|
HC THORACENTESIS ASPIRATN W GUID
|
Facility
|
IP
|
$4,259.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
909020158
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$851.80 |
| Max. Negotiated Rate |
$3,620.15 |
| Rate for Payer: Adventist Health Commercial |
$851.80
|
| Rate for Payer: Cash Price |
$1,916.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,981.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,703.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,703.60
|
| Rate for Payer: Galaxy Health WC |
$3,620.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,555.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,704.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,512.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,022.16
|
| Rate for Payer: Multiplan Commercial |
$3,407.20
|
| Rate for Payer: Networks By Design Commercial |
$2,768.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,620.15
|
|
|
HC THORACENTESIS ASPIRATN W GUID
|
Facility
|
OP
|
$4,259.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
909020158
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.11 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$851.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| 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 |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$1,916.55
|
| Rate for Payer: Cash Price |
$1,916.55
|
| Rate for Payer: Cash Price |
$1,916.55
|
| Rate for Payer: Cigna of CA HMO |
$2,725.76
|
| Rate for Payer: Cigna of CA PPO |
$3,151.66
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,981.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$3,620.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,555.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$155.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,704.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$175.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,129.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,022.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,016.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$3,407.20
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$2,768.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,620.15
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,555.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,129.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$806.82
|
| 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 THORACENTESIS ASPIRATN W GUID
|
Facility
|
OP
|
$4,259.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
900200007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.11 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$851.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| 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 |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$1,916.55
|
| Rate for Payer: Cash Price |
$1,916.55
|
| Rate for Payer: Cash Price |
$1,916.55
|
| Rate for Payer: Cigna of CA HMO |
$2,725.76
|
| Rate for Payer: Cigna of CA PPO |
$3,151.66
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,981.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$3,620.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,555.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$155.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,704.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$175.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,129.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,022.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,016.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$3,407.20
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$2,768.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,620.15
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,555.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,129.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$806.82
|
| 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 THORACENTESIS ASPIRATN W GUID
|
Facility
|
IP
|
$4,259.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
900200007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$851.80 |
| Max. Negotiated Rate |
$3,620.15 |
| Rate for Payer: Adventist Health Commercial |
$851.80
|
| Rate for Payer: Cash Price |
$1,916.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,981.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,703.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,703.60
|
| Rate for Payer: Galaxy Health WC |
$3,620.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,555.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,704.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,512.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,022.16
|
| Rate for Payer: Multiplan Commercial |
$3,407.20
|
| Rate for Payer: Networks By Design Commercial |
$2,768.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,620.15
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
IP
|
$2,907.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$581.40 |
| Max. Negotiated Rate |
$2,470.95 |
| Rate for Payer: Adventist Health Commercial |
$581.40
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,034.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,162.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,162.80
|
| Rate for Payer: Galaxy Health WC |
$2,470.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,744.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,845.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,715.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$697.68
|
| Rate for Payer: Multiplan Commercial |
$2,325.60
|
| Rate for Payer: Networks By Design Commercial |
$1,889.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,470.95
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
IP
|
$2,907.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$581.40 |
| Max. Negotiated Rate |
$2,470.95 |
| Rate for Payer: Adventist Health Commercial |
$581.40
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,034.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,162.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,162.80
|
| Rate for Payer: Galaxy Health WC |
$2,470.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,744.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,845.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,715.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$697.68
|
| Rate for Payer: Multiplan Commercial |
$2,325.60
|
| Rate for Payer: Networks By Design Commercial |
$1,889.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,470.95
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
OP
|
$2,907.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
901200036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$124.47 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$581.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| 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 |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Cigna of CA HMO |
$1,860.48
|
| Rate for Payer: Cigna of CA PPO |
$2,151.18
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,034.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$2,470.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,744.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$124.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,845.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,129.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$697.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,016.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$2,325.60
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$1,889.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,470.95
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,744.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,453.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$806.82
|
| 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 THORACENTESIS ASPIRATN WO GUID
|
Facility
|
OP
|
