|
HC TRANSCATH SEPTAL REDUCT THER
|
Facility
|
OP
|
$24,171.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906803583
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$845.39 |
| Max. Negotiated Rate |
$20,545.35 |
| Rate for Payer: Adventist Health Commercial |
$4,834.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,545.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,294.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,128.25
|
| 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 |
$13,294.05
|
| Rate for Payer: Cash Price |
$13,294.05
|
| Rate for Payer: Cash Price |
$13,294.05
|
| Rate for Payer: Cigna of CA HMO |
$15,469.44
|
| Rate for Payer: Cigna of CA PPO |
$17,886.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,545.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$20,545.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20,545.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,668.40
|
| Rate for Payer: EPIC Health Plan Senior |
$9,668.40
|
| Rate for Payer: Galaxy Health WC |
$20,545.35
|
| Rate for Payer: Global Benefits Group Commercial |
$14,502.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$845.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,122.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$956.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,961.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,801.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,919.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,919.70
|
| Rate for Payer: Multiplan Commercial |
$19,336.80
|
| Rate for Payer: Networks By Design Commercial |
$15,711.15
|
| Rate for Payer: Prime Health Services Commercial |
$20,545.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,502.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$20,545.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20,545.35
|
| Rate for Payer: Vantage Medical Group Senior |
$20,545.35
|
|
|
HC TRANSCATH SEPTAL REDUCT THER
|
Facility
|
IP
|
$23,492.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906820293
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,698.40 |
| Max. Negotiated Rate |
$19,968.20 |
| Rate for Payer: Adventist Health Commercial |
$4,698.40
|
| Rate for Payer: Cash Price |
$12,920.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,396.80
|
| Rate for Payer: EPIC Health Plan Senior |
$9,396.80
|
| Rate for Payer: Galaxy Health WC |
$19,968.20
|
| Rate for Payer: Global Benefits Group Commercial |
$14,095.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,669.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,950.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,541.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,638.08
|
| Rate for Payer: Multiplan Commercial |
$18,793.60
|
| Rate for Payer: Networks By Design Commercial |
$15,269.80
|
| Rate for Payer: Prime Health Services Commercial |
$19,968.20
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
|
OP
|
$8,608.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906820133
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,721.60 |
| Max. Negotiated Rate |
$7,316.80 |
| Rate for Payer: Adventist Health Commercial |
$1,721.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,645.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,316.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,734.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,456.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,782.56
|
| Rate for Payer: Blue Shield of California Commercial |
$5,268.10
|
| Rate for Payer: Blue Shield of California EPN |
$3,477.63
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Cigna of CA HMO |
$5,509.12
|
| Rate for Payer: Cigna of CA PPO |
$6,369.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,316.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,316.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,316.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,443.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,443.20
|
| Rate for Payer: Galaxy Health WC |
$7,316.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,164.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,741.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,328.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,065.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,025.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,025.60
|
| Rate for Payer: Multiplan Commercial |
$6,886.40
|
| Rate for Payer: Networks By Design Commercial |
$5,595.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,316.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,164.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,164.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,304.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,304.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,304.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,304.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,316.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,316.80
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.80
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
|
OP
|
$9,482.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906812173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,896.40 |
| Max. Negotiated Rate |
$8,059.70 |
| Rate for Payer: Adventist Health Commercial |
$1,896.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,219.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,059.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,215.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,111.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,782.56
|
| Rate for Payer: Blue Shield of California Commercial |
$5,802.98
|
| Rate for Payer: Blue Shield of California EPN |
$3,830.73
|
| Rate for Payer: Cash Price |
$5,215.10
|
| Rate for Payer: Cash Price |
$5,215.10
|
| Rate for Payer: Cigna of CA HMO |
$6,068.48
|
| Rate for Payer: Cigna of CA PPO |
$7,016.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,059.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,059.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,059.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,792.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,792.80
