|
HC SIGMDSCPY DX W WO COLLECT
|
Facility
|
OP
|
$3,196.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$639.20
|
| Rate for Payer: Adventist Health Commercial |
$579.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,791.58
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,975.13
|
| 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 |
$1,438.20
|
| Rate for Payer: Cash Price |
$1,438.20
|
| Rate for Payer: Cash Price |
$1,304.55
|
| Rate for Payer: Cash Price |
$1,304.55
|
| Rate for Payer: Cash Price |
$1,438.20
|
| Rate for Payer: Cash Price |
$1,304.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,884.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,077.40
|
| 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 |
$1,978.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,794.48
|
| 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 |
$1,382.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,524.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$578.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$524.72
|
| 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 |
$724.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$799.00
|
| 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 |
$2,397.00
|
| Rate for Payer: Multiplan Commercial |
$2,174.25
|
| 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 |
$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 SIGMDSCPY DX W WO COLLECT
|
Facility
|
IP
|
$3,196.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
906745330
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$578.48 |
| Max. Negotiated Rate |
$2,397.00 |
| Rate for Payer: Adventist Health Commercial |
$639.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,058.22
|
| Rate for Payer: Cash Price |
$1,438.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,163.69
|
| Rate for Payer: Heritage Provider Network Senior |
$2,163.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$578.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$799.00
|
| Rate for Payer: Multiplan Commercial |
$2,397.00
|
|
|
HC SIGMDSCPY FLEX W POLYPECTOMY
|
Facility
|
OP
|
$3,396.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
906745333
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$679.20
|
| Rate for Payer: Adventist Health Commercial |
$639.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,975.13
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,098.73
|
| 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 |
$1,528.20
|
| Rate for Payer: Cash Price |
$1,528.20
|
| Rate for Payer: Cash Price |
$1,438.20
|
| Rate for Payer: Cash Price |
$1,438.20
|
| Rate for Payer: Cash Price |
$1,528.20
|
| Rate for Payer: Cash Price |
$1,438.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,077.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,207.40
|
| 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 |
$2,102.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,978.32
|
| 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 |
$1,524.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,619.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$614.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$578.48
|
| 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 |
$799.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$849.00
|
| 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 |
$2,547.00
|
| Rate for Payer: Multiplan Commercial |
$2,397.00
|
| 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 SIGMDSCPY FLEX W POLYPECTOMY
|
Facility
|
IP
|
$3,196.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
906745333
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$578.48 |
| Max. Negotiated Rate |
$2,397.00 |
| Rate for Payer: Adventist Health Commercial |
$639.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,058.22
|
| Rate for Payer: Cash Price |
$1,438.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,163.69
|
| Rate for Payer: Heritage Provider Network Senior |
$2,163.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$578.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$799.00
|
| Rate for Payer: Multiplan Commercial |
$2,397.00
|
|
|
HC SIGMDSCPY W BLLN DILATION
|
Facility
|
OP
|
$2,430.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
906745340
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$486.00
|
| Rate for Payer: Adventist Health Commercial |
$423.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,307.69
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,501.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,093.50
|
| Rate for Payer: Cash Price |
$1,093.50
|
| Rate for Payer: Cash Price |
$952.20
|
| Rate for Payer: Cash Price |
$952.20
|
| Rate for Payer: Cash Price |
$1,093.50
|
| Rate for Payer: Cash Price |
$952.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,375.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,579.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,504.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,309.80
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,009.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,159.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$439.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$383.00
|
| 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 |
$529.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.50
|
| 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 |
$1,822.50
|
| Rate for Payer: Multiplan Commercial |
$1,587.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC SIGMDSCPY W BLLN DILATION
|
Facility
|
IP
|
$2,430.00
|
|
|
Service Code
|
CPT 45340
|
| Hospital Charge Code |
906745340
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$439.83 |
| Max. Negotiated Rate |
$1,822.50 |
| Rate for Payer: Adventist Health Commercial |
$486.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,564.92
|
| Rate for Payer: Cash Price |
$1,093.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,645.11
|
| Rate for Payer: Heritage Provider Network Senior |
$1,645.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$439.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$607.50
|
| Rate for Payer: Multiplan Commercial |
$1,822.50
|
|
|
HC SIGMDSCPY W BX SNGL OR MULTI
|
Facility
|
OP
|
$3,661.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$732.20
|
| Rate for Payer: Adventist Health Commercial |
$639.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,975.13
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,262.50
|
| 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 |
$1,647.45
|