$2,907.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$124.47 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$581.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| 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 |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Cigna of CA HMO |
$1,860.48
|
| Rate for Payer: Cigna of CA PPO |
$2,151.18
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,034.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$2,470.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,744.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$124.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,845.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,129.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$697.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,016.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$2,325.60
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$1,889.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,470.95
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,744.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,453.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$806.82
|
| 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 THORACENTESIS ASPIRATN WO GUID
|
Facility
|
IP
|
$2,907.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$581.40 |
| Max. Negotiated Rate |
$2,470.95 |
| Rate for Payer: Adventist Health Commercial |
$581.40
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,034.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,162.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,162.80
|
| Rate for Payer: Galaxy Health WC |
$2,470.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,744.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,845.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,715.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$697.68
|
| Rate for Payer: Multiplan Commercial |
$2,325.60
|
| Rate for Payer: Networks By Design Commercial |
$1,889.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,470.95
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
OP
|
$2,907.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$140.77 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$1,191.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$538.87
|
| 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 |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Cigna of CA HMO |
$1,860.48
|
| Rate for Payer: Cigna of CA PPO |
$2,151.18
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,034.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$2,470.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,744.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,845.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$867.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$697.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,016.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$2,325.60
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$1,889.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,470.95
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,744.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,744.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$806.82
|
| 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 THORACENTESIS ASPIRATN WO GUID
|
Facility
|
OP
|
$2,907.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.77 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$581.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| 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 |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Cigna of CA HMO |
$1,860.48
|
| Rate for Payer: Cigna of CA PPO |
$2,151.18
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,034.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,331.25
|
| Rate for Payer: EPIC Health Plan Senior |
$887.50
|
| Rate for Payer: Galaxy Health WC |
$2,470.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,744.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,323.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,845.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$867.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$697.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,016.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,081.14
|
| Rate for Payer: Multiplan Commercial |
$2,325.60
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$1,889.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,470.95
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,744.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,453.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,453.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,453.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,453.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$806.82
|
| 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 THORACENTESIS ASPIRATN WO GUID
|
Facility
|
IP
|
$2,907.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
901200036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$581.40 |
| Max. Negotiated Rate |
$2,470.95 |
| Rate for Payer: Adventist Health Commercial |
$581.40
|
| Rate for Payer: Cash Price |
$1,308.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,034.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,162.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,162.80
|
| Rate for Payer: Galaxy Health WC |
$2,470.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,744.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,845.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,715.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$697.68
|
| Rate for Payer: Multiplan Commercial |
$2,325.60
|
| Rate for Payer: Networks By Design Commercial |
$1,889.55
|
| Rate for Payer: Prime Health Services Commercial |
$2,470.95
|
|
|
HC THORACIC FACET JONT INJ,EA ADL
|
Facility
|
IP
|
$2,615.00
|
|
|
Service Code
|
CPT 64491
|
| Hospital Charge Code |
909000231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$523.00 |
| Max. Negotiated Rate |
$2,222.75 |
| Rate for Payer: Adventist Health Commercial |
$523.00
|
| Rate for Payer: Cash Price |
$1,176.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,830.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,046.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,046.00
|
| Rate for Payer: Galaxy Health WC |
$2,222.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,569.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,660.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,542.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$627.60
|
| Rate for Payer: Multiplan Commercial |
$2,092.00
|
| Rate for Payer: Networks By Design Commercial |
$1,699.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,222.75
|
|
|
HC THORACIC FACET JONT INJ,EA ADL
|
Facility
|
OP
|
$2,615.00
|
|
|
Service Code
|
CPT 64491
|
| Hospital Charge Code |
909000231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$133.85 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$523.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,222.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,438.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,961.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Cash Price |
$1,176.75
|
| Rate for Payer: Cash Price |
$1,176.75
|
| Rate for Payer: Cash Price |
$1,176.75
|
| Rate for Payer: Cigna of CA HMO |
$1,673.60
|
| Rate for Payer: Cigna of CA PPO |
$1,935.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,222.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,222.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,222.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,830.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,046.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,046.00
|
| Rate for Payer: Galaxy Health WC |
