|
HC TRLUML BLLN ANGIO ADDL VEIN
|
Facility
|
OP
|
$12,121.00
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
906820287
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$969.48 |
| Max. Negotiated Rate |
$10,302.85 |
| Rate for Payer: Adventist Health Commercial |
$2,424.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,666.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,090.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,712.00
|
| 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 |
$6,666.55
|
| Rate for Payer: Cash Price |
$6,666.55
|
| Rate for Payer: Cash Price |
$6,666.55
|
| Rate for Payer: Cigna of CA HMO |
$7,757.44
|
| Rate for Payer: Cigna of CA PPO |
$8,969.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,302.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,302.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,848.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,848.40
|
| Rate for Payer: Galaxy Health WC |
$10,302.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7,272.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$969.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,084.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,096.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,502.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,909.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,484.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,484.70
|
| Rate for Payer: Multiplan Commercial |
$9,696.80
|
| Rate for Payer: Networks By Design Commercial |
$7,878.65
|
| Rate for Payer: Prime Health Services Commercial |
$10,302.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,272.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,302.85
|
| Rate for Payer: Vantage Medical Group Senior |
$10,302.85
|
|
|
HC TRLUML BLLN ANGIO ADDL VEIN
|
Facility
|
IP
|
$12,471.00
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
909037249
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,494.20 |
| Max. Negotiated Rate |
$10,600.35 |
| Rate for Payer: Adventist Health Commercial |
$2,494.20
|
| Rate for Payer: Cash Price |
$6,859.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,988.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,988.40
|
| Rate for Payer: Galaxy Health WC |
$10,600.35
|
| Rate for Payer: Global Benefits Group Commercial |
$7,482.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,318.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,751.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,719.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,993.04
|
| Rate for Payer: Multiplan Commercial |
$9,976.80
|
| Rate for Payer: Networks By Design Commercial |
$8,106.15
|
| Rate for Payer: Prime Health Services Commercial |
$10,600.35
|
|
|
HC TRLUML BLLN ANGIO ADDL VEIN
|
Facility
|
OP
|
$12,471.00
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
909037249
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$969.48 |
| Max. Negotiated Rate |
$10,600.35 |
| Rate for Payer: Adventist Health Commercial |
$2,494.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,600.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,859.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,353.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,712.00
|
| 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 |
$6,859.05
|
| Rate for Payer: Cash Price |
$6,859.05
|
| Rate for Payer: Cash Price |
$6,859.05
|
| Rate for Payer: Cigna of CA HMO |
$7,981.44
|
| Rate for Payer: Cigna of CA PPO |
$9,228.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,600.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,600.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,600.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,988.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,988.40
|
| Rate for Payer: Galaxy Health WC |
$10,600.35
|
| Rate for Payer: Global Benefits Group Commercial |
$7,482.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$969.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,318.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,096.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,719.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,993.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,729.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,729.70
|
| Rate for Payer: Multiplan Commercial |
$9,976.80
|
| Rate for Payer: Networks By Design Commercial |
$8,106.15
|
| Rate for Payer: Prime Health Services Commercial |
$10,600.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,482.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,600.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,600.35
|
| Rate for Payer: Vantage Medical Group Senior |
$10,600.35
|
|
|
HC TRLUML BLLN ANGIO ADDL VEIN
|
Facility
|
IP
|
$12,121.00
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
906820287
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,424.20 |
| Max. Negotiated Rate |
$10,302.85 |
| Rate for Payer: Adventist Health Commercial |
$2,424.20
|
| Rate for Payer: Cash Price |
$6,666.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,848.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,848.40
|
| Rate for Payer: Galaxy Health WC |
$10,302.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7,272.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,084.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,618.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,502.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,909.04
|
| Rate for Payer: Multiplan Commercial |
$9,696.80
|
| Rate for Payer: Networks By Design Commercial |
$7,878.65
|
| Rate for Payer: Prime Health Services Commercial |
$10,302.85
|
|
|
HC TRLUML BLLN ANGIO INIT ART
|
Facility
|
IP
|
$28,291.00
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
906820284
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,658.20 |
| Max. Negotiated Rate |
$24,047.35 |
| Rate for Payer: Adventist Health Commercial |
$5,658.20
|
| Rate for Payer: Cash Price |
$15,560.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,316.40
|
| Rate for Payer: EPIC Health Plan Senior |
$11,316.40
|
| Rate for Payer: Galaxy Health WC |
$24,047.35
|
| Rate for Payer: Global Benefits Group Commercial |
$16,974.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,870.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,778.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,512.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,789.84
|
| Rate for Payer: Multiplan Commercial |
$22,632.80
|
| Rate for Payer: Networks By Design Commercial |
$18,389.15
|
| Rate for Payer: Prime Health Services Commercial |
$24,047.35
|
|
