|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
OP
|
$3,411.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$682.20 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,046.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$1,534.95
|
| Rate for Payer: Cash Price |
$1,534.95
|
| Rate for Payer: Cash Price |
$1,534.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,728.80
|
| Rate for Payer: Cigna of CA PPO |
$2,524.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$2,899.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,046.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,069.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,558.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$1,884.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,275.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$682.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$2,558.25
|
| Rate for Payer: Networks By Design Commercial |
$2,217.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,899.35
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,256.12
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,046.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
IP
|
$5,777.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,155.40 |
| Max. Negotiated Rate |
$5,199.30 |
| Rate for Payer: Cash Price |
$2,599.65
|
| Rate for Payer: Central Health Plan Commercial |
$4,621.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,310.80
|
| Rate for Payer: Galaxy Health WC |
$4,910.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,466.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,199.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,853.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,155.40
|
| Rate for Payer: Multiplan Commercial |
$4,332.75
|
| Rate for Payer: Networks By Design Commercial |
$3,755.05
|
| Rate for Payer: Prime Health Services Commercial |
$4,910.45
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
OP
|
$3,411.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$682.20 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,046.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,145.52
|
| Rate for Payer: Blue Shield of California EPN |
$1,667.98
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$1,534.95
|
| Rate for Payer: Cash Price |
$1,534.95
|
| Rate for Payer: Cash Price |
$1,534.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,728.80
|
| Rate for Payer: Cigna of CA HMO |
$2,183.04
|
| Rate for Payer: Cigna of CA PPO |
$2,524.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$2,899.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,046.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,069.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,558.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$1,884.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,275.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$682.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$2,558.25
|
| Rate for Payer: Networks By Design Commercial |
$2,217.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,899.35
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,046.60
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,046.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,046.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,705.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,705.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,705.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,705.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
IP
|
$5,777.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,155.40 |
| Max. Negotiated Rate |
$5,199.30 |
| Rate for Payer: Cash Price |
$2,599.65
|
| Rate for Payer: Central Health Plan Commercial |
$4,621.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,310.80
|
| Rate for Payer: Galaxy Health WC |
$4,910.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,466.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,199.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,853.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,155.40
|
| Rate for Payer: Multiplan Commercial |
$4,332.75
|
| Rate for Payer: Networks By Design Commercial |
$3,755.05
|
| Rate for Payer: Prime Health Services Commercial |
$4,910.45
|
|
|
HC SIGMDSCPY FLEX W POLYPECTOMY
|
Facility
OP
|
$3,995.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
906745333
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$799.00 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,397.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$1,797.75
|
| Rate for Payer: Cash Price |
$1,797.75
|
| Rate for Payer: Cash Price |
$1,797.75
|
| Rate for Payer: Central Health Plan Commercial |
$3,196.00
|
| Rate for Payer: Cigna of CA PPO |
$2,956.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$3,395.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,397.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,595.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,996.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$1,884.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,664.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$799.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$2,996.25
|
| Rate for Payer: Networks By Design Commercial |
$2,596.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,395.75
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,256.12
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,397.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC SIGMDSCPY FLEX W POLYPECTOMY
|
Facility
IP
|
$6,292.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
906745333
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,258.40 |
| Max. Negotiated Rate |
$5,662.80 |
| Rate for Payer: Cash Price |
$2,831.40
|
| Rate for Payer: Central Health Plan Commercial |
$5,033.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,516.80
|
| Rate for Payer: Galaxy Health WC |
$5,348.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,775.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,662.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,196.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,258.40
|
| Rate for Payer: Multiplan Commercial |
$4,719.00
|
| Rate for Payer: Networks By Design Commercial |
$4,089.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,348.20
|
|
|
HC SIGMDSCPY W BLLN DILATION
|
Facility
OP
|
$2,490.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
906745340
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$498.00 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,494.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$1,120.50
|
| Rate for Payer: Cash Price |
$1,120.50
|
| Rate for Payer: Cash Price |
$1,120.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,992.00
|
| Rate for Payer: Cigna of CA PPO |