|
| Rate for Payer: Galaxy Health WC |
$8,059.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,689.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,324.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,869.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,275.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,637.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,637.40
|
| Rate for Payer: Multiplan Commercial |
$7,585.60
|
| Rate for Payer: Networks By Design Commercial |
$6,163.30
|
| Rate for Payer: Prime Health Services Commercial |
$8,059.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,689.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,689.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,741.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,741.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,741.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,741.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,059.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,059.70
|
| Rate for Payer: Vantage Medical Group Senior |
$8,059.70
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
|
IP
|
$9,482.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906812173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,896.40 |
| Max. Negotiated Rate |
$8,059.70 |
| Rate for Payer: Adventist Health Commercial |
$1,896.40
|
| Rate for Payer: Cash Price |
$5,215.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,792.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,792.80
|
| Rate for Payer: Galaxy Health WC |
$8,059.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,689.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,324.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,612.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,869.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,275.68
|
| Rate for Payer: Multiplan Commercial |
$7,585.60
|
| Rate for Payer: Networks By Design Commercial |
$6,163.30
|
| Rate for Payer: Prime Health Services Commercial |
$8,059.70
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
|
IP
|
$8,608.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906820133
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,721.60 |
| Max. Negotiated Rate |
$7,316.80 |
| Rate for Payer: Adventist Health Commercial |
$1,721.60
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,443.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,443.20
|
| Rate for Payer: Galaxy Health WC |
$7,316.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,164.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,741.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,279.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,328.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,065.92
|
| Rate for Payer: Multiplan Commercial |
$6,886.40
|
| Rate for Payer: Networks By Design Commercial |
$5,595.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,316.80
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
|
IP
|
$24,898.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906810570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,979.60 |
| Max. Negotiated Rate |
$21,163.30 |
| Rate for Payer: Adventist Health Commercial |
$4,979.60
|
| Rate for Payer: Cash Price |
$13,693.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,959.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9,959.20
|
| Rate for Payer: Galaxy Health WC |
$21,163.30
|
| Rate for Payer: Global Benefits Group Commercial |
$14,938.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,606.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,486.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,411.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,975.52
|
| Rate for Payer: Multiplan Commercial |
$19,918.40
|
| Rate for Payer: Networks By Design Commercial |
$16,183.70
|
| Rate for Payer: Prime Health Services Commercial |
$21,163.30
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
|
IP
|
$24,198.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906820273
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,839.60 |
| Max. Negotiated Rate |
$20,568.30 |
| Rate for Payer: Adventist Health Commercial |
$4,839.60
|
| Rate for Payer: Cash Price |
$13,308.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,679.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9,679.20
|
| Rate for Payer: Galaxy Health WC |
$20,568.30
|
| Rate for Payer: Global Benefits Group Commercial |
$14,518.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,140.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,219.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,978.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,807.52
|
| Rate for Payer: Multiplan Commercial |
$19,358.40
|
| Rate for Payer: Networks By Design Commercial |
$15,728.70
|
| Rate for Payer: Prime Health Services Commercial |
$20,568.30
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
|
OP
|
$24,198.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906820273
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$570.02 |
| Max. Negotiated Rate |
$20,568.30 |
| Rate for Payer: Adventist Health Commercial |
$4,839.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,568.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,308.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,148.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| 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 |
$13,308.90
|
| Rate for Payer: Cash Price |
$13,308.90
|
| Rate for Payer: Cigna of CA HMO |
$15,486.72
|
| Rate for Payer: Cigna of CA PPO |
$17,906.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,568.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$20,568.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20,568.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,679.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9,679.20
|
| Rate for Payer: Galaxy Health WC |
$20,568.30
|
| Rate for Payer: Global Benefits Group Commercial |
$14,518.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,140.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,219.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,978.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,807.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,938.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,938.60
