|
HC COIL ULTIPAQ
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
909020103
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$705.90 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,084.55
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,679.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,421.90
|
| Rate for Payer: Blue Shield of California EPN |
$2,289.30
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,535.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Senior |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,535.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,414.10
|
| Rate for Payer: Heritage Provider Network Senior |
$2,414.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1,879.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$705.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC COIL ULTIPAQ
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
909020103
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$705.90 |
| Max. Negotiated Rate |
$2,925.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,679.30
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,640.30
|
| Rate for Payer: Heritage Provider Network Senior |
$2,640.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$705.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$975.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
|
|
HC COLD AGGLUTININS SCREEN
|
Facility
|
IP
|
$192.00
|
|
|
Service Code
|
CPT 86156
|
| Hospital Charge Code |
900904504
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$34.75 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Adventist Health Commercial |
$38.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$131.90
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$129.98
|
| Rate for Payer: Heritage Provider Network Senior |
$129.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.00
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
|
|
HC COLD AGGLUTININS SCREEN
|
Facility
|
OP
|
$192.00
|
|
|
Service Code
|
CPT 86156
|
| Hospital Charge Code |
900904504
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Adventist Health Commercial |
$38.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$19.51
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$131.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.62
|
| Rate for Payer: Blue Shield of California Commercial |
$52.32
|
| Rate for Payer: Blue Shield of California EPN |
$40.90
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$124.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.88
|
| Rate for Payer: Dignity Health Senior |
$8.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$124.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$118.85
|
| Rate for Payer: Heritage Provider Network Senior |
$118.85
|
| Rate for Payer: Humana Medicare |
$8.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$15.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.17
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.07
|
| Rate for Payer: TriValley Medical Group Senior |
$8.07
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.71
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.88
|
| Rate for Payer: Vantage Medical Group Senior |
$8.07
|
|
|
HC COLD AGGLUTININ TITER
|
Facility
|
IP
|
$268.00
|
|
|
Service Code
|
CPT 86157
|
| Hospital Charge Code |
900904451
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.51 |
| Max. Negotiated Rate |
$201.00 |
| Rate for Payer: Adventist Health Commercial |
$53.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$184.12
|
| Rate for Payer: Cash Price |
$120.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$181.44
|
| Rate for Payer: Heritage Provider Network Senior |
$181.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.00
|
| Rate for Payer: Multiplan Commercial |
$201.00
|
|
|
HC COLD AGGLUTININ TITER
|
Facility
|
OP
|
$268.00
|
|
|
Service Code
|
CPT 86157
|
| Hospital Charge Code |
900904451
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.06 |
| Max. Negotiated Rate |
$201.00 |
| Rate for Payer: Adventist Health Commercial |
$53.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$23.47
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$184.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.51
|
| Rate for Payer: Blue Shield of California Commercial |
$63.00
|
| Rate for Payer: Blue Shield of California EPN |
$49.25
|
| Rate for Payer: Cash Price |
$120.60
|
| Rate for Payer: Cash Price |
$120.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$174.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.87
|
| Rate for Payer: Dignity Health Senior |
$8.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$174.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.06
|
| Rate for Payer: Heritage Provider Network Commercial |
$165.89
|
| Rate for Payer: Heritage Provider Network Senior |
$165.89
|
| Rate for Payer: Humana Medicare |
$8.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$15.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.16
|
| Rate for Payer: Multiplan Commercial |
$201.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.06
|
| Rate for Payer: TriValley Medical Group Senior |
$8.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.70
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.87
|
| Rate for Payer: Vantage Medical Group Senior |
$8.06
|
|
|
HC COLLAR MULTI-POST (SOMI, GUILFORD)
|
Facility
|
OP
|
$1,815.00
|
|
|
Service Code
|
CPT L0190
|
| Hospital Charge Code |
905350190
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$363.00 |
| Max. Negotiated Rate |
$12,139.00 |
| Rate for Payer: Adventist Health Commercial |
$363.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$871.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,246.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,542.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$998.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,361.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,139.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,127.12
|
| Rate for Payer: Blue Shield of California EPN |
$1,065.40
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$834.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,542.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,542.75
|
| Rate for Payer: Dignity Health Senior |
$1,542.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,161.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$840.34
|
