Multiplan Commercial |
$44.25
|
| Rate for Payer: Networks By Design Commercial |
$38.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$5.51
|
| Rate for Payer: Prime Health Services Commercial |
$50.15
|
| Rate for Payer: Prime Health Services Medicare |
$5.84
|
| Rate for Payer: Riverside University Health System MISP |
$6.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.40
|
| 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 HMO |
$4.46
|
| Rate for Payer: United Healthcare HMO Rider |
$4.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.46
|
| 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 Medi-Cal |
$6.06
|
| Rate for Payer: Vantage Medical Group Senior |
$5.51
|
|
|
HC SICKLE CELL SCREEN
|
Facility
|
IP
|
$59.00
|
|
|
Service Code
|
CPT 85660
|
| Hospital Charge Code |
900910034
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.80 |
| Max. Negotiated Rate |
$53.10 |
| Rate for Payer: Adventist Health Commercial |
$11.80
|
| Rate for Payer: Cash Price |
$32.45
|
| Rate for Payer: Central Health Plan Commercial |
$47.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.60
|
| Rate for Payer: EPIC Health Plan Senior |
$23.60
|
| Rate for Payer: Galaxy Health WC |
$50.15
|
| Rate for Payer: Global Benefits Group Commercial |
$35.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$53.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.80
|
| Rate for Payer: Multiplan Commercial |
$44.25
|
| Rate for Payer: Networks By Design Commercial |
$38.35
|
| Rate for Payer: Prime Health Services Commercial |
$50.15
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
|
OP
|
$2,899.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$94.14 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$579.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,158.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,771.29
|
| Rate for Payer: Blue Shield of California EPN |
$1,156.70
|
| Rate for Payer: Cash Price |
$1,594.45
|
| Rate for Payer: Cash Price |
$1,594.45
|
| Rate for Payer: Cash Price |
$1,594.45
|
| 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 PPO |
$2,145.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$2,464.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,739.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,609.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$94.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,933.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$579.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,174.25
|
| Rate for Payer: Networks By Design Commercial |
$1,884.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Prime Health Services Commercial |
$2,464.15
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,739.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,739.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,449.50
|
| 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 Select/Navigate/Core |
$1,449.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
|
IP
|
$2,899.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$579.80 |
| Max. Negotiated Rate |
$2,609.10 |
| Rate for Payer: Adventist Health Commercial |
$579.80
|
| Rate for Payer: Cash Price |
$1,594.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,319.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,159.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,159.60
|
| Rate for Payer: Galaxy Health WC |
$2,464.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,739.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,609.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,933.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,104.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,794.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$579.80
|
| Rate for Payer: Multiplan Commercial |
$2,174.25
|
| Rate for Payer: Networks By Design Commercial |
$1,884.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,464.15
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
|
IP
|
$2,899.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$579.80 |
| Max. Negotiated Rate |
$2,609.10 |
| Rate for Payer: Adventist Health Commercial |
$579.80
|
| Rate for Payer: Cash Price |
$1,594.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,319.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,159.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,159.60
|
| Rate for Payer: Galaxy Health WC |
$2,464.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,739.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,609.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,933.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,104.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,794.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$579.80
|
| Rate for Payer: Multiplan Commercial |
$2,174.25
|
| Rate for Payer: Networks By Design Commercial |
$1,884.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,464.15
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
|
OP
|
$2,899.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$94.14 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$579.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,158.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,594.45
|
| Rate for Payer: Cash Price |
$1,594.45
|
| Rate for Payer: Cash Price |
$1,594.45
|
| 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 PPO |
$2,145.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$2,464.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,739.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,609.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$94.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,933.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$579.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,174.25
|
| Rate for Payer: Networks By Design Commercial |
$1,884.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Prime Health Services Commercial |
$2,464.15
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,739.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC SIGMDSCPY FLEX W POLYPECTOMY
|
Facility
|
OP
|
$3,396.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
906745333
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$182.51 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$679.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,158.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,867.80
