|
HC COLONOSCOPY W ABLATION TUMOR
|
Facility
|
OP
|
$3,955.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
906745388
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$791.00
|
| Rate for Payer: Adventist Health Commercial |
$653.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,018.39
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,444.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,779.75
|
| Rate for Payer: Cash Price |
$1,779.75
|
| Rate for Payer: Cash Price |
$1,469.70
|
| Rate for Payer: Cash Price |
$1,469.70
|
| Rate for Payer: Cash Price |
$1,779.75
|
| Rate for Payer: Cash Price |
$1,469.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,122.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,570.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,448.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,021.65
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,557.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,886.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$715.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$591.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$816.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$988.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$2,966.25
|
| Rate for Payer: Multiplan Commercial |
$2,449.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONOSCOPY W ABLATION TUMOR
|
Facility
|
IP
|
$3,955.00
|
|
|
Service Code
|
CPT 45388
|
| Hospital Charge Code |
906745388
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$715.86 |
| Max. Negotiated Rate |
$2,966.25 |
| Rate for Payer: Adventist Health Commercial |
$791.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,547.02
|
| Rate for Payer: Cash Price |
$1,779.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,677.53
|
| Rate for Payer: Heritage Provider Network Senior |
$2,677.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$715.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$988.75
|
| Rate for Payer: Multiplan Commercial |
$2,966.25
|
|
|
HC COLONOSCOPY W BAND LIGATION
|
Facility
|
OP
|
$2,005.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
906745398
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$362.90 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Adventist Health Commercial |
$401.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,239.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Cash Price |
$902.25
|
| Rate for Payer: Cash Price |
$902.25
|
| Rate for Payer: Cash Price |
$902.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,303.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,241.10
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$956.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$362.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$501.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$1,503.75
|
| 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 |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONOSCOPY W BAND LIGATION
|
Facility
|
IP
|
$2,005.00
|
|
|
Service Code
|
CPT 45398
|
| Hospital Charge Code |
906745398
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$362.90 |
| Max. Negotiated Rate |
$1,503.75 |
| Rate for Payer: Adventist Health Commercial |
$401.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,291.22
|
| Rate for Payer: Cash Price |
$902.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,357.38
|
| Rate for Payer: Heritage Provider Network Senior |
$1,357.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$362.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$501.25
|
| Rate for Payer: Multiplan Commercial |
$1,503.75
|
|
|
HC COLONOSCOPY W BX
|
Facility
|
OP
|
$4,700.00
|
|
|
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 |
$940.00
|
| Rate for Payer: Adventist Health Commercial |
$776.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,399.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,904.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$2,115.00
|
| Rate for Payer: Cash Price |
$2,115.00
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$2,115.00
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,523.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,055.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,909.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,402.96
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,851.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,241.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$850.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$702.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$970.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,175.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$3,525.00
|
| Rate for Payer: Multiplan Commercial |
$2,911.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONOSCOPY W BX
|
Facility
|
IP
|
$4,700.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
906745380
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$850.70 |
| Max. Negotiated Rate |
$3,525.00 |
| Rate for Payer: Adventist Health Commercial |
$940.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,026.80
|
| Rate for Payer: Cash Price |
$2,115.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,181.90
|
| Rate for Payer: Heritage Provider Network Senior |
$3,181.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$850.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,175.00
|
| Rate for Payer: Multiplan Commercial |
$3,525.00
|
|
|
HC COLONOSCOPY W CNTRL BLEEDING
|
Facility
|
OP
|
$4,653.00
|
|
|
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 |
$930.60
|
| Rate for Payer: Adventist Health Commercial |
$768.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,375.59
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,875.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$2,093.85
|
| Rate for Payer: Cash Price |
$2,093.85
|
| Rate for Payer: Cash Price |
$1,729.80
|
| Rate for Payer: Cash Price |
$1,729.80
|
| Rate for Payer: Cash Price |
$2,093.85
|
| Rate for Payer: Cash Price |
$1,729.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,498.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,024.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,880.21
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,379.44