| Rate for Payer: Heritage Provider Network Senior |
$840.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$405.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$907.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$907.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$907.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$453.75
|
| Rate for Payer: Multiplan Commercial |
$1,361.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$661.75
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$606.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,542.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,542.75
|
|
|
HC COLLAR MULTI-POST (SOMI, GUILFORD)
|
Facility
|
IP
|
$1,815.00
|
|
|
Service Code
|
CPT L0190
|
| Hospital Charge Code |
905350190
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$363.00 |
| Max. Negotiated Rate |
$12,173.00 |
| Rate for Payer: Adventist Health Commercial |
$363.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$871.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,246.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,173.00
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Cash Price |
$816.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$834.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$980.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,228.76
|
| Rate for Payer: Heritage Provider Network Senior |
$7,571.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$907.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$907.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$907.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$453.75
|
| Rate for Payer: Multiplan Commercial |
$1,361.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$661.75
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$606.39
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
OP
|
$258.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
901200035
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$46.70 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$51.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$57.84
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$177.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.08
|
| Rate for Payer: Blue Shield of California Commercial |
$160.22
|
| Rate for Payer: Blue Shield of California EPN |
$151.45
|
| Rate for Payer: Cash Price |
$116.10
|
| Rate for Payer: Cash Price |
$116.10
|
| Rate for Payer: Cash Price |
$116.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$167.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: Dignity Health Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$159.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$159.70
|
| Rate for Payer: Heritage Provider Network Senior |
$159.70
|
| Rate for Payer: Humana Medicare |
$159.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$303.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$188.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.10
|
| Rate for Payer: Multiplan Commercial |
$193.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$159.60
|
| Rate for Payer: TriValley Medical Group Senior |
$159.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC COLLECT BLOOD FROM ESTAB DEVICE
|
Facility
|
IP
|
$258.00
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
901200035
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$46.70 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Adventist Health Commercial |
$51.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$177.25
|
| Rate for Payer: Cash Price |
$116.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$174.67
|
| Rate for Payer: Heritage Provider Network Senior |
$174.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$46.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.50
|
| Rate for Payer: Multiplan Commercial |
$193.50
|
|
|
HC COLONOSCOPY DILATE STRICTURE
|
Facility
|
OP
|
$4,156.00
|
|
|
Service Code
|
CPT 45386
|
| Hospital Charge Code |
906745386
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$831.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,855.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$1,870.20
|
| Rate for Payer: Cash Price |
$1,870.20
|
| Rate for Payer: Cash Price |
$1,870.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,701.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: Dignity Health Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,474.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,572.56
|
| Rate for Payer: Heritage Provider Network Senior |
$1,813.54
|
| Rate for Payer: Humana Medicare |
$1,474.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,243.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,801.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$752.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,739.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,039.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,857.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,857.77
|
| Rate for Payer: Multiplan Commercial |
$3,117.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| 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 COLONOSCOPY DILATE STRICTURE
|
Facility
|
IP
|
$1,769.00
|
|
|
Service Code
|
CPT 45386
|
| Hospital Charge Code |
906745386
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$320.19 |
| Max. Negotiated Rate |
$1,326.75 |
| Rate for Payer: Adventist Health Commercial |
$353.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,215.30
|
| Rate for Payer: Cash Price |
$796.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,197.61
|
| Rate for Payer: Heritage Provider Network Senior |
$1,197.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$320.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$442.25
|
| Rate for Payer: Multiplan Commercial |
$1,326.75
|
|
|
HC COLONOSCOPY DX W WO COLLECT
|
Facility
|
OP
|
$4,567.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
906745378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$913.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,137.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$2,055.15
|
| Rate for Payer: Cash Price |
$2,055.15
|
| Rate for Payer: Cash Price |
$2,055.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,968.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,256.12
|
| Rate for Payer: Dignity Health Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,141.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,826.97