|
| Rate for Payer: Cash Price |
$1,867.80
|
| Rate for Payer: Cash Price |
$1,867.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,716.80
|
| Rate for Payer: Cigna of CA HMO |
$2,173.44
|
| Rate for Payer: Cigna of CA PPO |
$2,513.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$2,886.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,037.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,056.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$182.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,265.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$201.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$679.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,547.00
|
| Rate for Payer: Networks By Design Commercial |
$2,207.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Prime Health Services Commercial |
$2,886.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,037.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC SIGMDSCPY FLEX W POLYPECTOMY
|
Facility
|
IP
|
$3,396.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
906745333
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$679.20 |
| Max. Negotiated Rate |
$3,056.40 |
| Rate for Payer: Adventist Health Commercial |
$679.20
|
| Rate for Payer: Cash Price |
$1,867.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,716.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,358.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,358.40
|
| Rate for Payer: Galaxy Health WC |
$2,886.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,037.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,056.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,265.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,293.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,102.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$679.20
|
| Rate for Payer: Multiplan Commercial |
$2,547.00
|
| Rate for Payer: Networks By Design Commercial |
$2,207.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,886.60
|
|
|
HC SIGMDSCPY W BLLN DILATION
|
Facility
|
IP
|
$2,116.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
906745340
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$423.20 |
| Max. Negotiated Rate |
$1,904.40 |
| Rate for Payer: Adventist Health Commercial |
$423.20
|
| Rate for Payer: Cash Price |
$1,163.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,692.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$846.40
|
| Rate for Payer: EPIC Health Plan Senior |
$846.40
|
| Rate for Payer: Galaxy Health WC |
$1,798.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,269.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,904.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,411.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$806.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,309.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$423.20
|
| Rate for Payer: Multiplan Commercial |
$1,587.00
|
| Rate for Payer: Networks By Design Commercial |
$1,375.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,798.60
|
|
|
HC SIGMDSCPY W BLLN DILATION
|
Facility
|
OP
|
$2,116.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
906745340
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$423.20 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$423.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,498.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,163.80
|
| Rate for Payer: Cash Price |
$1,163.80
|
| Rate for Payer: Cash Price |
$1,163.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,692.80
|
| Rate for Payer: Cigna of CA HMO |
$1,354.24
|
| Rate for Payer: Cigna of CA PPO |
$1,565.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$1,798.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,269.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,904.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$611.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: InnovAge PACE Commercial |
$2,247.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,411.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$675.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$423.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,007.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$1,587.00
|
| Rate for Payer: Networks By Design Commercial |
$1,375.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Prime Health Services Commercial |
$1,798.60
|
| Rate for Payer: Prime Health Services Medicare |
$1,588.03
|
| Rate for Payer: Riverside University Health System MISP |
$1,647.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,269.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
|
OP
|
$3,661.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$124.24 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$732.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,158.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,013.55
|
| Rate for Payer: Cash Price |
$2,013.55
|
| Rate for Payer: Cash Price |
$2,013.55
|
| 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 PPO |
$2,709.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$3,111.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,196.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,294.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$124.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,441.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$732.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,745.75
|
| Rate for Payer: Networks By Design Commercial |
$2,379.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Prime Health Services Commercial |
$3,111.85
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,196.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
|
IP
|
$3,661.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$732.20 |
| Max. Negotiated Rate |
$3,294.90 |
| Rate for Payer: Adventist Health Commercial |
$732.20
|
| Rate for Payer: Cash Price |
$2,013.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,928.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,464.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,464.40
|
| Rate for Payer: Galaxy Health WC |