$2,222.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,569.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$133.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,660.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$151.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,542.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$627.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,830.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,830.50
|
| Rate for Payer: Multiplan Commercial |
$2,092.00
|
| Rate for Payer: Networks By Design Commercial |
$1,699.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,222.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,569.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,307.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,222.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,222.75
|
| Rate for Payer: Vantage Medical Group Senior |
$2,222.75
|
|
|
HC THORACIC SPINE 2VIEWS
|
Facility
|
OP
|
$796.00
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
909001311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$47.11 |
| Max. Negotiated Rate |
$676.60 |
| Rate for Payer: Adventist Health Commercial |
$159.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$165.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$192.00
|
| Rate for Payer: Blue Shield of California Commercial |
$335.12
|
| Rate for Payer: Blue Shield of California Commercial |
$507.85
|
| Rate for Payer: Cash Price |
$358.20
|
| Rate for Payer: Cash Price |
$358.20
|
| Rate for Payer: Cigna of CA HMO |
$509.44
|
| Rate for Payer: Cigna of CA PPO |
$589.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$557.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$676.60
|
| Rate for Payer: Global Benefits Group Commercial |
$477.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$47.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$505.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$53.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$191.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$169.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$636.80
|
| Rate for Payer: Networks By Design Commercial |
$517.40
|
| Rate for Payer: Prime Health Services Commercial |
$676.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$477.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$477.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC THORACIC SPINE 2VIEWS
|
Facility
|
IP
|
$796.00
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
909001311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$159.20 |
| Max. Negotiated Rate |
$676.60 |
| Rate for Payer: Adventist Health Commercial |
$159.20
|
| Rate for Payer: Cash Price |
$358.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$557.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$318.40
|
| Rate for Payer: EPIC Health Plan Senior |
$318.40
|
| Rate for Payer: Galaxy Health WC |
$676.60
|
| Rate for Payer: Global Benefits Group Commercial |
$477.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$505.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$469.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$191.04
|
| Rate for Payer: Multiplan Commercial |
$636.80
|
| Rate for Payer: Networks By Design Commercial |
$517.40
|
| Rate for Payer: Prime Health Services Commercial |
$676.60
|
|
|
HC THORACIC SPINE 3VIEWS
|
Facility
|
OP
|
$873.00
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
909001310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$51.79 |
| Max. Negotiated Rate |
$742.05 |
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: Adventist Health Commercial |
$174.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$194.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$218.20
|
| Rate for Payer: Blue Shield of California Commercial |
$367.53
|
| Rate for Payer: Blue Shield of California Commercial |
$556.97
|
| Rate for Payer: Cash Price |
$392.85
|
| Rate for Payer: Cash Price |
$392.85
|
| Rate for Payer: Cigna of CA HMO |
$558.72
|
| Rate for Payer: Cigna of CA PPO |
$646.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$611.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$742.05
|
| Rate for Payer: Global Benefits Group Commercial |
$523.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$51.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$554.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$58.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$169.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$698.40
|
| Rate for Payer: Networks By Design Commercial |
$567.45
|
| Rate for Payer: Prime Health Services Commercial |
$742.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$523.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$523.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC THORACIC SPINE 3VIEWS
|
Facility
|
IP
|
$873.00
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
909001310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$174.60 |
| Max. Negotiated Rate |
$742.05 |
| Rate for Payer: Adventist Health Commercial |
$174.60
|
| Rate for Payer: Cash Price |
$392.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$611.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$349.20
|
| Rate for Payer: Galaxy Health WC |
$742.05
|
| Rate for Payer: Global Benefits Group Commercial |
$523.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$554.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$515.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.52
|
| Rate for Payer: Multiplan Commercial |
$698.40
|
| Rate for Payer: Networks By Design Commercial |
$567.45
|
| Rate for Payer: Prime Health Services Commercial |
$742.05
|
|
|
HC THORACIC SPINE 4 VIEWS
|
Facility
|
IP
|
$1,176.00
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
909001313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$235.20 |
| Max. Negotiated Rate |
$999.60 |
| Rate for Payer: Adventist Health Commercial |
$235.20
|
| Rate for Payer: Cash Price |
$529.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$823.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$470.40
|
| Rate for Payer: EPIC Health Plan Senior |
$470.40
|
| Rate for Payer: Galaxy Health WC |
$999.60
|
| Rate for Payer: Global Benefits Group Commercial |
$705.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$746.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$693.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.24
|
| Rate for Payer: Multiplan Commercial |
$940.80
|
| Rate for Payer: Networks By Design Commercial |
$764.40
|
| Rate for Payer: Prime Health Services Commercial |
$999.60
|
|
|
HC THORACIC SPINE 4 VIEWS
|
Facility
|
OP
|
$1,176.00
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
909001313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$58.98 |
| Max. Negotiated Rate |
$999.60 |
| Rate for Payer: Adventist Health Commercial |
$235.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$243.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$269.48
|
| Rate for Payer: Blue Shield of California Commercial |
$495.10
|
| Rate for Payer: Blue Shield of California Commercial |
$750.29
|
| Rate for Payer: Cash Price |
$529.20
|
| Rate for Payer: Cash Price |
$529.20
|
| Rate for Payer: Cigna of CA HMO |
$752.64
|
| Rate for Payer: Cigna of CA PPO |
$870.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$823.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$999.60
|
| Rate for Payer: Global Benefits Group Commercial |
$705.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$58.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$746.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$66.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$169.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$940.80
|
| Rate for Payer: Networks By Design Commercial |
$764.40
|
| Rate for Payer: Prime Health Services Commercial |
$999.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$705.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$705.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC THORACOTOMY CARDIAC
|
Facility
|
OP
|
$3,682.00
|
|
|
Service Code
|
CPT 32160
|