|
HC TRLUML BLLN ANGIO INIT ART
|
Facility
|
IP
|
$21,205.00
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
909037246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,241.00 |
| Max. Negotiated Rate |
$18,024.25 |
| Rate for Payer: Adventist Health Commercial |
$4,241.00
|
| Rate for Payer: Cash Price |
$11,662.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,482.00
|
| Rate for Payer: EPIC Health Plan Senior |
$8,482.00
|
| Rate for Payer: Galaxy Health WC |
$18,024.25
|
| Rate for Payer: Global Benefits Group Commercial |
$12,723.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,143.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,079.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,125.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,089.20
|
| Rate for Payer: Multiplan Commercial |
$16,964.00
|
| Rate for Payer: Networks By Design Commercial |
$13,783.25
|
| Rate for Payer: Prime Health Services Commercial |
$18,024.25
|
|
|
HC TRLUML BLLN ANGIO INIT ART
|
Facility
|
OP
|
$21,205.00
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
909037246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,845.77 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$4,241.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,968.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,244.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,712.00
|
| 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 |
$11,662.75
|
| Rate for Payer: Cash Price |
$11,662.75
|
| Rate for Payer: Cash Price |
$11,662.75
|
| Rate for Payer: Cigna of CA HMO |
$13,571.20
|
| Rate for Payer: Cigna of CA PPO |
$15,691.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,968.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,244.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,779.87
|
| Rate for Payer: EPIC Health Plan Senior |
$7,244.35
|
| Rate for Payer: Galaxy Health WC |
$18,024.25
|
| Rate for Payer: Global Benefits Group Commercial |
$12,723.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,880.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,293.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,244.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,143.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,725.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,244.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,089.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,127.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,707.43
|
| Rate for Payer: Multiplan Commercial |
$16,964.00
|
| Rate for Payer: Multiplan WC |
$11,542.58
|
| Rate for Payer: Networks By Design Commercial |
$13,783.25
|
| Rate for Payer: Prime Health Services Commercial |
$18,024.25
|
| Rate for Payer: Prime Health Services WC |
$11,424.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,723.00
|
| 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 |
$7,244.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,968.78
|
| Rate for Payer: Vantage Medical Group Senior |
$7,244.35
|
|
|
HC TRLUML BLLN ANGIO INIT ART
|
Facility
|
OP
|
$28,291.00
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
906820284
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,845.77 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$5,658.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,968.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,244.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,712.00
|
| 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 |
$15,560.05
|
| Rate for Payer: Cash Price |
$15,560.05
|
| Rate for Payer: Cash Price |
$15,560.05
|
| Rate for Payer: Cigna of CA HMO |
$18,106.24
|
| Rate for Payer: Cigna of CA PPO |
$20,935.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,968.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,244.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,779.87
|
| Rate for Payer: EPIC Health Plan Senior |
$7,244.35
|
| Rate for Payer: Galaxy Health WC |
$24,047.35
|
| Rate for Payer: Global Benefits Group Commercial |
$16,974.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,880.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,293.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,244.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,870.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,725.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,244.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,789.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,127.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,707.43
|
| Rate for Payer: Multiplan Commercial |
$22,632.80
|
| Rate for Payer: Multiplan WC |
$11,542.58
|
| Rate for Payer: Networks By Design Commercial |
$18,389.15
|
| Rate for Payer: Prime Health Services Commercial |
$24,047.35
|
| Rate for Payer: Prime Health Services WC |
$11,424.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,974.60
|
| 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 |
$7,244.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,968.78
|
| Rate for Payer: Vantage Medical Group Senior |
$7,244.35
|
|
|
HC TRLUML BLLN ANGIO INIT VEIN
|
Facility
|
OP
|
$24,242.00
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
906820286
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,845.77 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$4,848.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,968.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,244.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,712.00
|
| 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 |
$13,333.10
|
| Rate for Payer: Cash Price |
$13,333.10
|
| Rate for Payer: Cash Price |
$13,333.10
|
| Rate for Payer: Cigna of CA HMO |
$15,514.88
|
| Rate for Payer: Cigna of CA PPO |
$17,939.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,968.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,244.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,779.87
|
| Rate for Payer: EPIC Health Plan Senior |
$7,244.35
|
| Rate for Payer: Galaxy Health WC |
$20,605.70
|
| Rate for Payer: Global Benefits Group Commercial |
$14,545.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,880.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,271.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,244.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,169.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,568.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,244.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,818.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,127.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,707.43
|
| Rate for Payer: Multiplan Commercial |