$3,111.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,196.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,294.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,441.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,394.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,266.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$732.20
|
| Rate for Payer: Multiplan Commercial |
$2,745.75
|
| Rate for Payer: Networks By Design Commercial |
$2,379.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,111.85
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
|
OP
|
$3,661.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$124.24 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$732.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,158.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,236.87
|
| Rate for Payer: Blue Shield of California EPN |
$1,460.74
|
| Rate for Payer: Cash Price |
$2,013.55
|
| Rate for Payer: Cash Price |
$2,013.55
|
| Rate for Payer: Cash Price |
$2,013.55
|
| 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 PPO |
$2,709.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$3,111.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,196.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,294.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$124.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,441.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$732.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,745.75
|
| Rate for Payer: Networks By Design Commercial |
$2,379.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Prime Health Services Commercial |
$3,111.85
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,196.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,196.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,830.50
|
| 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 Select/Navigate/Core |
$1,830.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
|
IP
|
$3,661.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$732.20 |
| Max. Negotiated Rate |
$3,294.90 |
| Rate for Payer: Adventist Health Commercial |
$732.20
|
| Rate for Payer: Cash Price |
$2,013.55
|
| Rate for Payer: Central Health Plan Commercial |
$2,928.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,464.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,464.40
|
| Rate for Payer: Galaxy Health WC |
$3,111.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,196.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,294.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,441.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,394.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,266.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$732.20
|
| Rate for Payer: Multiplan Commercial |
$2,745.75
|
| Rate for Payer: Networks By Design Commercial |
$2,379.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,111.85
|
|
|
HC SIGMDSCPY W CNTRL BLEEDING
|
Facility
|
IP
|
$3,091.00
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
906745334
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$618.20 |
| Max. Negotiated Rate |
$2,781.90 |
| Rate for Payer: Adventist Health Commercial |
$618.20
|
| Rate for Payer: Cash Price |
$1,700.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,472.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,236.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,236.40
|
| Rate for Payer: Galaxy Health WC |
$2,627.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,854.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,781.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,061.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,177.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,913.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$618.20
|
| Rate for Payer: Multiplan Commercial |
$2,318.25
|
| Rate for Payer: Networks By Design Commercial |
$2,009.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,627.35
|
|
|
HC SIGMDSCPY W CNTRL BLEEDING
|
Facility
|
OP
|
$3,091.00
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
906745334
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$211.96 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$618.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,498.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,498.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,700.05
|
| Rate for Payer: Cash Price |
$1,700.05
|
| Rate for Payer: Cash Price |
$1,700.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,472.80
|
| Rate for Payer: Cigna of CA HMO |
$1,978.24
|
| Rate for Payer: Cigna of CA PPO |
$2,287.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,647.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,498.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,022.49
|
| Rate for Payer: EPIC Health Plan Senior |
$1,498.14
|
| Rate for Payer: Galaxy Health WC |
$2,627.35
|
| Rate for Payer: Global Benefits Group Commercial |
$1,854.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,781.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,456.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$211.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,498.14
|
| Rate for Payer: InnovAge PACE Commercial |
$2,247.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,061.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$234.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,498.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$618.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,007.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,007.51
|
| Rate for Payer: Multiplan Commercial |
$2,318.25
|
| Rate for Payer: Networks By Design Commercial |
$2,009.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,498.14
|
| Rate for Payer: Prime Health Services Commercial |
$2,627.35
|
| Rate for Payer: Prime Health Services Medicare |
$1,588.03
|
| Rate for Payer: Riverside University Health System MISP |
$1,647.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,854.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,797.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,498.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,247.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,647.95
|
| Rate for Payer: Vantage Medical Group Senior |
$1,498.14
|
|
|
HC SIGMDSCPY W DECMPRS
|
Facility
|
IP
|
$4,324.00
|
|
|
Service Code
|
CPT 45337
|
| Hospital Charge Code |
906745337
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$864.80 |
| Max. Negotiated Rate |
