|
HC TRANSBRONCHIAL W/NEEDLE BIOPSY
|
Facility
|
OP
|
$3,801.00
|
|
|
Service Code
|
CPT 31629
|
| Hospital Charge Code |
900803508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$312.73 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$760.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,684.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$2,090.55
|
| Rate for Payer: Cash Price |
$2,090.55
|
| Rate for Payer: Cash Price |
$2,090.55
|
| Rate for Payer: Cigna of CA HMO |
$2,432.64
|
| Rate for Payer: Cigna of CA PPO |
$2,812.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,153.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,684.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,324.26
|
| Rate for Payer: EPIC Health Plan Senior |
$4,684.64
|
| Rate for Payer: Galaxy Health WC |
$3,230.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,280.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,682.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$312.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,684.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,535.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$353.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,684.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$912.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,902.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,277.42
|
| Rate for Payer: Multiplan Commercial |
$3,040.80
|
| Rate for Payer: Multiplan WC |
$7,464.14
|
| Rate for Payer: Networks By Design Commercial |
$2,470.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,230.85
|
| Rate for Payer: Prime Health Services WC |
$7,387.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,280.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,684.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,684.64
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
|
OP
|
$37,754.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906812218
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,014.59 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$7,550.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,339.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$20,764.70
|
| Rate for Payer: Cash Price |
$20,764.70
|
| Rate for Payer: Cash Price |
$20,764.70
|
| Rate for Payer: Cigna of CA HMO |
$24,540.10
|
| Rate for Payer: Cigna of CA PPO |
$27,937.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$32,090.90
|
| Rate for Payer: Global Benefits Group Commercial |
$22,652.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,014.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,181.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,147.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,060.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$30,203.20
|
| Rate for Payer: Networks By Design Commercial |
$24,540.10
|
| Rate for Payer: Prime Health Services Commercial |
$32,090.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22,652.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22,652.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
|
IP
|
$37,754.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906812218
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,550.80 |
| Max. Negotiated Rate |
$32,090.90 |
| Rate for Payer: Adventist Health Commercial |
$7,550.80
|
| Rate for Payer: Cash Price |
$20,764.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,101.60
|
| Rate for Payer: EPIC Health Plan Senior |
$15,101.60
|
| Rate for Payer: Galaxy Health WC |
$32,090.90
|
| Rate for Payer: Global Benefits Group Commercial |
$22,652.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,181.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,384.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,369.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,060.96
|
| Rate for Payer: Multiplan Commercial |
$30,203.20
|
| Rate for Payer: Networks By Design Commercial |
$24,540.10
|
| Rate for Payer: Prime Health Services Commercial |
$32,090.90
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
|
OP
|
$36,692.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906820084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,014.59 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$7,338.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,339.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$20,180.60
|
| Rate for Payer: Cash Price |
$20,180.60
|
| Rate for Payer: Cash Price |
$20,180.60
|
| Rate for Payer: Cigna of CA HMO |
$23,849.80
|
| Rate for Payer: Cigna of CA PPO |
$27,152.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$31,188.20
|
| Rate for Payer: Global Benefits Group Commercial |
$22,015.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,014.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,473.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,147.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,806.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$29,353.60
|
| Rate for Payer: Networks By Design Commercial |
$23,849.80
|
| Rate for Payer: Prime Health Services Commercial |
$31,188.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22,015.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22,015.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
|
IP
|
$36,692.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906820084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,338.40 |
| Max. Negotiated Rate |
$31,188.20 |
| Rate for Payer: Adventist Health Commercial |
$7,338.40
|
| Rate for Payer: Cash Price |
$20,180.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,676.80
|
| Rate for Payer: EPIC Health Plan Senior |
$14,676.80
|
| Rate for Payer: Galaxy Health WC |
$31,188.20
|
| Rate for Payer: Global Benefits Group Commercial |
$22,015.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,473.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,979.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,712.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,806.08
|
| Rate for Payer: Multiplan Commercial |
$29,353.60
|
| Rate for Payer: Networks By Design Commercial |
$23,849.80
|
| Rate for Payer: Prime Health Services Commercial |
$31,188.20
|
|
|
HC TRANS CATH CLOSURE/VSD
|
Facility
|
IP
|
$26,558.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906820085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,311.60 |