|
| Rate for Payer: Multiplan Commercial |
$19,358.40
|
| Rate for Payer: Networks By Design Commercial |
$15,728.70
|
| Rate for Payer: Prime Health Services Commercial |
$20,568.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,518.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$20,568.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20,568.30
|
| Rate for Payer: Vantage Medical Group Senior |
$20,568.30
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
|
OP
|
$24,898.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906810570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$570.02 |
| Max. Negotiated Rate |
$21,163.30 |
| Rate for Payer: Adventist Health Commercial |
$4,979.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,163.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,693.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,673.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| 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 |
$13,693.90
|
| Rate for Payer: Cash Price |
$13,693.90
|
| Rate for Payer: Cigna of CA HMO |
$15,934.72
|
| Rate for Payer: Cigna of CA PPO |
$18,424.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,163.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,163.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21,163.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,959.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9,959.20
|
| Rate for Payer: Galaxy Health WC |
$21,163.30
|
| Rate for Payer: Global Benefits Group Commercial |
$14,938.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,606.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,486.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,411.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,975.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,428.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,428.60
|
| Rate for Payer: Multiplan Commercial |
$19,918.40
|
| Rate for Payer: Networks By Design Commercial |
$16,183.70
|
| Rate for Payer: Prime Health Services Commercial |
$21,163.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,938.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$21,163.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,163.30
|
| Rate for Payer: Vantage Medical Group Senior |
$21,163.30
|
|
|
HC TRANSCATH TRICUSP VALVE ANNUL
|
Facility
|
IP
|
$78,157.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906820271
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,631.40 |
| Max. Negotiated Rate |
$66,433.45 |
| Rate for Payer: Adventist Health Commercial |
$15,631.40
|
| Rate for Payer: Cash Price |
$42,986.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,262.80
|
| Rate for Payer: EPIC Health Plan Senior |
$31,262.80
|
| Rate for Payer: Galaxy Health WC |
$66,433.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,894.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52,130.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,777.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,379.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,757.68
|
| Rate for Payer: Multiplan Commercial |
$62,525.60
|
| Rate for Payer: Networks By Design Commercial |
$50,802.05
|
| Rate for Payer: Prime Health Services Commercial |
$66,433.45
|
|
|
HC TRANSCATH TRICUSP VALVE ANNUL
|
Facility
|
IP
|
$80,419.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906810545
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$16,083.80 |
| Max. Negotiated Rate |
$68,356.15 |
| Rate for Payer: Adventist Health Commercial |
$16,083.80
|
| Rate for Payer: Cash Price |
$44,230.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,167.60
|
| Rate for Payer: EPIC Health Plan Senior |
$32,167.60
|
| Rate for Payer: Galaxy Health WC |
$68,356.15
|
| Rate for Payer: Global Benefits Group Commercial |
$48,251.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,639.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30,639.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,779.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,300.56
|
| Rate for Payer: Multiplan Commercial |
$64,335.20
|
| Rate for Payer: Networks By Design Commercial |
$52,272.35
|
| Rate for Payer: Prime Health Services Commercial |
$68,356.15
|
|
|
HC TRANSCATH TRICUSP VALVE ANNUL
|
Facility
|
OP
|
$78,157.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906820271
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$570.02 |
| Max. Negotiated Rate |
$66,433.45 |
| Rate for Payer: Adventist Health Commercial |
$15,631.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$66,433.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42,986.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58,617.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| 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 |
$42,986.35
|
| Rate for Payer: Cash Price |
$42,986.35
|
| Rate for Payer: Cigna of CA HMO |
$50,020.48
|
| Rate for Payer: Cigna of CA PPO |
$57,836.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$66,433.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$66,433.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$66,433.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,262.80
|
| Rate for Payer: EPIC Health Plan Senior |
$31,262.80
|
| Rate for Payer: Galaxy Health WC |
$66,433.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,894.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52,130.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,777.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,379.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,757.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,709.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,709.90
|
| Rate for Payer: Multiplan Commercial |
$62,525.60
|
| Rate for Payer: Networks By Design Commercial |
$50,802.05
|
| Rate for Payer: Prime Health Services Commercial |
$66,433.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46,894.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$66,433.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$66,433.45
|