| Rate for Payer: Cash Price |
$1,647.45
|
| Rate for Payer: Cash Price |
$1,438.20
|
| Rate for Payer: Cash Price |
$1,438.20
|
| Rate for Payer: Cash Price |
$1,647.45
|
| Rate for Payer: Cash Price |
$1,438.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,077.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,379.65
|
| 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 |
$2,266.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,978.32
|
| 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 |
$1,524.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,746.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$662.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$578.48
|
| 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 |
$799.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$915.25
|
| 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 |
$2,745.75
|
| Rate for Payer: Multiplan Commercial |
$2,397.00
|
| 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 SIGMDSCPY W BX SNGL OR MULTI
|
Facility
|
IP
|
$3,196.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
906745331
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$578.48 |
| Max. Negotiated Rate |
$2,397.00 |
| Rate for Payer: Adventist Health Commercial |
$639.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,058.22
|
| Rate for Payer: Cash Price |
$1,438.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,163.69
|
| Rate for Payer: Heritage Provider Network Senior |
$2,163.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$578.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$799.00
|
| Rate for Payer: Multiplan Commercial |
$2,397.00
|
|
|
HC SIGMDSCPY W CNTRL BLEEDING
|
Facility
|
OP
|
$3,692.00
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
906745334
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$738.40
|
| Rate for Payer: Adventist Health Commercial |
$618.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,910.24
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,281.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,661.40
|
| Rate for Payer: Cash Price |
$1,661.40
|
| Rate for Payer: Cash Price |
$1,390.95
|
| Rate for Payer: Cash Price |
$1,390.95
|
| Rate for Payer: Cash Price |
$1,661.40
|
| Rate for Payer: Cash Price |
$1,390.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,009.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,399.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,285.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,913.33
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,474.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,761.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$668.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$559.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,769.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$923.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$2,769.00
|
| Rate for Payer: Multiplan Commercial |
$2,318.25
|
| 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 SIGMDSCPY W CNTRL BLEEDING
|
Facility
|
IP
|
$3,692.00
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
906745334
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$668.25 |
| Max. Negotiated Rate |
$2,769.00 |
| Rate for Payer: Adventist Health Commercial |
$738.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,377.65
|
| Rate for Payer: Cash Price |
$1,661.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,499.48
|
| Rate for Payer: Heritage Provider Network Senior |
$2,499.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$668.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$923.00
|
| Rate for Payer: Multiplan Commercial |
$2,769.00
|
|
|
HC SIGMDSCPY W DECMPRS
|
Facility
|
OP
|
$5,084.00
|
|
|
Service Code
|
CPT 45337
|
| Hospital Charge Code |
906745337
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,315.69
|
| Rate for Payer: Adventist Health Commercial |
$1,016.80
|
| Rate for Payer: Adventist Health Commercial |
$864.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,672.23
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,141.91
|
| 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 |
$2,287.80
|
| Rate for Payer: Cash Price |
$2,287.80
|
| Rate for Payer: Cash Price |
$1,945.80
|
| Rate for Payer: Cash Price |
$1,945.80
|
| Rate for Payer: Cash Price |
$2,287.80
|
| Rate for Payer: Cash Price |
$1,945.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,810.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,304.60
|
| 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 |
$3,147.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,676.56
|
| 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 |
$2,062.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,425.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$920.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$782.64
|
| 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 |
$1,081.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,271.00
|
| 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 |
$3,813.00
|
| Rate for Payer: Multiplan Commercial |
$3,243.00
|
| 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 |
$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 Senior |
$1,196.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,196.08
|
|
|
HC SIGMDSCPY W DECMPRS
|
Facility
|
IP
|
$5,084.00
|
|
|
Service Code
|
CPT 45337
|
| Hospital Charge Code |
906745337
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$920.20 |
| Max. Negotiated Rate |
$3,813.00 |
| Rate for Payer: Adventist Health Commercial |
$1,016.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,274.10
|
| Rate for Payer: Cash Price |
$2,287.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,441.87
|
| Rate for Payer: Heritage Provider Network Senior |
$3,441.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$920.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,271.00
|
| Rate for Payer: Multiplan Commercial |
$3,813.00
|
|
|
HC SIGMDSCPY W ENDO US
|
Facility
|
OP
|
$3,064.00
|
|
|
Service Code
|
CPT 45341
|
| Hospital Charge Code |
906745341
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$612.80
|
| Rate for Payer: Adventist Health Commercial |
$572.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,769.95
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,893.55
|
| 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 |
$1,378.80
|
| Rate for Payer: Cash Price |
$1,378.80
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cash Price |
$1,378.80
|
| Rate for Payer: Cash Price |
