|
HC ENDOMYCARDIAL BIOPSY
|
Facility
|
OP
|
$4,737.00
|
|
|
Service Code
|
CPT 93505
|
| Hospital Charge Code |
906811308
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$857.40 |
| Max. Negotiated Rate |
$10,001.00 |
| Rate for Payer: Adventist Health Commercial |
$947.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,927.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| 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 |
$2,131.65
|
| Rate for Payer: Cash Price |
$2,131.65
|
| Rate for Payer: Cash Price |
$2,131.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,794.83
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,061.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,932.20
|
| Rate for Payer: Heritage Provider Network Senior |
$4,995.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7,715.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$857.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,670.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,184.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$3,552.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,810.00
|
| Rate for Payer: TriValley Medical Group Senior |
$1,810.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC ENDOSCOPIC PANCREATOSCOPY
|
Facility
|
OP
|
$6,274.00
|
|
|
Service Code
|
CPT 43273
|
| Hospital Charge Code |
906743273
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Adventist Health Commercial |
$1,254.80
|
| Rate for Payer: Adventist Health Commercial |
$1,277.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,948.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,877.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,430.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,332.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,450.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,513.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,705.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,791.75
|
| 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 |
$2,823.30
|
| Rate for Payer: Cash Price |
$2,875.05
|
| Rate for Payer: Cash Price |
$2,823.30
|
| Rate for Payer: Cash Price |
$2,875.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,152.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,078.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,332.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,430.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,332.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,430.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,430.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,332.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,883.61
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,954.79
|
| Rate for Payer: Heritage Provider Network Senior |
$3,954.79
|
| Rate for Payer: Heritage Provider Network Senior |
$3,883.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,992.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,047.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,135.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,156.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,597.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,568.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,391.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,472.30
|
| Rate for Payer: Multiplan Commercial |
$4,791.75
|
| Rate for Payer: Multiplan Commercial |
$4,705.50
|
| 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 |
$1,093.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,430.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,332.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,430.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,332.90
|
| Rate for Payer: Vantage Medical Group Senior |
$5,332.90
|
| Rate for Payer: Vantage Medical Group Senior |
$5,430.65
|
|
|
HC ENDOSCOPIC PANCREATOSCOPY
|
Facility
|
IP
|
$6,274.00
|
|
|
Service Code
|
CPT 43273
|
| Hospital Charge Code |
906743273
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,135.59 |
| Max. Negotiated Rate |
$4,705.50 |
| Rate for Payer: Adventist Health Commercial |
$1,254.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,040.46
|
| Rate for Payer: Cash Price |
$2,823.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,247.50
|
| Rate for Payer: Heritage Provider Network Senior |
$4,247.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,135.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,568.50
|
| Rate for Payer: Multiplan Commercial |
$4,705.50
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT
|
Facility
|
IP
|
$603.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
905601751
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$109.14 |
| Max. Negotiated Rate |
$452.25 |
| Rate for Payer: Adventist Health Commercial |
$120.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$388.33
|
| Rate for Payer: Cash Price |
$271.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$408.23
|
| Rate for Payer: Heritage Provider Network Senior |
$408.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$109.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.75
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT
|
Facility
|
OP
|
$603.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
905601751
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$109.14 |
| Max. Negotiated Rate |
$512.55 |
| Rate for Payer: Cash Price |
$271.35
|
| Rate for Payer: Adventist Health Commercial |
$247.23
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$372.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$512.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$331.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$452.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$271.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$391.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$512.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$512.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$512.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$391.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$373.26
|
| Rate for Payer: Heritage Provider Network Senior |
$373.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$287.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$109.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$422.10
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$512.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$512.55
|
| Rate for Payer: Vantage Medical Group Senior |
$512.55
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT MCAL
|
Facility
|
IP
|
$603.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
907000015
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$109.14 |
| Max. Negotiated Rate |
$452.25 |
| Rate for Payer: Adventist Health Commercial |
$120.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$388.33
|
| Rate for Payer: Cash Price |
$271.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$408.23
|
| Rate for Payer: Heritage Provider Network Senior |
$408.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$109.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.75