| Rate for Payer: Vantage Medical Group Senior |
$66,433.45
|
|
|
HC TRANSCATH TRICUSP VALVE ANNUL
|
Facility
|
OP
|
$80,419.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906810545
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$570.02 |
| Max. Negotiated Rate |
$68,356.15 |
| Rate for Payer: Adventist Health Commercial |
$16,083.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$68,356.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,230.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$60,314.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| 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 |
$44,230.45
|
| Rate for Payer: Cash Price |
$44,230.45
|
| Rate for Payer: Cigna of CA HMO |
$51,468.16
|
| Rate for Payer: Cigna of CA PPO |
$59,510.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$68,356.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$68,356.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$68,356.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,167.60
|
| Rate for Payer: EPIC Health Plan Senior |
$32,167.60
|
| Rate for Payer: Galaxy Health WC |
$68,356.15
|
| Rate for Payer: Global Benefits Group Commercial |
$48,251.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,639.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30,639.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,779.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,300.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,293.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,293.30
|
| Rate for Payer: Multiplan Commercial |
$64,335.20
|
| Rate for Payer: Networks By Design Commercial |
$52,272.35
|
| Rate for Payer: Prime Health Services Commercial |
$68,356.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48,251.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$68,356.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68,356.15
|
| Rate for Payer: Vantage Medical Group Senior |
$68,356.15
|
|
|
HC TRANSCATH TRICUSPVALVE IMPLANT
|
Facility
|
OP
|
$92,483.00
|
|
|
Service Code
|
CPT 0646T
|
| Hospital Charge Code |
906803799
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$570.02 |
| Max. Negotiated Rate |
$78,610.55 |
| Rate for Payer: Adventist Health Commercial |
$18,496.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$78,610.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$50,865.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$69,362.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56,793.81
|
| 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 |
$50,865.65
|
| Rate for Payer: Cash Price |
$50,865.65
|
| Rate for Payer: Cigna of CA HMO |
$59,189.12
|
| Rate for Payer: Cigna of CA PPO |
$68,437.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$78,610.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$78,610.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$78,610.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,993.20
|
| Rate for Payer: EPIC Health Plan Senior |
$36,993.20
|
| Rate for Payer: Galaxy Health WC |
$78,610.55
|
| Rate for Payer: Global Benefits Group Commercial |
$55,489.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$61,686.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35,236.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$57,246.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22,195.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64,738.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64,738.10
|
| Rate for Payer: Multiplan Commercial |
$73,986.40
|
| Rate for Payer: Networks By Design Commercial |
$60,113.95
|
| Rate for Payer: Prime Health Services Commercial |
$78,610.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$55,489.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$78,610.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$78,610.55
|
| Rate for Payer: Vantage Medical Group Senior |
$78,610.55
|
|
|
HC TRANSCATH TRICUSPVALVE IMPLANT
|
Facility
|
IP
|
$92,483.00
|
|
|
Service Code
|
CPT 0646T
|
| Hospital Charge Code |
906803799
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$18,496.60 |
| Max. Negotiated Rate |
$78,610.55 |
| Rate for Payer: Adventist Health Commercial |
$18,496.60
|
| Rate for Payer: Cash Price |
$50,865.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,993.20
|
| Rate for Payer: EPIC Health Plan Senior |
$36,993.20
|
| Rate for Payer: Galaxy Health WC |
$78,610.55
|
| Rate for Payer: Global Benefits Group Commercial |
$55,489.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$61,686.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35,236.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$57,246.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22,195.92
|
| Rate for Payer: Multiplan Commercial |
$73,986.40
|
| Rate for Payer: Networks By Design Commercial |
$60,113.95
|
| Rate for Payer: Prime Health Services Commercial |
$78,610.55
|
|
|
HC TRANSCATH TRICUSPVALVE IMPLANT
|
Facility
|
IP
|
$89,881.00
|
|
|
Service Code
|
CPT 0646T
|
| Hospital Charge Code |
906820300
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$17,976.20 |
| Max. Negotiated Rate |
$76,398.85 |
| Rate for Payer: Adventist Health Commercial |
$17,976.20
|
| Rate for Payer: Cash Price |
$49,434.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,952.40
|
| Rate for Payer: EPIC Health Plan Senior |
$35,952.40
|
| Rate for Payer: Galaxy Health WC |
$76,398.85
|
| Rate for Payer: Global Benefits Group Commercial |
$53,928.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59,950.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34,244.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,636.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21,571.44
|
| Rate for Payer: Multiplan Commercial |
$71,904.80
|
| Rate for Payer: Networks By Design Commercial |
$58,422.65
|
| Rate for Payer: Prime Health Services Commercial |
$76,398.85
|
|
|
HC TRANSCATH TRICUSPVALVE IMPLANT
|
Facility
|
OP
|
$89,881.00
|
|
|
Service Code
|
CPT 0646T
|
| Hospital Charge Code |
906820300
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$570.02 |
| Max. Negotiated Rate |
$76,398.85 |
| Rate for Payer: Adventist Health Commercial |
