|
HC COLONOSCOPY W BX
|
Facility
IP
|
$4,947.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
906745380
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$895.41 |
| Max. Negotiated Rate |
$3,710.25 |
| Rate for Payer: Adventist Health Commercial |
$989.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,398.59
|
| Rate for Payer: Cash Price |
$2,226.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,349.12
|
| Rate for Payer: Heritage Provider Network Senior |
$3,349.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$895.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,236.75
|
| Rate for Payer: Multiplan Commercial |
$3,710.25
|
|
|
HC COLONOSCOPY W BX
|
Facility
OP
|
$4,567.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
906745380
|
|
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: 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 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 |
$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 |
$2,826.97
|
| Rate for Payer: Heritage Provider Network Senior |
$1,813.54
|
| Rate for Payer: Humana Medicare |
$1,474.42
|
| Rate for Payer: IEHP Medi-Cal |
$515.16
|
| Rate for Payer: 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 |
$826.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,739.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,141.75
|
| 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 |
$3,425.25
|
| 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 |
$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 CNTRL BLEEDING
|
Facility
IP
|
$4,898.00
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
906745382
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$886.54 |
| Max. Negotiated Rate |
$3,673.50 |
| Rate for Payer: Adventist Health Commercial |
$979.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,364.93
|
| Rate for Payer: Cash Price |
$2,204.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,315.95
|
| Rate for Payer: Heritage Provider Network Senior |
$3,315.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$886.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,224.50
|
| Rate for Payer: Multiplan Commercial |
$3,673.50
|
|
|
HC COLONOSCOPY W CNTRL BLEEDING
|
Facility
OP
|
$4,522.00
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
906745382
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$904.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,106.61
|
| 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 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 |
$2,034.90
|
| Rate for Payer: Cash Price |
$2,034.90
|
| Rate for Payer: Cash Price |
$2,034.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,939.30
|
| 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 |
$2,799.12
|
| Rate for Payer: Heritage Provider Network Senior |
$1,813.54
|
| Rate for Payer: Humana Medicare |
$1,474.42
|
| Rate for Payer: IEHP Medi-Cal |
$648.16
|
| Rate for Payer: 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 |
$818.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,739.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,130.50
|
| 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 |
$3,391.50
|
| 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/CNTRL BLEEDING
|
Facility
OP
|
$1,988.00
|
|
|
Service Code
|
CPT 44391
|
| Hospital Charge Code |
906744391
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$359.83 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$397.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,365.76
|
| 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 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 |
$894.60
|
| Rate for Payer: Cash Price |
$894.60
|
| Rate for Payer: Cash Price |
$894.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,292.20
|
| 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 |
$1,230.57
|
| Rate for Payer: Heritage Provider Network Senior |
$1,813.54
|
| Rate for Payer: Humana Medicare |
$1,474.42
|
| Rate for Payer: IEHP Medi-Cal |
$361.25
|
| Rate for Payer: 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 |
$359.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,739.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$497.00
|
| 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 |
$1,491.00
|
| 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 W/CNTRL BLEEDING
|
Facility
IP
|
$1,769.00
|
|
|
Service Code
|
CPT 44391
|
| Hospital Charge Code |
906744391
|
|
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 ENDO MCSL RESCT
|
Facility
OP
|
$2,606.00
|
|
|
Service Code
|
CPT 45390
|
| Hospital Charge Code |
906745390
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$521.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,790.32
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,262.22
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,508.15
|
| 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 |
$1,172.70
|
| Rate for Payer: Cash Price |
$1,172.70
|
| Rate for Payer: Cash Price |
$1,172.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,693.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,262.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,858.96
|
| Rate for Payer: Dignity Health Senior |
$3,508.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,508.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,613.11
|
| Rate for Payer: Heritage Provider Network Senior |
$4,315.02
|
| Rate for Payer: Humana Medicare |
$3,508.15
|
| Rate for Payer: IEHP Medicare Advantage |
$3,508.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6,665.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$471.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,139.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$651.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,420.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,420.27
|
| Rate for Payer: Multiplan Commercial |
$1,954.50
|
| 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 |
$5,262.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,858.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,508.15
|
|
|
HC COLONOSCOPY W ENDO MCSL RESCT