$19,393.60
|
| Rate for Payer: Multiplan WC |
$11,542.58
|
| Rate for Payer: Networks By Design Commercial |
$15,757.30
|
| Rate for Payer: Prime Health Services Commercial |
$20,605.70
|
| Rate for Payer: Prime Health Services WC |
$11,424.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,545.20
|
| 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 |
$7,244.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,968.78
|
| Rate for Payer: Vantage Medical Group Senior |
$7,244.35
|
|
|
HC TRLUML BLLN ANGIO INIT VEIN
|
Facility
|
IP
|
$24,943.00
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
909037248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,988.60 |
| Max. Negotiated Rate |
$21,201.55 |
| Rate for Payer: Adventist Health Commercial |
$4,988.60
|
| Rate for Payer: Cash Price |
$13,718.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,977.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9,977.20
|
| Rate for Payer: Galaxy Health WC |
$21,201.55
|
| Rate for Payer: Global Benefits Group Commercial |
$14,965.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,636.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,503.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,439.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,986.32
|
| Rate for Payer: Multiplan Commercial |
$19,954.40
|
| Rate for Payer: Networks By Design Commercial |
$16,212.95
|
| Rate for Payer: Prime Health Services Commercial |
$21,201.55
|
|
|
HC TRLUML BLLN ANGIO INIT VEIN
|
Facility
|
OP
|
$24,943.00
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
909037248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,845.77 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$4,988.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,968.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,244.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,712.00
|
| 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 |
$13,718.65
|
| Rate for Payer: Cash Price |
$13,718.65
|
| Rate for Payer: Cash Price |
$13,718.65
|
| Rate for Payer: Cigna of CA HMO |
$15,963.52
|
| Rate for Payer: Cigna of CA PPO |
$18,457.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,968.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,244.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,779.87
|
| Rate for Payer: EPIC Health Plan Senior |
$7,244.35
|
| Rate for Payer: Galaxy Health WC |
$21,201.55
|
| Rate for Payer: Global Benefits Group Commercial |
$14,965.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,880.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,271.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,244.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,636.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,568.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,244.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,986.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,127.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,707.43
|
| Rate for Payer: Multiplan Commercial |
$19,954.40
|
| Rate for Payer: Multiplan WC |
$11,542.58
|
| Rate for Payer: Networks By Design Commercial |
$16,212.95
|
| Rate for Payer: Prime Health Services Commercial |
$21,201.55
|
| Rate for Payer: Prime Health Services WC |
$11,424.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,965.80
|
| 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 |
$7,244.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,968.78
|
| Rate for Payer: Vantage Medical Group Senior |
$7,244.35
|
|
|
HC TRLUML BLLN ANGIO INIT VEIN
|
Facility
|
IP
|
$24,242.00
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
906820286
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,848.40 |
| Max. Negotiated Rate |
$20,605.70 |
| Rate for Payer: Adventist Health Commercial |
$4,848.40
|
| Rate for Payer: Cash Price |
$13,333.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,696.80
|
| Rate for Payer: EPIC Health Plan Senior |
$9,696.80
|
| Rate for Payer: Galaxy Health WC |
$20,605.70
|
| Rate for Payer: Global Benefits Group Commercial |
$14,545.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,169.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,236.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,005.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,818.08
|
| Rate for Payer: Multiplan Commercial |
$19,393.60
|
| Rate for Payer: Networks By Design Commercial |
$15,757.30
|
| Rate for Payer: Prime Health Services Commercial |
$20,605.70
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP
|
Facility
|
OP
|
$373.00
|
|
|
Service Code
|
CPT 92508
|
| Hospital Charge Code |
908600386
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$457.00 |
| Rate for Payer: Adventist Health Commercial |
$152.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$244.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$317.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$205.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$279.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$205.15
|
| Rate for Payer: Cash Price |
$205.15
|
| Rate for Payer: Cash Price |
$205.15
|
| Rate for Payer: Cash Price |
$205.15
|
| Rate for Payer: Cigna of CA HMO |
$238.72
|
| Rate for Payer: Cigna of CA PPO |
$276.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$317.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$317.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.20
|
| Rate for Payer: EPIC Health Plan Senior |
$149.20
|
| Rate for Payer: Galaxy Health WC |
$317.05
|
| Rate for Payer: Global Benefits Group Commercial |
$223.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$248.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$230.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.10
|
| Rate for Payer: Multiplan Commercial |
$298.40
|
| Rate for Payer: Networks By Design Commercial |
$242.45
|
| Rate for Payer: Prime Health Services Commercial |
$317.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$223.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$223.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$317.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$317.05
|
| Rate for Payer: Vantage Medical Group Senior |
$317.05
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP
|
Facility
|
IP
|
$373.00
|
|
|
Service Code
|
CPT 92508
|
| Hospital Charge Code |
908600386
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$74.60 |
| Max. Negotiated Rate |
$317.05 |
| Rate for Payer: Adventist Health Commercial |
$74.60
|
| Rate for Payer: Cash Price |
$205.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.20
|
| Rate for Payer: EPIC Health Plan Senior |
$149.20
|
| Rate for Payer: Galaxy Health WC |
