|
HC PROC DENTOALVEOLAR STRUCTR
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
CPT 41899
|
| Hospital Charge Code |
900501221
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$271.50 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$300.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$927.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$712.50
|
| Rate for Payer: Blue Shield of California EPN |
$567.00
|
| Rate for Payer: Cash Price |
$675.00
|
| Rate for Payer: Cash Price |
$675.00
|
| Rate for Payer: Cash Price |
$675.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$975.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$304.63
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,015.50
|
| Rate for Payer: Heritage Provider Network Senior |
$1,015.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$715.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$271.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$350.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$375.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$408.20
|
| Rate for Payer: Multiplan Commercial |
$1,125.00
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: TriValley Medical Group Commercial |
$900.00
|
| Rate for Payer: TriValley Medical Group Senior |
$900.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Vantage Medical Group Senior |
$304.63
|
|
|
HC PROCEDURE ANUS
|
Facility
|
IP
|
$2,288.00
|
|
|
Service Code
|
CPT 46999
|
| Hospital Charge Code |
900501653
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$414.13 |
| Max. Negotiated Rate |
$1,716.00 |
| Rate for Payer: Adventist Health Commercial |
$457.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,473.47
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,548.98
|
| Rate for Payer: Heritage Provider Network Senior |
$1,548.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$414.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$572.00
|
| Rate for Payer: Multiplan Commercial |
$1,716.00
|
|
|
HC PROCEDURE ANUS
|
Facility
|
OP
|
$2,288.00
|
|
|
Service Code
|
CPT 46999
|
| Hospital Charge Code |
900501653
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$414.13 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$457.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,413.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,992.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,086.80
|
| Rate for Payer: Blue Shield of California EPN |
$864.86
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cash Price |
$1,029.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,487.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,196.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,548.98
|
| Rate for Payer: Heritage Provider Network Senior |
$1,548.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,091.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$414.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,375.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$572.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$1,716.00
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,372.80
|
| Rate for Payer: TriValley Medical Group Senior |
$1,372.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC PROCEDURE CARDIAC SURG
|
Facility
|
IP
|
$937.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
900501696
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$169.60 |
| Max. Negotiated Rate |
$702.75 |
| Rate for Payer: Adventist Health Commercial |
$187.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$603.43
|
| Rate for Payer: Cash Price |
$421.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$634.35
|
| Rate for Payer: Heritage Provider Network Senior |
$634.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$169.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$234.25
|
| Rate for Payer: Multiplan Commercial |
$702.75
|
|
|
HC PROCEDURE CARDIAC SURG
|
Facility
|
OP
|
$937.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
900501696
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$169.60 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$187.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$579.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$806.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,992.00
|
| Rate for Payer: Blue Shield of California Commercial |
$445.07
|
| Rate for Payer: Blue Shield of California EPN |
$354.19
|
| Rate for Payer: Cash Price |
$421.65
|
| Rate for Payer: Cash Price |
$421.65
|
| Rate for Payer: Cash Price |
$421.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$609.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$887.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$806.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$806.82
|
| Rate for Payer: Heritage Provider Network Commercial |
$634.35
|
| Rate for Payer: Heritage Provider Network Senior |
$634.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$446.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$169.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$927.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$234.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$702.75
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: TriValley Medical Group Commercial |
$562.20
|
| Rate for Payer: TriValley Medical Group Senior |
$562.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,210.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$887.50
|
| Rate for Payer: Vantage Medical Group Senior |
$806.82
|
|
|
HC PROCEDURE NOSE
|
Facility
|
IP
|
$1,056.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
900501667
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$191.14 |
| Max. Negotiated Rate |
$792.00 |
| Rate for Payer: Adventist Health Commercial |
$211.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$680.06
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$714.91
|
| Rate for Payer: Heritage Provider Network Senior |
$714.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$191.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.00
|
| Rate for Payer: Multiplan Commercial |
$792.00
|
|
|
HC PROCEDURE NOSE
|
Facility
|
OP
|
$1,056.00
|
|
|
Service Code
|
CPT 30999
|
| Hospital Charge Code |
900501667
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$191.14 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$211.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$652.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,992.00
|
| Rate for Payer: Blue Shield of California Commercial |
$501.60
|
| Rate for Payer: Blue Shield of California EPN |
$399.17
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cash Price |
$475.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$686.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$304.63
|
| Rate for Payer: Heritage Provider Network Commercial |
$714.91
|
| Rate for Payer: Heritage Provider Network Senior |
$714.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$503.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$191.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$350.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$408.20