$17,976.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76,398.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$49,434.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67,410.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55,195.92
|
| 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 |
$49,434.55
|
| Rate for Payer: Cash Price |
$49,434.55
|
| Rate for Payer: Cigna of CA HMO |
$57,523.84
|
| Rate for Payer: Cigna of CA PPO |
$66,511.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76,398.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$76,398.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$76,398.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,952.40
|
| Rate for Payer: EPIC Health Plan Senior |
$35,952.40
|
| Rate for Payer: Galaxy Health WC |
$76,398.85
|
| Rate for Payer: Global Benefits Group Commercial |
$53,928.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59,950.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34,244.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,636.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21,571.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62,916.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62,916.70
|
| Rate for Payer: Multiplan Commercial |
$71,904.80
|
| Rate for Payer: Networks By Design Commercial |
$58,422.65
|
| Rate for Payer: Prime Health Services Commercial |
$76,398.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$53,928.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$76,398.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$76,398.85
|
| Rate for Payer: Vantage Medical Group Senior |
$76,398.85
|
|
|
HC TRANSCATH TRICUSP VALVE REPAIR
|
Facility
|
OP
|
$80,419.00
|
|
|
Service Code
|
CPT 0569T
|
| Hospital Charge Code |
906810569
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$570.02 |
| Max. Negotiated Rate |
$68,356.15 |
| Rate for Payer: Adventist Health Commercial |
$16,083.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$68,356.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,230.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$60,314.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| 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 |
$44,230.45
|
| Rate for Payer: Cash Price |
$44,230.45
|
| Rate for Payer: Cigna of CA HMO |
$51,468.16
|
| Rate for Payer: Cigna of CA PPO |
$59,510.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$68,356.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$68,356.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$68,356.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,167.60
|
| Rate for Payer: EPIC Health Plan Senior |
$32,167.60
|
| Rate for Payer: Galaxy Health WC |
$68,356.15
|
| Rate for Payer: Global Benefits Group Commercial |
$48,251.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,639.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30,639.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,779.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,300.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,293.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,293.30
|
| Rate for Payer: Multiplan Commercial |
$64,335.20
|
| Rate for Payer: Networks By Design Commercial |
$52,272.35
|
| Rate for Payer: Prime Health Services Commercial |
$68,356.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48,251.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$68,356.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68,356.15
|
| Rate for Payer: Vantage Medical Group Senior |
$68,356.15
|
|
|
HC TRANSCATH TRICUSP VALVE REPAIR
|
Facility
|
OP
|
$78,157.00
|
|
|
Service Code
|
CPT 0569T
|
| Hospital Charge Code |
906820272
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$570.02 |
| Max. Negotiated Rate |
$66,433.45 |
| Rate for Payer: Adventist Health Commercial |
$15,631.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$66,433.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42,986.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58,617.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| 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 |
$42,986.35
|
| Rate for Payer: Cash Price |
$42,986.35
|
| Rate for Payer: Cigna of CA HMO |
$50,020.48
|
| Rate for Payer: Cigna of CA PPO |
$57,836.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$66,433.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$66,433.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$66,433.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,262.80
|
| Rate for Payer: EPIC Health Plan Senior |
$31,262.80
|
| Rate for Payer: Galaxy Health WC |
$66,433.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,894.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52,130.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,777.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,379.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,757.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,709.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,709.90
|
| Rate for Payer: Multiplan Commercial |
$62,525.60
|
| Rate for Payer: Networks By Design Commercial |
$50,802.05
|
| Rate for Payer: Prime Health Services Commercial |
$66,433.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46,894.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$66,433.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$66,433.45
|
| Rate for Payer: Vantage Medical Group Senior |
$66,433.45
|
|
|
HC TRANSCATH TRICUSP VALVE REPAIR
|
Facility
|
IP
|
$78,157.00
|
|
|
Service Code
|
CPT 0569T
|
| Hospital Charge Code |
906820272
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,631.40 |
| Max. Negotiated Rate |
$66,433.45 |
| Rate for Payer: Adventist Health Commercial |
$15,631.40
|
| Rate for Payer: Cash Price |
$42,986.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,262.80
|
| Rate for Payer: EPIC Health Plan Senior |
$31,262.80
|
| Rate for Payer: Galaxy Health WC |
$66,433.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,894.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52,130.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,777.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,379.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,757.68
|
| Rate for Payer: Multiplan Commercial |
$62,525.60
|