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,833.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,219.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$842.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$695.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$961.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,163.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$3,489.75
|
| Rate for Payer: Multiplan Commercial |
$2,883.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONOSCOPY W CNTRL BLEEDING
|
Facility
|
IP
|
$4,653.00
|
|
|
Service Code
|
CPT 45382
|
| Hospital Charge Code |
906745382
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$842.19 |
| Max. Negotiated Rate |
$3,489.75 |
| Rate for Payer: Adventist Health Commercial |
$930.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,996.53
|
| Rate for Payer: Cash Price |
$2,093.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,150.08
|
| Rate for Payer: Heritage Provider Network Senior |
$3,150.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$842.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,163.25
|
| Rate for Payer: Multiplan Commercial |
$3,489.75
|
|
|
HC COLONOSCOPY W/CNTRL BLEEDING
|
Facility
|
IP
|
$1,681.00
|
|
|
Service Code
|
CPT 44391
|
| Hospital Charge Code |
906744391
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$304.26 |
| Max. Negotiated Rate |
$1,260.75 |
| Rate for Payer: Adventist Health Commercial |
$336.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,082.56
|
| Rate for Payer: Cash Price |
$756.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,138.04
|
| Rate for Payer: Heritage Provider Network Senior |
$1,138.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$304.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$420.25
|
| Rate for Payer: Multiplan Commercial |
$1,260.75
|
|
|
HC COLONOSCOPY W/CNTRL BLEEDING
|
Facility
|
OP
|
$1,690.00
|
|
|
Service Code
|
CPT 44391
|
| Hospital Charge Code |
906744391
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$305.89 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$338.00
|
| Rate for Payer: Adventist Health Commercial |
$336.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,038.86
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,044.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$760.50
|
| Rate for Payer: Cash Price |
$760.50
|
| Rate for Payer: Cash Price |
$756.45
|
| Rate for Payer: Cash Price |
$756.45
|
| Rate for Payer: Cash Price |
$760.50
|
| Rate for Payer: Cash Price |
$756.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,092.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,098.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,046.11
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,040.54
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$801.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$806.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$305.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$304.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$420.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$422.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$1,267.50
|
| Rate for Payer: Multiplan Commercial |
$1,260.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONOSCOPY W ENDO MCSL RESCT
|
Facility
|
IP
|
$2,332.00
|
|
|
Service Code
|
CPT 45390
|
| Hospital Charge Code |
906745390
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$422.09 |
| Max. Negotiated Rate |
$1,749.00 |
| Rate for Payer: Adventist Health Commercial |
$466.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,501.81
|
| Rate for Payer: Cash Price |
$1,049.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,578.76
|
| Rate for Payer: Heritage Provider Network Senior |
$1,578.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$422.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$583.00
|
| Rate for Payer: Multiplan Commercial |
$1,749.00
|
|
|
HC COLONOSCOPY W ENDO MCSL RESCT
|
Facility
|
OP
|
$2,332.00
|
|
|
Service Code
|
CPT 45390
|
| Hospital Charge Code |
906745390
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$422.09 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$466.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,441.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,569.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,049.40
|
| Rate for Payer: Cash Price |
$1,049.40
|
| Rate for Payer: Cash Price |
$1,049.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,515.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,926.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,569.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,569.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,443.51
|
| Rate for Payer: Heritage Provider Network Senior |
$4,391.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,112.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$422.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,105.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$583.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,783.75
|
| Rate for Payer: Multiplan Commercial |
$1,749.00
|
| 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 |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,569.96
|
|
|
HC COLONOSCOPY W/ENDOS US
|
Facility
|
OP
|
$4,142.00
|
|
|
Service Code
|
CPT 45392
|
| Hospital Charge Code |
906745392
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$828.40
|
| Rate for Payer: Adventist Health Commercial |
$704.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,176.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,559.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,863.90
|
| Rate for Payer: Cash Price |
$1,863.90
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cash Price |
$1,863.90
|
| Rate for Payer: Cash Price |
$1,584.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,289.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,692.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,563.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,180.12
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,679.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,975.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$749.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$637.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$880.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,035.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$3,106.50