| Max. Negotiated Rate |
$22,574.30 |
| Rate for Payer: Adventist Health Commercial |
$5,311.60
|
| Rate for Payer: Cash Price |
$14,606.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,623.20
|
| Rate for Payer: EPIC Health Plan Senior |
$10,623.20
|
| Rate for Payer: Galaxy Health WC |
$22,574.30
|
| Rate for Payer: Global Benefits Group Commercial |
$15,934.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,714.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,118.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,439.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,373.92
|
| Rate for Payer: Multiplan Commercial |
$21,246.40
|
| Rate for Payer: Networks By Design Commercial |
$17,262.70
|
| Rate for Payer: Prime Health Services Commercial |
$22,574.30
|
|
|
HC TRANS CATH CLOSURE/VSD
|
Facility
|
OP
|
$26,558.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906820085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,278.01 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$5,311.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,339.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$14,606.90
|
| Rate for Payer: Cash Price |
$14,606.90
|
| Rate for Payer: Cash Price |
$14,606.90
|
| Rate for Payer: Cigna of CA HMO |
$17,262.70
|
| Rate for Payer: Cigna of CA PPO |
$19,652.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$22,574.30
|
| Rate for Payer: Global Benefits Group Commercial |
$15,934.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,278.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,714.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,445.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,373.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$21,246.40
|
| Rate for Payer: Networks By Design Commercial |
$17,262.70
|
| Rate for Payer: Prime Health Services Commercial |
$22,574.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,934.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,934.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC TRANS CATH CLOSURE/VSD
|
Facility
|
OP
|
$27,327.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906812219
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,278.01 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$5,465.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,339.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$15,029.85
|
| Rate for Payer: Cash Price |
$15,029.85
|
| Rate for Payer: Cash Price |
$15,029.85
|
| Rate for Payer: Cigna of CA HMO |
$17,762.55
|
| Rate for Payer: Cigna of CA PPO |
$20,221.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$23,227.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16,396.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,278.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,227.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,445.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,558.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$21,861.60
|
| Rate for Payer: Networks By Design Commercial |
$17,762.55
|
| Rate for Payer: Prime Health Services Commercial |
$23,227.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,396.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,396.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC TRANS CATH CLOSURE/VSD
|
Facility
|
IP
|
$27,327.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906812219
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,465.40 |
| Max. Negotiated Rate |
$23,227.95 |
| Rate for Payer: Adventist Health Commercial |
$5,465.40
|
| Rate for Payer: Cash Price |
$15,029.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,930.80
|
| Rate for Payer: EPIC Health Plan Senior |
$10,930.80
|
| Rate for Payer: Galaxy Health WC |
$23,227.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16,396.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,227.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,411.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,915.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,558.48
|
| Rate for Payer: Multiplan Commercial |
$21,861.60
|
| Rate for Payer: Networks By Design Commercial |
$17,762.55
|
| Rate for Payer: Prime Health Services Commercial |
$23,227.95
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$6,605.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
909081356
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,321.00 |
| Max. Negotiated Rate |
$5,614.25 |
| Rate for Payer: Adventist Health Commercial |
$1,321.00
|
| Rate for Payer: Cash Price |
$3,632.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,642.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,642.00
|
| Rate for Payer: Galaxy Health WC |
$5,614.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,963.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,405.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,516.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,088.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,585.20
|
| Rate for Payer: Multiplan Commercial |
$5,284.00
|
| Rate for Payer: Networks By Design Commercial |
$4,293.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,614.25
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$6,928.00
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
909081664
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,385.60 |
| Max. Negotiated Rate |
$5,888.80 |
| Rate for Payer: Adventist Health Commercial |
$1,385.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,544.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,888.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,810.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,196.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,244.19
|
| Rate for Payer: Blue Shield of California Commercial |
$4,239.94
|
| Rate for Payer: Blue Shield of California EPN |
$2,798.91
|
| Rate for Payer: Cash Price |
$3,810.40
|
| Rate for Payer: Cash Price |
$3,810.40
|
| Rate for Payer: Cigna of CA HMO |
$4,433.92
|
| Rate for Payer: Cigna of CA PPO |
$5,126.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,888.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,888.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,888.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,771.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,771.20