| Hospital Charge Code |
900501127
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$187.64 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$736.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,129.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,025.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,761.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,323.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Cash Price |
$1,656.90
|
| Rate for Payer: Cash Price |
$1,656.90
|
| Rate for Payer: Cash Price |
$1,656.90
|
| Rate for Payer: Cigna of CA HMO |
$2,356.48
|
| Rate for Payer: Cigna of CA PPO |
$2,724.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,129.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,129.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,129.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,577.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,472.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,472.80
|
| Rate for Payer: Galaxy Health WC |
$3,129.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,209.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$187.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,338.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$212.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,172.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$883.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,577.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,577.40
|
| Rate for Payer: Multiplan Commercial |
$2,945.60
|
| Rate for Payer: Networks By Design Commercial |
$2,393.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,129.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,209.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,841.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,129.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,129.70
|
| Rate for Payer: Vantage Medical Group Senior |
$3,129.70
|
|
|
HC THORACOTOMY CARDIAC
|
Facility
|
IP
|
$3,682.00
|
|
|
Service Code
|
CPT 32160
|
| Hospital Charge Code |
900501127
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$736.40 |
| Max. Negotiated Rate |
$3,129.70 |
| Rate for Payer: Adventist Health Commercial |
$736.40
|
| Rate for Payer: Cash Price |
$1,656.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,577.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,472.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,472.80
|
| Rate for Payer: Galaxy Health WC |
$3,129.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,209.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,338.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,172.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$883.68
|
| Rate for Payer: Multiplan Commercial |
$2,945.60
|
| Rate for Payer: Networks By Design Commercial |
$2,393.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,129.70
|
|
|
HC THORACOTOMY; WITH EXPLORATION
|
Facility
|
IP
|
$1,833.00
|
|
|
Service Code
|
CPT 32100
|
| Hospital Charge Code |
900502100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$366.60 |
| Max. Negotiated Rate |
$1,558.05 |
| Rate for Payer: Adventist Health Commercial |
$366.60
|
| Rate for Payer: Cash Price |
$824.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,283.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$733.20
|
| Rate for Payer: EPIC Health Plan Senior |
$733.20
|
| Rate for Payer: Galaxy Health WC |
$1,558.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,099.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,163.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,081.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.92
|
| Rate for Payer: Multiplan Commercial |
$1,466.40
|
| Rate for Payer: Networks By Design Commercial |
$1,191.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,558.05
|
|
|
HC THORACOTOMY; WITH EXPLORATION
|
Facility
|
OP
|
$1,833.00
|
|
|
Service Code
|
CPT 32100
|
| Hospital Charge Code |
900502100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$170.13 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$366.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,558.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,008.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,374.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Cash Price |
$824.85
|
| Rate for Payer: Cash Price |
$824.85
|
| Rate for Payer: Cash Price |
$824.85
|
| Rate for Payer: Cigna of CA HMO |
$1,173.12
|
| Rate for Payer: Cigna of CA PPO |
$1,356.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,558.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,558.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,558.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,283.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$733.20
|
| Rate for Payer: EPIC Health Plan Senior |
$733.20
|
| Rate for Payer: Galaxy Health WC |
$1,558.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,099.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$170.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,163.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,081.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$439.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,283.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,283.10
|
| Rate for Payer: Multiplan Commercial |
$1,466.40
|
| Rate for Payer: Networks By Design Commercial |
$1,191.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,558.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,099.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$916.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,558.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,558.05
|
| Rate for Payer: Vantage Medical Group Senior |
$1,558.05
|
|
|
HC THROMBECTOMY CATH, 6&7F HYDROL
|
Facility
|
OP
|
$1,440.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909081406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.00 |
| Max. Negotiated Rate |
$1,224.00 |
| Rate for Payer: Adventist Health Commercial |
$288.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,224.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$792.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,080.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$871.63
|
| Rate for Payer: Blue Shield of California Commercial |
$1,107.36
|
| Rate for Payer: Blue Shield of California Commercial |
$730.08
|
| Rate for Payer: Cash Price |
$648.00
|
| Rate for Payer: Cigna of CA HMO |
$1,008.00
|
| Rate for Payer: Cigna of CA PPO |
$1,008.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,224.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,224.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,224.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,008.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$576.00
|
| Rate for Payer: EPIC Health Plan Senior |
$576.00
|
| Rate for Payer: Galaxy Health WC |
$1,224.00
|
| Rate for Payer: Global Benefits Group Commercial |
$864.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$914.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$522.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$849.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$345.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,008.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,008.00
|
| Rate for Payer: Multiplan Commercial |
$1,152.00
|
| Rate for Payer: Networks By Design Commercial |
$720.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,224.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$864.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$864.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$540.43
|
| Rate for Payer: United Healthcare All Other HMO |
$526.03
|
| Rate for Payer: United Healthcare HMO Rider |
$514.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$471.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,224.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,224.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,224.00
|
|