|
| Rate for Payer: Multiplan Commercial |
$2,641.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONOSCOPY W/ENDOS US
|
Facility
|
IP
|
$4,142.00
|
|
|
Service Code
|
CPT 45392
|
| Hospital Charge Code |
906745392
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$749.70 |
| Max. Negotiated Rate |
$3,106.50 |
| Rate for Payer: Adventist Health Commercial |
$828.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,667.45
|
| Rate for Payer: Cash Price |
$1,863.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,804.13
|
| Rate for Payer: Heritage Provider Network Senior |
$2,804.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$749.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,035.50
|
| Rate for Payer: Multiplan Commercial |
$3,106.50
|
|
|
HC COLONOSCOPY W ENDOS US EXAM
|
Facility
|
OP
|
$4,152.00
|
|
|
Service Code
|
CPT 45391
|
| Hospital Charge Code |
906745391
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$830.40
|
| Rate for Payer: Adventist Health Commercial |
$706.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,183.39
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,565.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,296.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,698.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,570.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,186.93
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,685.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,980.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$751.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$639.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$883.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,038.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$3,114.00
|
| Rate for Payer: Multiplan Commercial |
$2,649.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONOSCOPY W ENDOS US EXAM
|
Facility
|
IP
|
$4,152.00
|
|
|
Service Code
|
CPT 45391
|
| Hospital Charge Code |
906745391
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$751.51 |
| Max. Negotiated Rate |
$3,114.00 |
| Rate for Payer: Adventist Health Commercial |
$830.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,673.89
|
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,810.90
|
| Rate for Payer: Heritage Provider Network Senior |
$2,810.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$751.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,038.00
|
| Rate for Payer: Multiplan Commercial |
$3,114.00
|
|
|
HC COLONOSCOPY W FB REMOVAL
|
Facility
|
IP
|
$2,522.00
|
|
|
Service Code
|
CPT 45379
|
| Hospital Charge Code |
906745379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$456.48 |
| Max. Negotiated Rate |
$1,891.50 |
| Rate for Payer: Adventist Health Commercial |
$504.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,624.17
|
| Rate for Payer: Cash Price |
$1,134.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,707.39
|
| Rate for Payer: Heritage Provider Network Senior |
$1,707.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$456.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$630.50
|
| Rate for Payer: Multiplan Commercial |
$1,891.50
|
|
|
HC COLONOSCOPY W FB REMOVAL
|
Facility
|
OP
|
$3,533.00
|
|
|
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 |
$706.60
|
| Rate for Payer: Adventist Health Commercial |
$504.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,558.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,183.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Cash Price |
$1,134.90
|
| Rate for Payer: Cash Price |
$1,134.90
|
| Rate for Payer: Cash Price |
$1,589.85
|
| Rate for Payer: Cash Price |
$1,134.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,639.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,296.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,186.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,561.12
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,202.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,685.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$639.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$456.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$630.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$883.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$2,649.75
|
| Rate for Payer: Multiplan Commercial |
$1,891.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONOSCOPY W POLYPECTOMY
|
Facility
|
OP
|
$3,126.00
|
|
|
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 |
$625.20
|
| Rate for Payer: Adventist Health Commercial |
$516.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,595.06
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,931.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,406.70
|
| Rate for Payer: Cash Price |
$1,406.70
|
| Rate for Payer: Cash Price |
$1,161.45
|
| Rate for Payer: Cash Price |
$1,161.45
|
| Rate for Payer: Cash Price |
$1,406.70
|
| Rate for Payer: Cash Price |
$1,161.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,677.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,031.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,934.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,597.64
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,231.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,491.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$565.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$467.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$645.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$781.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$2,344.50
|
| Rate for Payer: Multiplan Commercial |
$1,935.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONOSCOPY W POLYPECTOMY
|
Facility
|
IP
|
$3,126.00
|
|
|
Service Code
|
CPT 45384
|
| Hospital Charge Code |
906745384
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$565.81 |
| Max. Negotiated Rate |
$2,344.50 |
| Rate for Payer: Adventist Health Commercial |
$625.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,013.14
|
| Rate for Payer: Cash Price |
$1,406.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,116.30
|