|
Facility
IP
|
$2,606.00
|
|
|
Service Code
|
CPT 45390
|
| Hospital Charge Code |
906745390
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$471.69 |
| Max. Negotiated Rate |
$1,954.50 |
| Rate for Payer: Adventist Health Commercial |
$521.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,790.32
|
| Rate for Payer: Cash Price |
$1,172.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,764.26
|
| Rate for Payer: Heritage Provider Network Senior |
$1,764.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$471.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$651.50
|
| Rate for Payer: Multiplan Commercial |
$1,954.50
|
|
|
HC COLONOSCOPY W/ENDOS US
|
Facility
OP
|
$4,143.00
|
|
|
Service Code
|
CPT 45392
|
| Hospital Charge Code |
906745392
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$335.38 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$828.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,846.24
|
| 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 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 |
$1,864.35
|
| Rate for Payer: Cash Price |
$1,864.35
|
| Rate for Payer: Cash Price |
$1,864.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,692.95
|
| 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 |
$2,564.52
|
| Rate for Payer: Heritage Provider Network Senior |
$1,813.54
|
| Rate for Payer: Humana Medicare |
$1,474.42
|
| Rate for Payer: IEHP Medi-Cal |
$335.38
|
| Rate for Payer: 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 |
$749.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,739.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,035.75
|
| 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 |
$3,107.25
|
| 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 |
$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/ENDOS US
|
Facility
IP
|
$4,360.00
|
|
|
Service Code
|
CPT 45392
|
| Hospital Charge Code |
906745392
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$789.16 |
| Max. Negotiated Rate |
$3,270.00 |
| Rate for Payer: Adventist Health Commercial |
$872.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,995.32
|
| Rate for Payer: Cash Price |
$1,962.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,951.72
|
| Rate for Payer: Heritage Provider Network Senior |
$2,951.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$789.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,090.00
|
| Rate for Payer: Multiplan Commercial |
$3,270.00
|
|
|
HC COLONOSCOPY W ENDOS US EXAM
|
Facility
OP
|
$4,156.00
|
|
|
Service Code
|
CPT 45391
|
| Hospital Charge Code |
906745391
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$264.65 |
| 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: 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 HMO/PPO |
$4,547.00
|
| 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 |
$1,870.20
|
| 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: IEHP Medi-Cal |
$264.65
|
| Rate for Payer: 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 W ENDOS US EXAM
|
Facility
IP
|
$4,371.00
|
|
|
Service Code
|
CPT 45391
|
| Hospital Charge Code |
906745391
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$791.15 |
| Max. Negotiated Rate |
$3,278.25 |
| Rate for Payer: Adventist Health Commercial |
$874.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,002.88
|
| Rate for Payer: Cash Price |
$1,966.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,959.17
|
| Rate for Payer: Heritage Provider Network Senior |
$2,959.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$791.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,092.75
|
| Rate for Payer: Multiplan Commercial |
$3,278.25
|
|
|
HC COLONOSCOPY W FB REMOVAL
|
Facility
OP
|
$4,156.00
|
|
|
Service Code
|
CPT 45379
|
| Hospital Charge Code |
906745379
|
|
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: 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 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 |
$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: IEHP Medi-Cal |
$573.24
|
| Rate for Payer: 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 W FB REMOVAL
|
Facility
IP
|
$2,655.00
|
|
|
Service Code
|
CPT 45379
|
| Hospital Charge Code |
906745379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$480.56 |
| Max. Negotiated Rate |
$1,991.25 |
| Rate for Payer: Adventist Health Commercial |
$531.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,823.98
|
| Rate for Payer: Cash Price |
$1,194.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,797.44
|
| Rate for Payer: Heritage Provider Network Senior |
$1,797.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$480.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$663.75
|
| Rate for Payer: Multiplan Commercial |
$1,991.25
|
|
|
HC COLONOSCOPY W POLYPECTOMY
|
Facility
IP
|
$3,290.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
906745384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$595.49 |
| Max. Negotiated Rate |
$2,467.50 |
| Rate for Payer: Adventist Health Commercial |
$658.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,260.23
|
| Rate for Payer: Cash Price |
$1,480.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,227.33
|
| Rate for Payer: Heritage Provider Network Senior |
$2,227.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$595.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$822.50
|
| Rate for Payer: Multiplan Commercial |
$2,467.50
|
|
|
HC COLONOSCOPY W POLYPECTOMY
|
Facility
OP
|
$3,037.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
906745384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$607.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,086.42
|
| 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 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 |
$1,366.65
|
| Rate for Payer: Cash Price |
$1,366.65
|
| Rate for Payer: Cash Price |
$1,366.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,974.05
|
| 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 |
$1,879.90
|
| Rate for Payer: Heritage Provider Network Senior |
$1,813.54
|
| Rate for Payer: Humana Medicare |
$1,474.42
|