$1,288.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,861.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,991.60
|
| 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 |
$1,896.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,772.82
|
| 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 |
$1,366.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,461.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$554.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$518.38
|
| 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 |
$716.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$766.00
|
| 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 |
$2,298.00
|
| Rate for Payer: Multiplan Commercial |
$2,148.00
|
| 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 |
$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 SIGMDSCPY W ENDO US
|
Facility
|
IP
|
$3,064.00
|
|
|
Service Code
|
CPT 45341
|
| Hospital Charge Code |
906745341
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$554.58 |
| Max. Negotiated Rate |
$2,298.00 |
| Rate for Payer: Adventist Health Commercial |
$612.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,973.22
|
| Rate for Payer: Cash Price |
$1,378.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,074.33
|
| Rate for Payer: Heritage Provider Network Senior |
$2,074.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$554.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$766.00
|
| Rate for Payer: Multiplan Commercial |
$2,298.00
|
|
|
HC SIGMDSCPY W FB RMVL
|
Facility
|
OP
|
$2,773.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
906745332
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$554.60
|
| Rate for Payer: Adventist Health Commercial |
$211.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$653.84
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,713.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,247.85
|
| Rate for Payer: Cash Price |
$1,247.85
|
| Rate for Payer: Cash Price |
$476.10
|
| Rate for Payer: Cash Price |
$476.10
|
| Rate for Payer: Cash Price |
$1,247.85
|
| Rate for Payer: Cash Price |
$476.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$687.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,802.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,692.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,539.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,716.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$654.90
|
| 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 |
$504.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,322.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$501.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$191.50
|
| 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 |
$264.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$693.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$2,079.75
|
| Rate for Payer: Multiplan Commercial |
$793.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC SIGMDSCPY W FB RMVL
|
Facility
|
IP
|
$1,058.00
|
|
|
Service Code
|
CPT 45332
|
| Hospital Charge Code |
906745332
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$191.50 |
| Max. Negotiated Rate |
$793.50 |
| Rate for Payer: Adventist Health Commercial |
$211.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$681.35
|
| Rate for Payer: Cash Price |
$476.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$716.27
|
| Rate for Payer: Heritage Provider Network Senior |
$716.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$191.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.50
|
| Rate for Payer: Multiplan Commercial |
$793.50
|
|
|
HC SIGMDSCPY W TRNS-EN US
|
Facility
|
OP
|
$3,064.00
|
|
|
Service Code
|
CPT 45342
|
| Hospital Charge Code |
906745342
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$612.80
|
| Rate for Payer: Adventist Health Commercial |
$521.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,610.51
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,893.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,378.80
|
| Rate for Payer: Cash Price |
$1,378.80
|
| Rate for Payer: Cash Price |
$1,172.70
|
| Rate for Payer: Cash Price |
$1,172.70
|
| Rate for Payer: Cash Price |
$1,378.80
|
| Rate for Payer: Cash Price |
$1,172.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,693.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,991.60
|
| 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 |
$1,896.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,613.11
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,243.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,461.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$554.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$471.69
|
| 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 |
$651.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$766.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$2,298.00
|
| Rate for Payer: Multiplan Commercial |
$1,954.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC SIGMDSCPY W TRNS-EN US
|
Facility
|
IP
|
$3,064.00
|
|
|
Service Code
|
CPT 45342
|
| Hospital Charge Code |
906745342
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$554.58 |
| Max. Negotiated Rate |
$2,298.00 |
| Rate for Payer: Adventist Health Commercial |
$612.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,973.22
|
| Rate for Payer: Cash Price |
$1,378.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,074.33
|
| Rate for Payer: Heritage Provider Network Senior |
$2,074.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$554.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$766.00
|
| Rate for Payer: Multiplan Commercial |
$2,298.00
|
|
|
HC SIGMDSCPY W TUMOR ABLATION
|
Facility
|
IP
|
$2,645.00
|
|
|
Service Code
|
CPT 45346
|
| Hospital Charge Code |
906745346
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$478.75 |
| Max. Negotiated Rate |
$1,983.75 |
| Rate for Payer: Adventist Health Commercial |
$529.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,703.38
|
| Rate for Payer: Cash Price |
$1,190.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,790.66
|
| Rate for Payer: Heritage Provider Network Senior |
$1,790.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$478.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$661.25
|
| Rate for Payer: Multiplan Commercial |
$1,983.75
|
|
|
HC SIGMDSCPY W TUMOR ABLATION
|
Facility
|
OP
|
$2,645.00
|
|
|
Service Code
|
CPT 45346
|
| Hospital Charge Code |
906745346
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$529.00
|
| Rate for Payer: Adventist Health Commercial |