$1,842.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$2,116.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,494.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,241.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,867.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: IEHP Medicare Advantage |
$1,474.42
|
| Rate for Payer: Innovage PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,660.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$498.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$1,867.50
|
| Rate for Payer: Networks By Design Commercial |
$1,618.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,116.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,621.86
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,494.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC SIGMDSCPY W BLLN DILATION
|
Facility
IP
|
$3,922.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
906745340
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$784.40 |
| Max. Negotiated Rate |
$3,529.80 |
| Rate for Payer: Cash Price |
$1,764.90
|
| Rate for Payer: Central Health Plan Commercial |
$3,137.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,568.80
|
| Rate for Payer: Galaxy Health WC |
$3,333.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,353.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,529.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,615.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$784.40
|
| Rate for Payer: Multiplan Commercial |
$2,941.50
|
| Rate for Payer: Networks By Design Commercial |
$2,549.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,333.70
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
OP
|
$4,307.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$861.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,584.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,709.10
|
| Rate for Payer: Blue Shield of California EPN |
$2,106.12
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$1,938.15
|
| Rate for Payer: Cash Price |
$1,938.15
|
| Rate for Payer: Cash Price |
$1,938.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,445.60
|
| Rate for Payer: Cigna of CA HMO |
$2,756.48
|
| Rate for Payer: Cigna of CA PPO |
$3,187.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$3,660.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,584.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,876.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,230.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$1,884.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,872.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$861.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$3,230.25
|
| Rate for Payer: Networks By Design Commercial |
$2,799.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,660.95
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,584.20
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,584.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,584.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,153.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,153.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,153.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,153.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
IP
|
$6,785.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$1,357.00 |
| Max. Negotiated Rate |
$6,106.50 |
| Rate for Payer: Cash Price |
$3,053.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,428.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,714.00
|
| Rate for Payer: Galaxy Health WC |
$5,767.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,071.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,106.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,525.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,357.00
|
| Rate for Payer: Multiplan Commercial |
$5,088.75
|
| Rate for Payer: Networks By Design Commercial |
$4,410.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,767.25
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
OP
|
$4,307.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$861.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,584.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$1,938.15
|
| Rate for Payer: Cash Price |
$1,938.15
|
| Rate for Payer: Cash Price |
$1,938.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,445.60
|
| Rate for Payer: Cigna of CA PPO |
$3,187.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$3,660.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,584.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,876.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,230.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$1,884.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,872.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$861.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$3,230.25
|
| Rate for Payer: Networks By Design Commercial |
$2,799.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,660.95
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,256.12
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,584.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
IP
|
$6,785.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,357.00 |
| Max. Negotiated Rate |
$6,106.50 |
| Rate for Payer: Cash Price |
$3,053.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,428.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,714.00
|
| Rate for Payer: Galaxy Health WC |
$5,767.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,071.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,106.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,525.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,357.00
|
| Rate for Payer: Multiplan Commercial |
$5,088.75
|
| Rate for Payer: Networks By Design Commercial |
$4,410.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,767.25
|
|
|
HC SIGMDSCPY W CNTRL BLEEDING
|
Facility
IP
|
$5,727.00
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
906745334
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,145.40 |
| Max. Negotiated Rate |
$5,154.30 |
| Rate for Payer: Cash Price |
$2,577.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,581.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,290.80
|
| Rate for Payer: Galaxy Health WC |
$4,867.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,436.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,154.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,819.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,145.40
|
| Rate for Payer: Multiplan Commercial |
$4,295.25
|
| Rate for Payer: Networks By Design Commercial |
$3,722.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,867.95
|
|
|
HC SIGMDSCPY W CNTRL BLEEDING
|
Facility
OP
|
$3,637.00
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
906745334
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$727.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,182.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$1,636.65