| Rate for Payer: Networks By Design Commercial |
$50,802.05
|
| Rate for Payer: Prime Health Services Commercial |
$66,433.45
|
|
|
HC TRANSCATH TRICUSP VALVE REPAIR
|
Facility
|
IP
|
$80,419.00
|
|
|
Service Code
|
CPT 0569T
|
| Hospital Charge Code |
906810569
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$16,083.80 |
| Max. Negotiated Rate |
$68,356.15 |
| Rate for Payer: Adventist Health Commercial |
$16,083.80
|
| Rate for Payer: Cash Price |
$44,230.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,167.60
|
| Rate for Payer: EPIC Health Plan Senior |
$32,167.60
|
| Rate for Payer: Galaxy Health WC |
$68,356.15
|
| Rate for Payer: Global Benefits Group Commercial |
$48,251.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,639.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30,639.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49,779.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,300.56
|
| Rate for Payer: Multiplan Commercial |
$64,335.20
|
| Rate for Payer: Networks By Design Commercial |
$52,272.35
|
| Rate for Payer: Prime Health Services Commercial |
$68,356.15
|
|
|
HC TRANSCRANIAL DUPLEX/DOPPLER
|
Facility
|
IP
|
$2,543.00
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
906601143
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$508.60 |
| Max. Negotiated Rate |
$2,161.55 |
| Rate for Payer: Adventist Health Commercial |
$508.60
|
| Rate for Payer: Cash Price |
$1,398.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,017.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,017.20
|
| Rate for Payer: Galaxy Health WC |
$2,161.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,525.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,696.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$968.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,574.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$610.32
|
| Rate for Payer: Multiplan Commercial |
$2,034.40
|
| Rate for Payer: Networks By Design Commercial |
$1,652.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,161.55
|
|
|
HC TRANSCRANIAL DUPLEX/DOPPLER
|
Facility
|
OP
|
$2,543.00
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
906601143
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$307.13 |
| Max. Negotiated Rate |
$2,161.55 |
| Rate for Payer: Adventist Health Commercial |
$508.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,667.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$307.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,561.66
|
| Rate for Payer: Blue Shield of California Commercial |
$1,556.32
|
| Rate for Payer: Blue Shield of California EPN |
$1,027.37
|
| Rate for Payer: Cash Price |
$1,398.65
|
| Rate for Payer: Cash Price |
$1,398.65
|
| Rate for Payer: Cash Price |
$1,398.65
|
| Rate for Payer: Cigna of CA HMO |
$1,627.52
|
| Rate for Payer: Cigna of CA PPO |
$1,881.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$307.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$414.63
|
| Rate for Payer: EPIC Health Plan Senior |
$307.13
|
| Rate for Payer: Galaxy Health WC |
$2,161.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,525.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$503.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$329.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$307.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,696.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$372.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$307.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$610.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$411.55
|
| Rate for Payer: Multiplan Commercial |
$2,034.40
|
| Rate for Payer: Networks By Design Commercial |
$1,652.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,161.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,525.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,525.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,588.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,289.00
|
| Rate for Payer: United Healthcare HMO Rider |
$978.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$895.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$307.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.84
|
| Rate for Payer: Vantage Medical Group Senior |
$307.13
|
|
|
HC TRANSDUCER PED A-LINE CVP
|
Facility
|
OP
|
$242.20
|
|
| Hospital Charge Code |
901604261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.44 |
| Max. Negotiated Rate |
$205.87 |
| Rate for Payer: Adventist Health Commercial |
$48.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$158.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$205.87
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$133.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$181.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$148.74
|
| Rate for Payer: Cash Price |
$133.21
|
| Rate for Payer: Cigna of CA HMO |
$155.01
|
| Rate for Payer: Cigna of CA PPO |
$179.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$205.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$205.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$205.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.88
|
| Rate for Payer: EPIC Health Plan Senior |
$96.88
|
| Rate for Payer: Galaxy Health WC |
$205.87
|
| Rate for Payer: Global Benefits Group Commercial |
$145.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$161.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$149.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$169.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$169.54
|
| Rate for Payer: Multiplan Commercial |
$193.76
|
| Rate for Payer: Networks By Design Commercial |
$157.43
|
| Rate for Payer: Prime Health Services Commercial |
$205.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$145.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$145.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.10
|
| Rate for Payer: United Healthcare All Other HMO |
$121.10
|
| Rate for Payer: United Healthcare HMO Rider |
$121.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$121.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$205.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$205.87
|
| Rate for Payer: Vantage Medical Group Senior |
$205.87
|
|