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
|
|
HC ENDOSCOPIC STUDY SWALLOW FUNCT MCAL
|
Facility
|
OP
|
$603.00
|
|
|
Service Code
|
CPT 92612
|
| Hospital Charge Code |
907000015
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$109.14 |
| Max. Negotiated Rate |
$512.55 |
| Rate for Payer: Adventist Health Commercial |
$247.23
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$372.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$512.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$331.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$452.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$271.35
|
| Rate for Payer: Cash Price |
$271.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$391.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$512.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$512.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$512.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$391.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$373.26
|
| Rate for Payer: Heritage Provider Network Senior |
$373.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$287.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$109.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$422.10
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$125.00
|
| Rate for Payer: TriValley Medical Group Senior |
$125.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$512.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$512.55
|
| Rate for Payer: Vantage Medical Group Senior |
$512.55
|
|
|
HC ENDOSCOPIC US EXAM
|
Facility
|
IP
|
$1,978.00
|
|
|
Service Code
|
CPT 43237
|
| Hospital Charge Code |
906743237
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$358.02 |
| Max. Negotiated Rate |
$1,483.50 |
| Rate for Payer: Adventist Health Commercial |
$395.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,273.83
|
| Rate for Payer: Cash Price |
$890.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,339.11
|
| Rate for Payer: Heritage Provider Network Senior |
$1,339.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$358.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$494.50
|
| Rate for Payer: Multiplan Commercial |
$1,483.50
|
|
|
HC ENDOSCOPIC US EXAM
|
Facility
|
OP
|
$1,978.00
|
|
|
Service Code
|
CPT 43237
|
| Hospital Charge Code |
906743237
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$358.02 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$395.60
|
| Rate for Payer: Adventist Health Commercial |
$302.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$934.42
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,222.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| 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 |
$890.10
|
| Rate for Payer: Cash Price |
$890.10
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Cash Price |
$890.10
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$982.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,285.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| 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 |
$2,468.04
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,468.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,224.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$935.93
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$721.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$943.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$358.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$273.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$378.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$494.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$1,483.50
|
| Rate for Payer: Multiplan Commercial |
$1,134.00
|
| 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 |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT CNTRL BLEEDING
|
Facility
|
OP
|
$4,026.00
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
906744366
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$805.20
|
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,908.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,488.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| 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 |
$1,811.70
|
| Rate for Payer: Cash Price |
$1,811.70
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,811.70
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,007.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,616.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| 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 |
$2,468.04
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,468.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,492.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,911.47
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,472.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,920.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$728.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$558.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,006.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$3,019.50
|
| Rate for Payer: Multiplan Commercial |
$2,316.00
|
| 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 |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT CNTRL BLEEDING
|
Facility
|
IP
|
$4,026.00
|
|
|
Service Code
|
CPT 44366
|
| Hospital Charge Code |
906744366
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$728.71 |
| Max. Negotiated Rate |
$3,019.50 |
| Rate for Payer: Adventist Health Commercial |
$805.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,592.74
|
| Rate for Payer: Cash Price |
$1,811.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,725.60
|
| Rate for Payer: Heritage Provider Network Senior |
$2,725.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$728.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,006.50
|
| Rate for Payer: Multiplan Commercial |
$3,019.50
|
|
|
HC ENDO SM INTEST ENDO W/BX SNGL OR MUL
|
Facility
|
OP
|
$5,368.00
|
|
|
Service Code
|
CPT 44361
|
| Hospital Charge Code |
906744361
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,685.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,317.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| 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 |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$1,227.15
|
| Rate for Payer: Cash Price |
$1,227.15
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$1,227.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,772.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,489.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| 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 |
$2,468.04
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,468.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,322.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,688.01
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,300.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,560.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$971.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$493.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,342.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$4,026.00