|
| Rate for Payer: Cash Price |
$1,636.65
|
| Rate for Payer: Cash Price |
$1,636.65
|
| Rate for Payer: Central Health Plan Commercial |
$2,909.60
|
| Rate for Payer: Cigna of CA PPO |
$2,691.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$3,091.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,182.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,273.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,727.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: IEHP Medicare Advantage |
$1,474.42
|
| Rate for Payer: Innovage PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,425.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$727.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$2,727.75
|
| Rate for Payer: Networks By Design Commercial |
$2,364.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,091.45
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,621.86
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,182.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC SIGMDSCPY W DECMPRS
|
Facility
OP
|
$5,087.00
|
|
|
Service Code
|
CPT 45337
|
| Hospital Charge Code |
906745337
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,017.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,052.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$2,289.15
|
| Rate for Payer: Cash Price |
$2,289.15
|
| Rate for Payer: Cash Price |
$2,289.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,069.60
|
| Rate for Payer: Cigna of CA PPO |
$3,764.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$4,323.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,052.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,578.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,815.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$1,884.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,393.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,017.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$3,815.25
|
| Rate for Payer: Networks By Design Commercial |
$3,306.55
|
| Rate for Payer: Prime Health Services Commercial |
$4,323.95
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,256.12
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,052.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC SIGMDSCPY W DECMPRS
|
Facility
IP
|
$8,012.00
|
|
|
Service Code
|
CPT 45337
|
| Hospital Charge Code |
906745337
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,602.40 |
| Max. Negotiated Rate |
$7,210.80 |
| Rate for Payer: Cash Price |
$3,605.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,409.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,204.80
|
| Rate for Payer: Galaxy Health WC |
$6,810.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,807.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,210.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,344.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,602.40
|
| Rate for Payer: Multiplan Commercial |
$6,009.00
|
| Rate for Payer: Networks By Design Commercial |
$5,207.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,810.20
|
|
|
HC SIGMDSCPY W ENDO US
|
Facility
IP
|
$6,207.00
|
|
|
Service Code
|
CPT 45341
|
| Hospital Charge Code |
906745341
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,241.40 |
| Max. Negotiated Rate |
$5,586.30 |
| Rate for Payer: Cash Price |
$2,793.15
|
| Rate for Payer: Central Health Plan Commercial |
$4,965.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,482.80
|
| Rate for Payer: Galaxy Health WC |
$5,275.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,724.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,586.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,140.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,241.40
|
| Rate for Payer: Multiplan Commercial |
$4,655.25
|
| Rate for Payer: Networks By Design Commercial |
$4,034.55
|
| Rate for Payer: Prime Health Services Commercial |
$5,275.95
|
|
|
HC SIGMDSCPY W ENDO US
|
Facility
OP
|
$3,369.00
|
|
|
Service Code
|
CPT 45341
|
| Hospital Charge Code |
906745341
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$673.80 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,141.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,021.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,141.93
|
| Rate for Payer: Cash Price |
$1,516.05
|
| Rate for Payer: Cash Price |
$1,516.05
|
| Rate for Payer: Cash Price |
$1,516.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,695.20
|
| Rate for Payer: Cigna of CA PPO |
$2,493.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,541.61
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,141.93
|
| Rate for Payer: Galaxy Health WC |
$2,863.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,021.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,032.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,526.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,872.77
|
| Rate for Payer: IEHP medi-cal |
$1,884.18
|
| Rate for Payer: IEHP Medicare Advantage |
$1,141.93
|
| Rate for Payer: Innovage PACE Commercial |
$1,712.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,247.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,141.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$673.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,530.19
|
| Rate for Payer: Multiplan Commercial |
$2,526.75
|
| Rate for Payer: Networks By Design Commercial |
$2,189.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,863.65
|
| Rate for Payer: Prime Health Services Medicare |
$1,210.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,256.12
|
| Rate for Payer: Riverside University Health MISP |
$1,256.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,021.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,370.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Vantage Medical Group Senior |
$1,141.93
|
|
|
HC SIGMDSCPY W FB RMVL
|
Facility
OP
|
$3,262.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
906745332
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$652.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,957.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$1,467.90
|
| Rate for Payer: Cash Price |
$1,467.90
|
| Rate for Payer: Cash Price |
$1,467.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,609.60
|
| Rate for Payer: Cigna of CA PPO |
$2,413.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$2,772.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,957.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,935.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,446.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: IEHP Medicare Advantage |
$1,474.42
|
| Rate for Payer: Innovage PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,175.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$652.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$2,446.50