|
| Rate for Payer: Heritage Provider Network Senior |
$1,404.57
|
| Rate for Payer: Humana Medicare |
$1,141.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$460.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,141.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,169.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$826.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,347.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,141.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,438.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,438.83
|
| Rate for Payer: Multiplan Commercial |
$3,425.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| 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 COLONOSCOPY DX W WO COLLECT
|
Facility
|
IP
|
$4,502.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
906745378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$814.86 |
| Max. Negotiated Rate |
$3,376.50 |
| Rate for Payer: Adventist Health Commercial |
$900.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,092.87
|
| Rate for Payer: Cash Price |
$2,025.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,047.85
|
| Rate for Payer: Heritage Provider Network Senior |
$3,047.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$814.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,125.50
|
| Rate for Payer: Multiplan Commercial |
$3,376.50
|
|
|
HC COLONOSCOPY STOMA W BX
|
Facility
|
IP
|
$1,769.00
|
|
|
Service Code
|
CPT 44389
|
| Hospital Charge Code |
906744389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$320.19 |
| Max. Negotiated Rate |
$1,326.75 |
| Rate for Payer: Adventist Health Commercial |
$353.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,215.30
|
| Rate for Payer: Cash Price |
$796.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,197.61
|
| Rate for Payer: Heritage Provider Network Senior |
$1,197.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$320.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$442.25
|
| Rate for Payer: Multiplan Commercial |
$1,326.75
|
|
|
HC COLONOSCOPY STOMA W BX
|
Facility
|
OP
|
$3,793.00
|
|
|
Service Code
|
CPT 44389
|
| Hospital Charge Code |
906744389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$282.27 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$758.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,605.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$1,706.85
|
| Rate for Payer: Cash Price |
$1,706.85
|
| Rate for Payer: Cash Price |
$1,706.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,465.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: Dignity Health Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,474.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,347.87
|
| Rate for Payer: Heritage Provider Network Senior |
$1,813.54
|
| Rate for Payer: Humana Medicare |
$1,474.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$282.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,801.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$686.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,739.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$948.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,857.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,857.77
|
| Rate for Payer: Multiplan Commercial |
$2,844.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| 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 COLONOSCOPY STOMA W RMVL
|
Facility
|
OP
|
$3,793.00
|
|
|
Service Code
|
CPT 44392
|
| Hospital Charge Code |
906744392
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$372.87 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$758.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,605.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$1,706.85
|
| Rate for Payer: Cash Price |
$1,706.85
|
| Rate for Payer: Cash Price |
$1,706.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,465.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: Dignity Health Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,474.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,347.87
|
| Rate for Payer: Heritage Provider Network Senior |
$1,813.54
|
| Rate for Payer: Humana Medicare |
$1,474.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$372.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,801.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$686.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,739.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$948.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,857.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,857.77
|
| Rate for Payer: Multiplan Commercial |
$2,844.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| 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 COLONOSCOPY STOMA W RMVL
|
Facility
|
IP
|
$1,769.00
|
|
|
Service Code
|
CPT 44392
|
| Hospital Charge Code |
906744392
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$320.19 |
| Max. Negotiated Rate |
$1,326.75 |
| Rate for Payer: Adventist Health Commercial |
$353.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,215.30
|
| Rate for Payer: Cash Price |
$796.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,197.61
|
| Rate for Payer: Heritage Provider Network Senior |
$1,197.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$320.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$442.25
|
| Rate for Payer: Multiplan Commercial |
$1,326.75
|
|
|
HC COLONOSCOPY STOMA W STNT PLCMT
|
Facility
|
OP
|
$5,193.00
|
|
|
Service Code
|
CPT 44402
|
| Hospital Charge Code |
906744402
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$13,529.58 |
| Rate for Payer: Adventist Health Commercial |
$1,038.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,567.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,120.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$2,336.85
|
| Rate for Payer: Cash Price |
$2,336.85
|
| Rate for Payer: Cash Price |
$2,336.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,375.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,832.91
|
| Rate for Payer: Dignity Health Senior |
$7,120.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,120.83
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,214.47
|
| Rate for Payer: Heritage Provider Network Senior |
$8,758.62
|
| Rate for Payer: Humana Medicare |