$450.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,390.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,634.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,539.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,190.25
|
| Rate for Payer: Cash Price |
$1,190.25
|
| Rate for Payer: Cash Price |
$1,012.50
|
| Rate for Payer: Cash Price |
$1,012.50
|
| Rate for Payer: Cash Price |
$1,190.25
|
| Rate for Payer: Cash Price |
$1,012.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,462.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,719.25
|
| 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 |
$1,637.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,392.75
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,073.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,261.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$478.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$407.25
|
| 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 |
$562.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$661.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$1,983.75
|
| Rate for Payer: Multiplan Commercial |
$1,687.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,308.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,692.99
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1,539.08
|
|
|
HC SIGMDSCPY W TUMOR SNARE RMVL
|
Facility
|
IP
|
$2,725.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
906745338
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$493.23 |
| Max. Negotiated Rate |
$2,043.75 |
| Rate for Payer: Adventist Health Commercial |
$545.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,754.90
|
| Rate for Payer: Cash Price |
$1,226.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,844.83
|
| Rate for Payer: Heritage Provider Network Senior |
$1,844.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$493.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.25
|
| Rate for Payer: Multiplan Commercial |
$2,043.75
|
|
|
HC SIGMDSCPY W TUMOR SNARE RMVL
|
Facility
|
OP
|
$2,725.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
906745338
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$425.00 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$545.00
|
| Rate for Payer: Adventist Health Commercial |
$494.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,528.31
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,684.05
|
| 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 |
$1,226.25
|
| Rate for Payer: Cash Price |
$1,226.25
|
| Rate for Payer: Cash Price |
$1,112.85
|
| Rate for Payer: Cash Price |
$1,112.85
|
| Rate for Payer: Cash Price |
$1,226.25
|
| Rate for Payer: Cash Price |
$1,112.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,607.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,771.25
|
| 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 |
$1,686.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,530.79
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$1,893.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,539.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,179.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,299.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$493.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$447.61
|
| 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 |
$618.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$681.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,062.37
|
| Rate for Payer: Multiplan Commercial |
$2,043.75
|
| Rate for Payer: Multiplan Commercial |
$1,854.75
|
| 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 SIGMOIDOSCOPY W ENDO MCSL RESC
|
Facility
|
OP
|
$2,332.00
|
|
|
Service Code
|
CPT 45349
|
| Hospital Charge Code |
906745349
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$422.09 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Cigna of CA HMO/PPO |
$1,515.80
|
| Rate for Payer: Adventist Health Commercial |
$466.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,441.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,569.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$1,049.40
|
| Rate for Payer: Cash Price |
$1,049.40
|
| Rate for Payer: Cash Price |
$1,049.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,926.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,569.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,569.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,443.51
|
| Rate for Payer: Heritage Provider Network Senior |
$4,391.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,569.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,112.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$422.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,105.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$583.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,783.75
|
| Rate for Payer: Multiplan Commercial |
$1,749.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$425.00
|
| Rate for Payer: TriValley Medical Group Senior |
$425.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,354.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,926.96
|
| Rate for Payer: Vantage Medical Group Senior |
$3,569.96
|
|
|
HC SIGMOIDOSCOPY W ENDO MCSL RESC
|
Facility
|
IP
|
$2,332.00
|
|
|
Service Code
|
CPT 45349
|
| Hospital Charge Code |
906745349
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$422.09 |
| Max. Negotiated Rate |
$1,749.00 |
| Rate for Payer: Adventist Health Commercial |
$466.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,501.81
|
| Rate for Payer: Cash Price |
$1,049.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,578.76
|
| Rate for Payer: Heritage Provider Network Senior |
$1,578.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$422.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$583.00
|
| Rate for Payer: Multiplan Commercial |
$1,749.00
|
|
|
HC SIGMOIDOSCOPY W STENT PLCMNT
|
Facility
|
IP
|
$5,143.00
|
|
|
Service Code
|
CPT 45347
|
| Hospital Charge Code |
906745347
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$930.88 |
| Max. Negotiated Rate |
$3,857.25 |
| Rate for Payer: Adventist Health Commercial |
$1,028.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,312.09
|
| Rate for Payer: Cash Price |
$2,314.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,481.81
|
| Rate for Payer: Heritage Provider Network Senior |
$3,481.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$930.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,285.75
|
| Rate for Payer: Multiplan Commercial |
$3,857.25
|
|