|
| Rate for Payer: Multiplan Commercial |
$792.00
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: TriValley Medical Group Commercial |
$633.60
|
| Rate for Payer: TriValley Medical Group Senior |
$633.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Vantage Medical Group Senior |
$304.63
|
|
|
HC PROC PHARYNX ADENOIDS
|
Facility
|
IP
|
$1,314.00
|
|
|
Service Code
|
CPT 42999
|
| Hospital Charge Code |
900501360
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$237.83 |
| Max. Negotiated Rate |
$985.50 |
| Rate for Payer: Adventist Health Commercial |
$262.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$846.22
|
| Rate for Payer: Cash Price |
$591.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$889.58
|
| Rate for Payer: Heritage Provider Network Senior |
$889.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$237.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$328.50
|
| Rate for Payer: Multiplan Commercial |
$985.50
|
|
|
HC PROC PHARYNX ADENOIDS
|
Facility
|
OP
|
$1,314.00
|
|
|
Service Code
|
CPT 42999
|
| Hospital Charge Code |
900501360
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$237.83 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$262.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$812.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$304.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,992.00
|
| Rate for Payer: Blue Shield of California Commercial |
$624.15
|
| Rate for Payer: Blue Shield of California EPN |
$496.69
|
| Rate for Payer: Cash Price |
$591.30
|
| Rate for Payer: Cash Price |
$591.30
|
| Rate for Payer: Cash Price |
$591.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$854.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$335.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$304.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$304.63
|
| Rate for Payer: Heritage Provider Network Commercial |
$889.58
|
| Rate for Payer: Heritage Provider Network Senior |
$889.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$304.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$626.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$237.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$350.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$328.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$408.20
|
| Rate for Payer: Multiplan Commercial |
$985.50
|
| Rate for Payer: Multiplan WC |
$470.13
|
| Rate for Payer: TriValley Medical Group Commercial |
$788.40
|
| Rate for Payer: TriValley Medical Group Senior |
$788.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$456.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$335.09
|
| Rate for Payer: Vantage Medical Group Senior |
$304.63
|
|
|
HC PROC RECTUM
|
Facility
|
OP
|
$2,070.00
|
|
|
Service Code
|
CPT 45999
|
| Hospital Charge Code |
900501387
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$374.67 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$414.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,279.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,992.00
|
| Rate for Payer: Blue Shield of California Commercial |
$983.25
|
| Rate for Payer: Blue Shield of California EPN |
$782.46
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,345.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,196.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,401.39
|
| Rate for Payer: Heritage Provider Network Senior |
$1,401.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$987.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$374.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,375.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$517.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$1,552.50
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,242.00
|
| Rate for Payer: TriValley Medical Group Senior |
$1,242.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC PROC RECTUM
|
Facility
|
IP
|
$2,070.00
|
|
|
Service Code
|
CPT 45999
|
| Hospital Charge Code |
900501387
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$374.67 |
| Max. Negotiated Rate |
$1,552.50 |
| Rate for Payer: Adventist Health Commercial |
$414.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,333.08
|
| Rate for Payer: Cash Price |
$931.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,401.39
|
| Rate for Payer: Heritage Provider Network Senior |
$1,401.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$374.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$517.50
|
| Rate for Payer: Multiplan Commercial |
$1,552.50
|
|
|
HC PROC SK MUC MEMB & SUB
|
Facility
|
IP
|
$91.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
900501051
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$16.47 |
| Max. Negotiated Rate |
$68.25 |
| Rate for Payer: Adventist Health Commercial |
$18.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$58.60
|
| Rate for Payer: Cash Price |
$40.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$61.61
|
| Rate for Payer: Heritage Provider Network Senior |
$61.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.75
|
| Rate for Payer: Multiplan Commercial |
$68.25
|
|
|
HC PROC SK MUC MEMB & SUB
|
Facility
|
OP
|
$91.00
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
900501051
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$16.47 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$18.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$56.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,992.00
|
| Rate for Payer: Blue Shield of California Commercial |
$43.23
|
| Rate for Payer: Blue Shield of California EPN |
$34.40
|
| Rate for Payer: Cash Price |
$40.95
|
| Rate for Payer: Cash Price |
$40.95
|
| Rate for Payer: Cash Price |
$40.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$59.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$258.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$61.61
|
| Rate for Payer: Heritage Provider Network Senior |
$61.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$43.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$296.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$68.25
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: TriValley Medical Group Commercial |
$54.60
|
| Rate for Payer: TriValley Medical Group Senior |
$54.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
HC PROCTOSIGMODISOCPY W REMOVAL
|
Facility
|
IP
|
$2,047.00
|
|
|
Service Code
|
CPT 45309
|
| Hospital Charge Code |
906745309
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$370.51 |
| Max. Negotiated Rate |
$1,535.25 |
| Rate for Payer: Adventist Health Commercial |
$409.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,318.27
|
| Rate for Payer: Cash Price |
$921.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,385.82
|
| Rate for Payer: Heritage Provider Network Senior |
$1,385.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$370.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$511.75
|
| Rate for Payer: Multiplan Commercial |
$1,535.25
|
|
|
HC PROCTOSIGMODISOCPY W REMOVAL
|
Facility
|
OP
|