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
| 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 |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INTEST ENDO W/BX SNGL OR MUL
|
Facility
|
IP
|
$2,727.00
|
|
|
Service Code
|
CPT 44361
|
| Hospital Charge Code |
906744361
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$493.59 |
| Max. Negotiated Rate |
$2,045.25 |
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,756.19
|
| Rate for Payer: Cash Price |
$1,227.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,846.18
|
| Rate for Payer: Heritage Provider Network Senior |
$1,846.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$493.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
|
|
HC ENDO SM INTEST W WO CO
|
Facility
|
OP
|
$5,368.00
|
|
|
Service Code
|
CPT 44360
|
| Hospital Charge Code |
906744360
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,073.60
|
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,685.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,317.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| 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 |
$2,415.60
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$1,227.15
|
| Rate for Payer: Cash Price |
$1,227.15
|
| Rate for Payer: Cash Price |
$2,415.60
|
| Rate for Payer: Cash Price |
$1,227.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,772.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,489.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| 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 |
$2,468.04
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,468.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,322.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,688.01
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,300.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,560.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$971.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$493.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,342.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$4,026.00
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
| 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 |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INTEST W WO CO
|
Facility
|
IP
|
$2,727.00
|
|
|
Service Code
|
CPT 44360
|
| Hospital Charge Code |
906744360
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$493.59 |
| Max. Negotiated Rate |
$2,045.25 |
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,756.19
|
| Rate for Payer: Cash Price |
$1,227.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,846.18
|
| Rate for Payer: Heritage Provider Network Senior |
$1,846.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$493.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
|
|
HC ENDO SM INT ILEUM DIAG
|
Facility
|
OP
|
$6,511.00
|
|
|
Service Code
|
CPT 44376
|
| Hospital Charge Code |
906744376
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,302.20
|
| Rate for Payer: Adventist Health Commercial |
$1,117.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,454.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,023.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| 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 |
$2,929.95
|
| Rate for Payer: Cash Price |
$2,929.95
|
| Rate for Payer: Cash Price |
$2,515.05
|
| Rate for Payer: Cash Price |
$2,515.05
|
| Rate for Payer: Cash Price |
$2,929.95
|
| Rate for Payer: Cash Price |
$2,515.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,632.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,232.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| 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 |
$2,468.04
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,468.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,030.31
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,459.59
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,665.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,105.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,178.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,011.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,397.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,627.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$4,883.25
|
| Rate for Payer: Multiplan Commercial |
$4,191.75
|
| 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 |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT ILEUM DIAG
|
Facility
|
IP
|
$6,511.00
|
|
|
Service Code
|
CPT 44376
|
| Hospital Charge Code |
906744376
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,178.49 |
| Max. Negotiated Rate |
$4,883.25 |
| Rate for Payer: Adventist Health Commercial |
$1,302.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,193.08
|
| Rate for Payer: Cash Price |
$2,929.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,407.95
|
| Rate for Payer: Heritage Provider Network Senior |
$4,407.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,178.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,627.75
|
| Rate for Payer: Multiplan Commercial |
$4,883.25
|
|
|
HC ENDO SM INT ILEUM W BX
|
Facility
|
IP
|
$2,727.00
|
|
|
Service Code
|
CPT 44377
|
| Hospital Charge Code |
906744377
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$493.59 |
| Max. Negotiated Rate |
$2,045.25 |
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,756.19
|
| Rate for Payer: Cash Price |
$1,227.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,846.18
|
| Rate for Payer: Heritage Provider Network Senior |
$1,846.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$493.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
|
|
HC ENDO SM INT ILEUM W BX
|
Facility
|
OP
|
$3,088.00
|
|
|
Service Code
|
CPT 44377
|
| Hospital Charge Code |
906744377
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| Rate for Payer: Adventist Health Commercial |
$545.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,685.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,908.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| 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 |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,227.15
|
| Rate for Payer: Cash Price |
$1,227.15
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,227.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,772.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,007.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| 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 |
$2,468.04
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,468.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,911.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,688.01
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,300.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,472.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$558.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$493.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$2,316.00
|
| Rate for Payer: Multiplan Commercial |
$2,045.25
|