|
| Rate for Payer: Galaxy Health WC |
$5,888.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,156.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,620.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,288.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,662.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,849.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,849.60
|
| Rate for Payer: Multiplan Commercial |
$5,542.40
|
| Rate for Payer: Networks By Design Commercial |
$4,503.20
|
| Rate for Payer: Prime Health Services Commercial |
$5,888.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,156.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,156.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,464.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,464.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,464.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,464.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,888.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,888.80
|
| Rate for Payer: Vantage Medical Group Senior |
$5,888.80
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$14,590.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
906811700
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$231.42 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,918.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$8,024.50
|
| Rate for Payer: Cash Price |
$8,024.50
|
| Rate for Payer: Cash Price |
$8,024.50
|
| Rate for Payer: Cigna of CA HMO |
$9,337.60
|
| Rate for Payer: Cigna of CA PPO |
$10,796.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,272.45
|
| Rate for Payer: EPIC Health Plan Senior |
$6,868.48
|
| Rate for Payer: Galaxy Health WC |
$12,401.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8,754.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,264.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$231.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,731.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$261.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,501.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,654.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,203.76
|
| Rate for Payer: Multiplan Commercial |
$11,672.00
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: Networks By Design Commercial |
$9,483.50
|
| Rate for Payer: Prime Health Services Commercial |
$12,401.50
|
| Rate for Payer: Prime Health Services WC |
$10,832.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,754.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,868.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$6,928.00
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
909081664
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,385.60 |
| Max. Negotiated Rate |
$5,888.80 |
| Rate for Payer: Adventist Health Commercial |
$1,385.60
|
| Rate for Payer: Cash Price |
$3,810.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,771.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,771.20
|
| Rate for Payer: Galaxy Health WC |
$5,888.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,156.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,620.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,639.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,288.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,662.72
|
| Rate for Payer: Multiplan Commercial |
$5,542.40
|
| Rate for Payer: Networks By Design Commercial |
$4,503.20
|
| Rate for Payer: Prime Health Services Commercial |
$5,888.80
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$14,590.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
906811700
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,918.00 |
| Max. Negotiated Rate |
$12,401.50 |
| Rate for Payer: Adventist Health Commercial |
$2,918.00
|
| Rate for Payer: Cash Price |
$8,024.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,836.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,836.00
|
| Rate for Payer: Galaxy Health WC |
$12,401.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8,754.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,731.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,558.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,031.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,501.60
|
| Rate for Payer: Multiplan Commercial |
$11,672.00
|
| Rate for Payer: Networks By Design Commercial |
$9,483.50
|
| Rate for Payer: Prime Health Services Commercial |
$12,401.50
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$6,605.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
909081356
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$231.42 |
| Max. Negotiated Rate |
$12,491.00 |
| Rate for Payer: Adventist Health Commercial |
$1,321.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,042.26
|
| Rate for Payer: Blue Shield of California EPN |
$2,668.42
|
| Rate for Payer: Cash Price |
$3,632.75
|
| Rate for Payer: Cash Price |
$3,632.75
|
| Rate for Payer: Cash Price |
$3,632.75
|
| Rate for Payer: Cigna of CA HMO |
$4,227.20
|
| Rate for Payer: Cigna of CA PPO |
$4,887.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,272.45
|
| Rate for Payer: EPIC Health Plan Senior |
$6,868.48
|
| Rate for Payer: Galaxy Health WC |
$5,614.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,963.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,264.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$231.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,405.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$261.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,585.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,654.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,203.76
|
| Rate for Payer: Multiplan Commercial |
$5,284.00
|
| Rate for Payer: Networks By Design Commercial |
$4,293.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,614.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,963.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,963.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,302.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,302.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,302.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,302.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,868.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