$2,047.00
|
|
|
Service Code
|
CPT 45309
|
| Hospital Charge Code |
906745309
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$370.51 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$409.40
|
| Rate for Payer: Adventist Health Commercial |
$348.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,075.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,265.05
|
| 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 |
$921.15
|
| Rate for Payer: Cash Price |
$921.15
|
| Rate for Payer: Cash Price |
$783.45
|
| Rate for Payer: Cash Price |
$783.45
|
| Rate for Payer: Cash Price |
$921.15
|
| Rate for Payer: Cash Price |
$783.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,131.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,330.55
|
| 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 |
$1,267.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,077.68
|
| 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 |
$830.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$976.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$370.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$315.12
|
| 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 |
$435.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$511.75
|
| 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 |
$1,535.25
|
| Rate for Payer: Multiplan Commercial |
$1,305.75
|
| 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 PROCTOSIGMOIDOSCOPY RIGID/DIL
|
Facility
|
IP
|
$1,738.00
|
|
|
Service Code
|
CPT 45303
|
| Hospital Charge Code |
906745303
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$314.58 |
| Max. Negotiated Rate |
$1,303.50 |
| Rate for Payer: Adventist Health Commercial |
$347.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,119.27
|
| Rate for Payer: Cash Price |
$782.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,176.63
|
| Rate for Payer: Heritage Provider Network Senior |
$1,176.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$314.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$434.50
|
| Rate for Payer: Multiplan Commercial |
$1,303.50
|
|
|
HC PROCTOSIGMOIDOSCOPY RIGID/DIL
|
Facility
|
OP
|
$1,738.00
|
|
|
Service Code
|
CPT 45303
|
| Hospital Charge Code |
906745303
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$314.58 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$347.60
|
| Rate for Payer: Adventist Health Commercial |
$320.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$990.65
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,074.08
|
| 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 |
$782.10
|
| Rate for Payer: Cash Price |
$782.10
|
| Rate for Payer: Cash Price |
$721.35
|
| Rate for Payer: Cash Price |
$721.35
|
| Rate for Payer: Cash Price |
$782.10
|
| Rate for Payer: Cash Price |
$721.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,041.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,129.70
|
| 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 |
$1,075.82
|
| Rate for Payer: Heritage Provider Network Commercial |
$992.26
|
| 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 |
$764.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$829.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$314.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$290.14
|
| 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 |
$400.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$434.50
|
| 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 |
$1,303.50
|
| Rate for Payer: Multiplan Commercial |
$1,202.25
|
| 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 |
$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 PROCTOSIGMOIDOSCOPY W FB RMVL
|
Facility
|
OP
|
$7,347.00
|
|
|
Service Code
|
CPT 45307
|
| Hospital Charge Code |
906745307
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,469.40
|
| Rate for Payer: Adventist Health Commercial |
$746.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,306.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,540.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,354.94
|
| 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 Medi-Cal |
$3,926.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,569.96
|
| 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: 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 |
$3,306.15
|
| Rate for Payer: Cash Price |
$3,306.15
|
| Rate for Payer: Cash Price |
$1,679.40
|
| Rate for Payer: Cash Price |
$1,679.40
|
| Rate for Payer: Cash Price |
$3,306.15
|
| Rate for Payer: Cash Price |
$1,679.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,425.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,775.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,354.94
|
| 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 Medi-Cal |
$3,926.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,569.96
|
| 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 Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,569.96
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,569.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,547.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,310.11
|
| Rate for Payer: Heritage Provider Network Senior |
$4,391.05
|
| 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: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,780.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,504.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,329.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$675.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,105.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,105.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$933.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,836.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,783.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,783.75
|
| Rate for Payer: Multiplan Commercial |
$5,510.25
|
| Rate for Payer: Multiplan Commercial |
$2,799.00
|
| 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 |
$7,454.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7,454.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6,273.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6,273.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,354.94
|
| 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 Medi-Cal |
$3,926.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,569.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,569.96
|
|
|
HC PROCTOSIGMOIDOSCOPY W FB RMVL
|
Facility
|
IP
|
$7,347.00
|
|
|
Service Code
|
CPT 45307
|
| Hospital Charge Code |
906745307
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,329.81 |
| Max. Negotiated Rate |
$5,510.25 |
| Rate for Payer: Adventist Health Commercial |
$1,469.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,731.47
|
| Rate for Payer: Cash Price |
$3,306.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,973.92
|
| Rate for Payer: Heritage Provider Network Senior |
$4,973.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,329.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,836.75
|
| Rate for Payer: Multiplan Commercial |
$5,510.25