$7,120.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,120.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,529.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$939.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,402.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,298.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,972.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,972.25
|
| Rate for Payer: Multiplan Commercial |
$3,894.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,681.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: Vantage Medical Group Senior |
$7,120.83
|
|
|
HC COLONOSCOPY STOMA W STNT PLCMT
|
Facility
|
IP
|
$5,414.00
|
|
|
Service Code
|
CPT 44402
|
| Hospital Charge Code |
906744402
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$979.93 |
| Max. Negotiated Rate |
$4,060.50 |
| Rate for Payer: Adventist Health Commercial |
$1,082.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,719.42
|
| Rate for Payer: Cash Price |
$2,436.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,665.28
|
| Rate for Payer: Heritage Provider Network Senior |
$3,665.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$979.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,353.50
|
| Rate for Payer: Multiplan Commercial |
$4,060.50
|
|
|
HC COLONOSCOPY STOMA W WO COLLECT
|
Facility
|
IP
|
$1,769.00
|
|
|
Service Code
|
CPT 44388
|
| Hospital Charge Code |
906744388
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$320.19 |
| Max. Negotiated Rate |
$1,326.75 |
| Rate for Payer: Adventist Health Commercial |
$353.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,215.30
|
| Rate for Payer: Cash Price |
$796.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,197.61
|
| Rate for Payer: Heritage Provider Network Senior |
$1,197.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$320.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$442.25
|
| Rate for Payer: Multiplan Commercial |
$1,326.75
|
|
|
HC COLONOSCOPY STOMA W WO COLLECT
|
Facility
|
OP
|
$3,452.00
|
|
|
Service Code
|
CPT 44388
|
| Hospital Charge Code |
906744388
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$249.74 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$690.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,371.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,256.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,141.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$1,553.40
|
| Rate for Payer: Cash Price |
$1,553.40
|
| Rate for Payer: Cash Price |
$1,553.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,243.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,712.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,256.12
|
| Rate for Payer: Dignity Health Senior |
$1,141.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,141.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,136.79
|
| Rate for Payer: Heritage Provider Network Senior |
$1,404.57
|
| Rate for Payer: Humana Medicare |
$1,141.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$249.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,141.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,169.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$624.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,347.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$863.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,438.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,438.83
|
| Rate for Payer: Multiplan Commercial |
$2,589.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| 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 COLONOSCOPY W ABLATION
|
Facility
|
IP
|
$1,769.00
|
|
|
Service Code
|
CPT 44401
|
| Hospital Charge Code |
906744401
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$320.19 |
| Max. Negotiated Rate |
$1,326.75 |
| Rate for Payer: Adventist Health Commercial |
$353.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,215.30
|
| Rate for Payer: Cash Price |
$796.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,197.61
|
| Rate for Payer: Heritage Provider Network Senior |
$1,197.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$320.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$442.25
|
| Rate for Payer: Multiplan Commercial |
$1,326.75
|
|
|
HC COLONOSCOPY W ABLATION
|
Facility
|
OP
|
$2,289.00
|
|
|
Service Code
|
CPT 44401
|
| Hospital Charge Code |
906744401
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$414.31 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$457.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,572.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,621.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,474.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,237.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$1,030.05
|
| Rate for Payer: Cash Price |
$1,030.05
|
| Rate for Payer: Cash Price |
$1,030.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,487.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,211.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,621.86
|
| Rate for Payer: Dignity Health Senior |
$1,474.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,474.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,416.89
|
| Rate for Payer: Heritage Provider Network Senior |
$1,813.54
|
| Rate for Payer: Humana Medicare |
$1,474.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,474.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,801.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$414.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,739.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$572.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,857.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,857.77
|
| Rate for Payer: Multiplan Commercial |
$1,716.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| 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 COLONOSCOPY W ABLATION TUMOR
|
Facility
|
IP
|
$4,163.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
906745388
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$753.50 |
| Max. Negotiated Rate |
$3,122.25 |
| Rate for Payer: Adventist Health Commercial |
$832.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,859.98
|
| Rate for Payer: Cash Price |
$1,873.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,818.35
|
| Rate for Payer: Heritage Provider Network Senior |
$2,818.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$753.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,040.75
|
| Rate for Payer: Multiplan Commercial |
$3,122.25
|
|