|
IP
|
$24,432.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906820253
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,886.40 |
| Max. Negotiated Rate |
$20,767.20 |
| Rate for Payer: Adventist Health Commercial |
$4,886.40
|
| Rate for Payer: Cash Price |
$13,437.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,772.80
|
| Rate for Payer: EPIC Health Plan Senior |
$9,772.80
|
| Rate for Payer: Galaxy Health WC |
$20,767.20
|
| Rate for Payer: Global Benefits Group Commercial |
$14,659.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,296.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,308.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,123.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,863.68
|
| Rate for Payer: Multiplan Commercial |
$19,545.60
|
| Rate for Payer: Networks By Design Commercial |
$15,880.80
|
| Rate for Payer: Prime Health Services Commercial |
$20,767.20
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
|
IP
|
$14,171.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906811451
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,834.20 |
| Max. Negotiated Rate |
$12,045.35 |
| Rate for Payer: Adventist Health Commercial |
$2,834.20
|
| Rate for Payer: Cash Price |
$7,794.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,668.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,668.40
|
| Rate for Payer: Galaxy Health WC |
$12,045.35
|
| Rate for Payer: Global Benefits Group Commercial |
$8,502.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,452.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,399.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,771.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,401.04
|
| Rate for Payer: Multiplan Commercial |
$11,336.80
|
| Rate for Payer: Networks By Design Commercial |
$9,211.15
|
| Rate for Payer: Prime Health Services Commercial |
$12,045.35
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
|
OP
|
$14,171.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906811451
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$425.95 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,834.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$7,794.05
|
| Rate for Payer: Cash Price |
$7,794.05
|
| Rate for Payer: Cash Price |
$7,794.05
|
| Rate for Payer: Cigna of CA HMO |
$9,211.15
|
| Rate for Payer: Cigna of CA PPO |
$10,486.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$12,045.35
|
| Rate for Payer: Global Benefits Group Commercial |
$8,502.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$425.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,452.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$481.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,401.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$11,336.80
|
| Rate for Payer: Networks By Design Commercial |
$9,211.15
|
| Rate for Payer: Prime Health Services Commercial |
$12,045.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,502.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,502.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
|
OP
|
$24,432.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906820253
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$425.95 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$4,886.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$13,437.60
|
| Rate for Payer: Cash Price |
$13,437.60
|
| Rate for Payer: Cash Price |
$13,437.60
|
| Rate for Payer: Cigna of CA HMO |
$15,880.80
|
| Rate for Payer: Cigna of CA PPO |
$18,079.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$20,767.20
|
| Rate for Payer: Global Benefits Group Commercial |
$14,659.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$425.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,296.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$481.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,863.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$19,545.60
|
| Rate for Payer: Networks By Design Commercial |
$15,880.80
|
| Rate for Payer: Prime Health Services Commercial |
$20,767.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,659.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14,659.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0796T
|
| Hospital Charge Code |
906819778
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,740.80 |
| Max. Negotiated Rate |
$37,148.40 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Cash Price |
$24,037.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,481.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,481.60
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29,150.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,651.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,052.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,488.96
|
| Rate for Payer: Multiplan Commercial |
$34,963.20
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0796T
|
| Hospital Charge Code |
906819778
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$570.02 |
| Max. Negotiated Rate |
$39,740.18 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,655.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,231.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26,838.63
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$570.02
|
| Rate for Payer: Cash Price |
$24,037.20
|
| Rate for Payer: Cash Price |
$24,037.20
|
| Rate for Payer: Cash Price |
$24,037.20
|
| Rate for Payer: Cigna of CA HMO |
$27,970.56
|
| Rate for Payer: Cigna of CA PPO |
$32,340.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,655.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,231.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,712.96
|
| Rate for Payer: EPIC Health Plan Senior |
$24,231.82
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$39,740.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,231.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29,150.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,651.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,231.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,488.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,532.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,470.64
|
| Rate for Payer: Multiplan Commercial |