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
IP
|
$3,203.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
906745300
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$579.74 |
| Max. Negotiated Rate |
$2,402.25 |
| Rate for Payer: Adventist Health Commercial |
$640.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,062.73
|
| Rate for Payer: Cash Price |
$1,441.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,168.43
|
| Rate for Payer: Heritage Provider Network Senior |
$2,168.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$579.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$800.75
|
| Rate for Payer: Multiplan Commercial |
$2,402.25
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
OP
|
$3,203.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
906745300
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$640.60
|
| Rate for Payer: Adventist Health Commercial |
$544.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,683.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,979.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| 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 |
$1,441.35
|
| Rate for Payer: Cash Price |
$1,441.35
|
| Rate for Payer: Cash Price |
$1,225.80
|
| Rate for Payer: Cash Price |
$1,225.80
|
| Rate for Payer: Cash Price |
$1,441.35
|
| Rate for Payer: Cash Price |
$1,225.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,770.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,081.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| 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 |
$1,196.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,196.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,982.66
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,686.16
|
| Rate for Payer: Heritage Provider Network Senior |
$1,471.18
|
| Rate for Payer: Heritage Provider Network Senior |
$1,471.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,299.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,527.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$579.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$493.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,375.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,375.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$800.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$2,402.25
|
| Rate for Payer: Multiplan Commercial |
$2,043.00
|
| 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 |
$2,731.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,731.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,298.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
IP
|
$3,203.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
900501380
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$579.74 |
| Max. Negotiated Rate |
$2,402.25 |
| Rate for Payer: Adventist Health Commercial |
$640.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,062.73
|
| Rate for Payer: Cash Price |
$1,441.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,168.43
|
| Rate for Payer: Heritage Provider Network Senior |
$2,168.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$579.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$800.75
|
| Rate for Payer: Multiplan Commercial |
$2,402.25
|
|
|
HC PROCTOSIGMOIDOSCOPY W WO COLL
|
Facility
|
OP
|
$3,203.00
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
900501380
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$579.74 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$640.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,979.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,196.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,521.42
|
| Rate for Payer: Blue Shield of California EPN |
$1,210.73
|
| Rate for Payer: Cash Price |
$1,441.35
|
| Rate for Payer: Cash Price |
$1,441.35
|
| Rate for Payer: Cash Price |
$1,441.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,081.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,315.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,196.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,196.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,168.43
|
| Rate for Payer: Heritage Provider Network Senior |
$2,168.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,196.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,527.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$579.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,375.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$800.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,602.75
|
| Rate for Payer: Multiplan Commercial |
$2,402.25
|
| Rate for Payer: Multiplan WC |
$1,845.73
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,921.80
|
| Rate for Payer: TriValley Medical Group Senior |
$1,921.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,794.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC PROCTOSIGMOIDOSCPY RIG W/BX
|
Facility
|
IP
|
$1,738.00
|
|
|
Service Code
|
CPT 45305
|
| Hospital Charge Code |
906745305
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$314.58 |
| Max. Negotiated Rate |
$1,303.50 |
| Rate for Payer: Adventist Health Commercial |
$347.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,119.27
|
| Rate for Payer: Cash Price |
$782.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,176.63
|
| Rate for Payer: Heritage Provider Network Senior |
$1,176.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$314.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$434.50
|
| Rate for Payer: Multiplan Commercial |
$1,303.50
|
|
|
HC PROCTOSIGMOIDOSCPY RIG W/BX
|
Facility
|
OP
|
$1,738.00
|
|
|
Service Code
|
CPT 45305
|
| Hospital Charge Code |
906745305
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$314.58 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$347.60
|
| Rate for Payer: Adventist Health Commercial |
$291.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$901.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,074.08
|
| 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 |
$782.10
|
| Rate for Payer: Cash Price |
$782.10
|
| Rate for Payer: Cash Price |
$656.55
|
| Rate for Payer: Cash Price |
$656.55
|
| Rate for Payer: Cash Price |
$782.10
|
| Rate for Payer: Cash Price |
$656.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$948.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,129.70
|
| 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 |
$1,075.82
|
| Rate for Payer: Heritage Provider Network Commercial |
$903.12
|
| 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 |
$695.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$829.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$314.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$264.08
|
| 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 |
$364.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$434.50
|
| 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 |
$1,303.50
|
| Rate for Payer: Multiplan Commercial |
$1,094.25
|
| 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 |
$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
|
|