|
| Rate for Payer: Networks By Design Commercial |
$2,120.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,772.70
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,621.86
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,957.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC SIGMDSCPY W FB RMVL
|
Facility
IP
|
$6,421.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
906745332
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,284.20 |
| Max. Negotiated Rate |
$5,778.90 |
| Rate for Payer: Cash Price |
$2,889.45
|
| Rate for Payer: Central Health Plan Commercial |
$5,136.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,568.40
|
| Rate for Payer: Galaxy Health WC |
$5,457.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,852.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,778.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,282.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,284.20
|
| Rate for Payer: Multiplan Commercial |
$4,815.75
|
| Rate for Payer: Networks By Design Commercial |
$4,173.65
|
| Rate for Payer: Prime Health Services Commercial |
$5,457.85
|
|
|
HC SIGMDSCPY W TRNS-EN US
|
Facility
IP
|
$5,043.00
|
|
|
Service Code
|
CPT 45342
|
| Hospital Charge Code |
906745342
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,008.60 |
| Max. Negotiated Rate |
$4,538.70 |
| Rate for Payer: Cash Price |
$2,269.35
|
| Rate for Payer: Central Health Plan Commercial |
$4,034.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,017.20
|
| Rate for Payer: Galaxy Health WC |
$4,286.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,025.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,538.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,363.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,008.60
|
| Rate for Payer: Multiplan Commercial |
$3,782.25
|
| Rate for Payer: Networks By Design Commercial |
$3,277.95
|
| Rate for Payer: Prime Health Services Commercial |
$4,286.55
|
|
|
HC SIGMDSCPY W TRNS-EN US
|
Facility
OP
|
$3,066.00
|
|
|
Service Code
|
CPT 45342
|
| Hospital Charge Code |
906745342
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$613.20 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,839.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$1,379.70
|
| Rate for Payer: Cash Price |
$1,379.70
|
| Rate for Payer: Cash Price |
$1,379.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,452.80
|
| Rate for Payer: Cigna of CA PPO |
$2,268.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$2,606.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,839.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,759.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,299.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: IEHP Medicare Advantage |
$1,474.42
|
| Rate for Payer: Innovage PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,045.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$613.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$2,299.50
|
| Rate for Payer: Networks By Design Commercial |
$1,992.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,606.10
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,621.86
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,839.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC SIGMDSCPY W TUMOR ABLATION
|
Facility
IP
|
$4,169.00
|
|
|
Service Code
|
CPT 45346
|
| Hospital Charge Code |
906745346
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$833.80 |
| Max. Negotiated Rate |
$3,752.10 |
| Rate for Payer: Cash Price |
$1,876.05
|
| Rate for Payer: Central Health Plan Commercial |
$3,335.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,667.60
|
| Rate for Payer: Galaxy Health WC |
$3,543.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,501.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,752.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,780.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$833.80
|
| Rate for Payer: Multiplan Commercial |
$3,126.75
|
| Rate for Payer: Networks By Design Commercial |
$2,709.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,543.65
|
|
|
HC SIGMDSCPY W TUMOR ABLATION
|
Facility
OP
|
$2,647.00
|
|
|
Service Code
|
CPT 45346
|
| Hospital Charge Code |
906745346
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$529.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,474.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$1,588.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$1,474.42
|
| Rate for Payer: Cash Price |
$1,191.15
|
| Rate for Payer: Cash Price |
$1,191.15
|
| Rate for Payer: Cash Price |
$1,191.15
|
| Rate for Payer: Central Health Plan Commercial |
$2,117.60
|
| Rate for Payer: Cigna of CA PPO |
$1,958.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,990.47
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,474.42
|
| Rate for Payer: Galaxy Health WC |
$2,249.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,588.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,382.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,985.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,418.05
|
| Rate for Payer: IEHP medi-cal |
$2,432.79
|
| Rate for Payer: IEHP Medicare Advantage |
$1,474.42
|
| Rate for Payer: Innovage PACE Commercial |
$2,211.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,765.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,474.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$529.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,975.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,975.72
|
| Rate for Payer: Multiplan Commercial |
$1,985.25
|
| Rate for Payer: Networks By Design Commercial |
$1,720.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,249.95
|
| Rate for Payer: Prime Health Services Medicare |
$1,562.89
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,621.86
|
| Rate for Payer: Riverside University Health MISP |
$1,621.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,588.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,769.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,474.42
|
|
|
HC SIGMDSCPY W TUMOR SNARE RMVL
|
Facility
IP
|
$4,581.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
906745338
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$916.20 |
| Max. Negotiated Rate |
$4,122.90 |
| Rate for Payer: Cash Price |
$2,061.45
|
| Rate for Payer: Central Health Plan Commercial |
$3,664.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,832.40
|
| Rate for Payer: Galaxy Health WC |
$3,893.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,748.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,122.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,055.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$916.20
|
| Rate for Payer: Multiplan Commercial |
$3,435.75
|
| Rate for Payer: Networks By Design Commercial |
$2,977.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,893.85
|
|