| 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 |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT ILEUM W CNTRL BLEEDING
|
Facility
|
IP
|
$4,026.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
906744378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$728.71 |
| Max. Negotiated Rate |
$3,019.50 |
| Rate for Payer: Adventist Health Commercial |
$805.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,592.74
|
| Rate for Payer: Cash Price |
$1,811.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,725.60
|
| Rate for Payer: Heritage Provider Network Senior |
$2,725.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$728.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,006.50
|
| Rate for Payer: Multiplan Commercial |
$3,019.50
|
|
|
HC ENDO SM INT ILEUM W CNTRL BLEEDING
|
Facility
|
OP
|
$4,026.00
|
|
|
Service Code
|
CPT 44378
|
| Hospital Charge Code |
906744378
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$805.20
|
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,908.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,488.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| 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 |
$1,811.70
|
| Rate for Payer: Cash Price |
$1,811.70
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,811.70
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,007.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,616.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| 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 |
$2,468.04
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,468.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,492.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,911.47
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,472.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,920.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$728.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$558.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,006.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$3,019.50
|
| Rate for Payer: Multiplan Commercial |
$2,316.00
|
| 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 |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT ILEUM W STNT PLCMNT
|
Facility
|
IP
|
$7,687.00
|
|
|
Service Code
|
CPT 44379
|
| Hospital Charge Code |
906744379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,391.35 |
| Max. Negotiated Rate |
$5,765.25 |
| Rate for Payer: Adventist Health Commercial |
$1,537.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,950.43
|
| Rate for Payer: Cash Price |
$3,459.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,204.10
|
| Rate for Payer: Heritage Provider Network Senior |
$5,204.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,391.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,921.75
|
| Rate for Payer: Multiplan Commercial |
$5,765.25
|
|
|
HC ENDO SM INT ILEUM W STNT PLCMNT
|
Facility
|
OP
|
$8,470.00
|
|
|
Service Code
|
CPT 44379
|
| Hospital Charge Code |
906744379
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$14,574.13 |
| Rate for Payer: Adventist Health Commercial |
$1,694.00
|
| Rate for Payer: Adventist Health Commercial |
$1,537.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,750.57
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,234.46
|
| 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 |
$5,158.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California Commercial |
$14,574.13
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Blue Shield of California EPN |
$11,673.59
|
| Rate for Payer: Cash Price |
$3,811.50
|
| Rate for Payer: Cash Price |
$3,811.50
|
| Rate for Payer: Cash Price |
$3,459.15
|
| Rate for Payer: Cash Price |
$3,459.15
|
| Rate for Payer: Cash Price |
$3,811.50
|
| Rate for Payer: Cash Price |
$3,459.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,996.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,505.50
|
| 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 |
$5,242.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,758.25
|
| 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 |
$3,666.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$4,040.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,533.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,391.35
|
| 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 |
$1,921.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,117.50
|
| 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 |
$6,352.50
|
| Rate for Payer: Multiplan Commercial |
$5,765.25
|
| 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 |
$10,001.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10,001.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.00
|
| 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 ENDO SM INT W/ABLATION
|
Facility
|
OP
|
$4,026.00
|
|
|
Service Code
|
CPT 44369
|
| Hospital Charge Code |
906744369
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$805.20
|
| Rate for Payer: Adventist Health Commercial |
$617.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,908.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,488.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| 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 |
$1,811.70
|
| Rate for Payer: Cash Price |
$1,811.70
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cash Price |
$1,811.70
|
| Rate for Payer: Cash Price |
$1,389.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,007.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,616.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| 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 |
$2,468.04
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,468.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,492.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,911.47
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Heritage Provider Network Senior |
$3,035.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,472.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,920.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$728.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$558.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,838.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,006.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$3,019.50
|
| Rate for Payer: Multiplan Commercial |
$2,316.00
|
| 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 |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC ENDO SM INT W/ABLATION
|
Facility
|
IP
|
$4,026.00
|
|
|
Service Code
|
CPT 44369
|
| Hospital Charge Code |
906744369
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$728.71 |
| Max. Negotiated Rate |
$3,019.50 |
| Rate for Payer: Adventist Health Commercial |
$805.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,592.74
|
| Rate for Payer: Cash Price |
$1,811.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,725.60
|
| Rate for Payer: Heritage Provider Network Senior |
$2,725.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$728.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,006.50
|
| Rate for Payer: Multiplan Commercial |
$3,019.50
|
|