| Rate for Payer: Heritage Provider Network Senior |
$2,116.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$565.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$781.50
|
| Rate for Payer: Multiplan Commercial |
$2,344.50
|
|
|
HC COLONOSCOPY W STENT PLCMNT
|
Facility
|
IP
|
$6,781.00
|
|
|
Service Code
|
CPT 45389
|
| Hospital Charge Code |
906745389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,227.36 |
| Max. Negotiated Rate |
$5,085.75 |
| Rate for Payer: Adventist Health Commercial |
$1,356.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,366.96
|
| Rate for Payer: Cash Price |
$3,051.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,590.74
|
| Rate for Payer: Heritage Provider Network Senior |
$4,590.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,227.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,695.25
|
| Rate for Payer: Multiplan Commercial |
$5,085.75
|
|
|
HC COLONOSCOPY W STENT PLCMNT
|
Facility
|
OP
|
$6,781.00
|
|
|
Service Code
|
CPT 45389
|
| Hospital Charge Code |
906745389
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$11,712.28 |
| Rate for Payer: Adventist Health Commercial |
$1,356.20
|
| Rate for Payer: Adventist Health Commercial |
$861.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,661.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,190.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,808.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,808.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$3,051.45
|
| Rate for Payer: Cash Price |
$3,051.45
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cash Price |
$3,051.45
|
| Rate for Payer: Cash Price |
$1,937.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,798.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,407.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,589.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,589.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,808.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,808.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,808.19
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,808.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,197.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,665.41
|
| Rate for Payer: Heritage Provider Network Senior |
$9,604.07
|
| Rate for Payer: Heritage Provider Network Senior |
$9,604.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,808.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,053.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,234.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,227.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$779.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,979.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,979.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,076.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,695.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,462.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,462.97
|
| Rate for Payer: Multiplan Commercial |
$5,085.75
|
| Rate for Payer: Multiplan Commercial |
$3,229.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,712.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,589.01
|
| Rate for Payer: Vantage Medical Group Senior |
$7,808.19
|
| Rate for Payer: Vantage Medical Group Senior |
$7,808.19
|
|
|
HC COLONOSCOPY W SUBMUCOSAL INJ
|
Facility
|
IP
|
$2,713.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
906745381
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$491.05 |
| Max. Negotiated Rate |
$2,034.75 |
| Rate for Payer: Adventist Health Commercial |
$542.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,747.17
|
| Rate for Payer: Cash Price |
$1,220.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,836.70
|
| Rate for Payer: Heritage Provider Network Senior |
$1,836.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$491.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.25
|
| Rate for Payer: Multiplan Commercial |
$2,034.75
|
|
|
HC COLONOSCOPY W SUBMUCOSAL INJ
|
Facility
|
OP
|
$3,882.00
|
|
|
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 |
$776.40
|
| Rate for Payer: Adventist Health Commercial |
$542.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,676.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,399.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$1,220.85
|
| Rate for Payer: Cash Price |
$1,220.85
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$1,220.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,763.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,523.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,402.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,679.35
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,294.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,851.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$702.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$491.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$970.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$2,911.50
|
| Rate for Payer: Multiplan Commercial |
$2,034.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC COLONOSCOPY W/TUMOR SNARE RMVL
|
Facility
|
OP
|
$4,152.00
|
|
|
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 |
$830.40
|
| Rate for Payer: Adventist Health Commercial |
$776.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,399.08
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,565.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cash Price |
$1,868.40
|
| Rate for Payer: Cash Price |
$1,746.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,523.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,698.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,570.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,402.96
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,851.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,980.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$751.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$702.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$970.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,038.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$3,114.00
|
| Rate for Payer: Multiplan Commercial |
$2,911.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