$3,891.60 |
| Rate for Payer: Adventist Health Commercial |
$864.80
|
| Rate for Payer: Cash Price |
$2,378.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,459.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,729.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,729.60
|
| Rate for Payer: Galaxy Health WC |
$3,675.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,594.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,891.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,884.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,647.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,676.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$864.80
|
| Rate for Payer: Multiplan Commercial |
$3,243.00
|
| Rate for Payer: Networks By Design Commercial |
$2,810.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,675.40
|
|
|
HC SIGMDSCPY W DECMPRS
|
Facility
|
OP
|
$4,324.00
|
|
|
Service Code
|
CPT 45337
|
| Hospital Charge Code |
906745337
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$214.52 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$864.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,158.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$2,378.20
|
| Rate for Payer: Cash Price |
$2,378.20
|
| Rate for Payer: Cash Price |
$2,378.20
|
| Rate for Payer: Central Health Plan Commercial |
$3,459.20
|
| Rate for Payer: Cigna of CA HMO |
$2,767.36
|
| Rate for Payer: Cigna of CA PPO |
$3,199.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$3,675.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,594.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,891.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$214.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,884.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$236.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$864.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$3,243.00
|
| Rate for Payer: Networks By Design Commercial |
$2,810.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Prime Health Services Commercial |
$3,675.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,594.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC SIGMDSCPY W ENDO US
|
Facility
|
OP
|
$2,864.00
|
|
|
Service Code
|
CPT 45341
|
| Hospital Charge Code |
906745341
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$297.13 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$572.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,158.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,158.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,291.20
|
| Rate for Payer: Cigna of CA HMO |
$1,832.96
|
| Rate for Payer: Cigna of CA PPO |
$2,119.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,274.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,158.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,563.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1,158.42
|
| Rate for Payer: Galaxy Health WC |
$2,434.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,718.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,577.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,899.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$297.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,158.42
|
| Rate for Payer: InnovAge PACE Commercial |
$1,737.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,910.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,158.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$572.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,552.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,552.28
|
| Rate for Payer: Multiplan Commercial |
$2,148.00
|
| Rate for Payer: Networks By Design Commercial |
$1,861.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,158.42
|
| Rate for Payer: Prime Health Services Commercial |
$2,434.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,227.93
|
| Rate for Payer: Riverside University Health System MISP |
$1,274.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,718.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,158.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,737.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,274.26
|
| Rate for Payer: Vantage Medical Group Senior |
$1,158.42
|
|
|
HC SIGMDSCPY W ENDO US
|
Facility
|
IP
|
$2,864.00
|
|
|
Service Code
|
CPT 45341
|
| Hospital Charge Code |
906745341
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$572.80 |
| Max. Negotiated Rate |
$2,577.60 |
| Rate for Payer: Adventist Health Commercial |
$572.80
|
| Rate for Payer: Cash Price |
$1,575.20
|
| Rate for Payer: Central Health Plan Commercial |
$2,291.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,145.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,145.60
|
| Rate for Payer: Galaxy Health WC |
$2,434.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,718.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,577.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,910.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,091.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,772.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$572.80
|
| Rate for Payer: Multiplan Commercial |
$2,148.00
|
| Rate for Payer: Networks By Design Commercial |
$1,861.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,434.40
|
|
|
HC SIGMDSCPY W FB RMVL
|
Facility
|
IP
|
$2,773.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
906745332
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$554.60 |
| Max. Negotiated Rate |
$2,495.70 |
| Rate for Payer: Adventist Health Commercial |
$554.60
|
| Rate for Payer: Cash Price |
$1,525.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,218.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,109.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,109.20
|
| Rate for Payer: Galaxy Health WC |
$2,357.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,663.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,495.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,849.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,056.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,716.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$554.60
|
| Rate for Payer: Multiplan Commercial |
$2,079.75
|
| Rate for Payer: Networks By Design Commercial |
$1,802.45
|
| Rate for Payer: Prime Health Services Commercial |
$2,357.05
|
|