| Rate for Payer: IEHP Medi-Cal |
$584.86
|
| Rate for Payer: 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 |
$549.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,739.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$759.25
|
| 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 |
$2,277.75
|
| 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 STENT PLCMNT
|
Facility
OP
|
$5,066.00
|
|
|
Service Code
|
CPT 45389
|
| Hospital Charge Code |
906745389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$13,529.58 |
| Rate for Payer: Adventist Health Commercial |
$1,013.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2,869.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,480.34
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,681.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,832.91
|
| Rate for Payer: AlphaCare 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 |
$2,279.70
|
| Rate for Payer: Cash Price |
$2,279.70
|
| Rate for Payer: Cash Price |
$2,279.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,292.90
|
| 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 |
$3,135.85
|
| Rate for Payer: Heritage Provider Network Senior |
$8,758.62
|
| Rate for Payer: Humana Medicare |
$7,120.83
|
| Rate for Payer: 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 |
$916.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,402.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,266.50
|
| 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 |
$3,799.50
|
| 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 W STENT PLCMNT
|
Facility
IP
|
$7,978.00
|
|
|
Service Code
|
CPT 45389
|
| Hospital Charge Code |
906745389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,444.02 |
| Max. Negotiated Rate |
$5,983.50 |
| Rate for Payer: Adventist Health Commercial |
$1,595.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,480.89
|
| Rate for Payer: Cash Price |
$3,590.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,401.11
|
| Rate for Payer: Heritage Provider Network Senior |
$5,401.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,444.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,994.50
|
| Rate for Payer: Multiplan Commercial |
$5,983.50
|
|
|
HC COLONOSCOPY W SUBMUCOSAL INJ
|
Facility
IP
|
$2,856.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
906745381
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$516.94 |
| Max. Negotiated Rate |
$2,142.00 |
| Rate for Payer: Adventist Health Commercial |
$571.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,962.07
|
| Rate for Payer: Cash Price |
$1,285.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,933.51
|
| Rate for Payer: Heritage Provider Network Senior |
$1,933.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$516.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$714.00
|
| Rate for Payer: Multiplan Commercial |
$2,142.00
|
|
|
HC COLONOSCOPY W SUBMUCOSAL INJ
|
Facility
OP
|
$4,567.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
906745381
|
|
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: 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 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 |
$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 |
$2,826.97
|
| Rate for Payer: Heritage Provider Network Senior |
$1,813.54
|
| Rate for Payer: Humana Medicare |
$1,474.42
|
| Rate for Payer: IEHP Medi-Cal |
$643.89
|
| Rate for Payer: 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 |
$826.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,739.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,141.75
|
| 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 |
$3,425.25
|
| 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 |
$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/TUMOR SNARE RMVL
|
Facility
IP
|
$4,371.00
|
|
|
Service Code
|
CPT 45385
|
| Hospital Charge Code |
906745385
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$791.15 |
| Max. Negotiated Rate |
$3,278.25 |
| Rate for Payer: Adventist Health Commercial |
$874.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,002.88
|
| Rate for Payer: Cash Price |
$1,966.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,959.17
|
| Rate for Payer: Heritage Provider Network Senior |
$2,959.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$791.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,092.75
|
| Rate for Payer: Multiplan Commercial |
$3,278.25
|
|
|
HC COLONOSCOPY W/TUMOR SNARE RMVL
|
Facility
OP
|
$4,567.00
|
|
|
Service Code
|
CPT 45385
|
| Hospital Charge Code |
906745385
|
|
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: 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 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 |
$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 |
$2,826.97
|
| Rate for Payer: Heritage Provider Network Senior |
$1,813.54
|
| Rate for Payer: Humana Medicare |
$1,474.42
|
| Rate for Payer: IEHP Medi-Cal |
$624.34
|
| Rate for Payer: 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 |
$826.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,739.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,141.75
|
| 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 |
$3,425.25
|
| 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 |
$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 COLONSCOPY STOMA W RMVL
|
Facility
IP
|
$1,769.00
|
|
|
Service Code
|
CPT 44394
|
| Hospital Charge Code |
906744394
|
|
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 COLONSCOPY STOMA W RMVL
|
Facility
OP
|
$3,793.00
|
|
|
Service Code
|
CPT 44394
|
| Hospital Charge Code |
906744394
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| 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: 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 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: IEHP Medi-Cal |
$484.38
|
| Rate for Payer: 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 COLON VIA STOMA W FB REMOVAL
|
Facility
IP
|
$1,769.00
|
|
|
Service Code
|
CPT 44390
|
| Hospital Charge Code |
906744390
|
|
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
|
|