$34,963.20
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
| Rate for Payer: Prime Health Services WC |
$38,215.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26,222.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,852.00
|
| Rate for Payer: United Healthcare All Other HMO |
$21,852.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,852.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,852.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$24,231.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,655.00
|
| Rate for Payer: Vantage Medical Group Senior |
$24,231.82
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA RV COMP SYS
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0795T
|
| Hospital Charge Code |
906819777
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,740.80 |
| Max. Negotiated Rate |
$37,148.40 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Cash Price |
$24,037.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,481.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,481.60
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29,150.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,651.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,052.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,488.96
|
| Rate for Payer: Multiplan Commercial |
$34,963.20
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA RV COMP SYS
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0795T
|
| Hospital Charge Code |
906819777
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$570.02 |
| Max. Negotiated Rate |
$39,740.18 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13,494.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,655.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,231.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26,838.63
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$570.02
|
| Rate for Payer: Cash Price |
$24,037.20
|
| Rate for Payer: Cash Price |
$24,037.20
|
| Rate for Payer: Cash Price |
$24,037.20
|
| Rate for Payer: Cigna of CA HMO |
$27,970.56
|
| Rate for Payer: Cigna of CA PPO |
$32,340.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,655.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,231.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,712.96
|
| Rate for Payer: EPIC Health Plan Senior |
$24,231.82
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$39,740.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,231.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29,150.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,651.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,231.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,488.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,532.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,470.64
|
| Rate for Payer: Multiplan Commercial |
$34,963.20
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
| Rate for Payer: Prime Health Services WC |
$38,215.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26,222.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,852.00
|
| Rate for Payer: United Healthcare All Other HMO |
$21,852.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,852.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,852.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$24,231.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,655.00
|
| Rate for Payer: Vantage Medical Group Senior |
$24,231.82
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RV PM COMPNT
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0797T
|
| Hospital Charge Code |
906819779
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,740.80 |
| Max. Negotiated Rate |
$37,148.40 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Cash Price |
$24,037.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,481.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,481.60
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29,150.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,651.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,052.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,488.96
|
| Rate for Payer: Multiplan Commercial |
$34,963.20
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RV PM COMPNT
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0797T
|
| Hospital Charge Code |
906819779
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$570.02 |
| Max. Negotiated Rate |
$39,740.18 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26,655.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,231.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26,838.63
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$570.02
|
| Rate for Payer: Cash Price |
$24,037.20
|
| Rate for Payer: Cash Price |
$24,037.20
|
| Rate for Payer: Cash Price |
$24,037.20
|
| Rate for Payer: Cigna of CA HMO |
$27,970.56
|
| Rate for Payer: Cigna of CA PPO |
$32,340.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,655.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,231.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,712.96
|
| Rate for Payer: EPIC Health Plan Senior |
$24,231.82
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$39,740.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,231.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29,150.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,651.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,231.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,488.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,532.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,470.64
|
| Rate for Payer: Multiplan Commercial |
$34,963.20
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
| Rate for Payer: Prime Health Services WC |
$38,215.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26,222.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,852.00
|
| Rate for Payer: United Healthcare All Other HMO |
$21,852.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,852.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,852.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$24,231.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,347.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,655.00
|
| Rate for Payer: Vantage Medical Group Senior |
$24,231.82
|
|