$317.05
|
| Rate for Payer: Global Benefits Group Commercial |
$223.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$248.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$230.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.52
|
| Rate for Payer: Multiplan Commercial |
$298.40
|
| Rate for Payer: Networks By Design Commercial |
$242.45
|
| Rate for Payer: Prime Health Services Commercial |
$317.05
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP MCAL
|
Facility
|
OP
|
$879.00
|
|
|
Service Code
|
CPT X4302
|
| Hospital Charge Code |
907000038
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$44.64 |
| Max. Negotiated Rate |
$747.15 |
| Rate for Payer: Adventist Health Commercial |
$360.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$576.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$747.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$483.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$659.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$483.45
|
| Rate for Payer: Cash Price |
$483.45
|
| Rate for Payer: Cash Price |
$483.45
|
| Rate for Payer: Cash Price |
$483.45
|
| Rate for Payer: Cigna of CA HMO |
$562.56
|
| Rate for Payer: Cigna of CA PPO |
$650.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$747.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$747.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$747.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.60
|
| Rate for Payer: EPIC Health Plan Senior |
$351.60
|
| Rate for Payer: Galaxy Health WC |
$747.15
|
| Rate for Payer: Global Benefits Group Commercial |
$527.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$44.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$586.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$544.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$615.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$615.30
|
| Rate for Payer: Multiplan Commercial |
$703.20
|
| Rate for Payer: Networks By Design Commercial |
$571.35
|
| Rate for Payer: Prime Health Services Commercial |
$747.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$527.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$527.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$747.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$747.15
|
| Rate for Payer: Vantage Medical Group Senior |
$747.15
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP MCAL
|
Facility
|
IP
|
$879.00
|
|
|
Service Code
|
CPT X4302
|
| Hospital Charge Code |
907000038
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$175.80 |
| Max. Negotiated Rate |
$747.15 |
| Rate for Payer: Adventist Health Commercial |
$175.80
|
| Rate for Payer: Cash Price |
$483.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$351.60
|
| Rate for Payer: EPIC Health Plan Senior |
$351.60
|
| Rate for Payer: Galaxy Health WC |
$747.15
|
| Rate for Payer: Global Benefits Group Commercial |
$527.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$586.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$334.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$544.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.96
|
| Rate for Payer: Multiplan Commercial |
$703.20
|
| Rate for Payer: Networks By Design Commercial |
$571.35
|
| Rate for Payer: Prime Health Services Commercial |
$747.15
|
|
|
HC TRMNT SPEECH/LANG/VOICE INDIV MCAL
|
Facility
|
OP
|
$642.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000041
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$49.93 |
| Max. Negotiated Rate |
$545.70 |
| Rate for Payer: Adventist Health Commercial |
$263.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$421.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$545.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$353.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$481.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: Cigna of CA HMO |
$410.88
|
| Rate for Payer: Cigna of CA PPO |
$475.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$545.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$545.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$545.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$256.80
|
| Rate for Payer: EPIC Health Plan Senior |
$256.80
|
| Rate for Payer: Galaxy Health WC |
$545.70
|
| Rate for Payer: Global Benefits Group Commercial |
$385.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$49.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$428.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$397.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$449.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$449.40
|
| Rate for Payer: Multiplan Commercial |
$513.60
|
| Rate for Payer: Networks By Design Commercial |
$417.30
|
| Rate for Payer: Prime Health Services Commercial |
$545.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$385.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$385.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$545.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$545.70
|
| Rate for Payer: Vantage Medical Group Senior |
$545.70
|
|
|
HC TRMNT SPEECH/LANG/VOICE INDIV MCAL
|
Facility
|
IP
|
$642.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000041
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$128.40 |
| Max. Negotiated Rate |
$545.70 |
| Rate for Payer: Adventist Health Commercial |
$128.40
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$256.80
|
| Rate for Payer: EPIC Health Plan Senior |
$256.80
|
| Rate for Payer: Galaxy Health WC |
$545.70
|
| Rate for Payer: Global Benefits Group Commercial |
$385.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$428.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$244.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$397.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.08
|
| Rate for Payer: Multiplan Commercial |
$513.60
|
| Rate for Payer: Networks By Design Commercial |
$417.30
|
| Rate for Payer: Prime Health Services Commercial |
$545.70
|
|
|
HC TRMNT STRESS MANAGEMENT
|
Facility
|
IP
|
$246.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
907804066
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$209.10 |
| Rate for Payer: Adventist Health Commercial |
$49.20
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$98.40
|
| Rate for Payer: EPIC Health Plan Senior |
$98.40
|
| Rate for Payer: Galaxy Health WC |
$209.10
|
| Rate for Payer: Global Benefits Group Commercial |
$147.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$164.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$93.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$152.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.04
|
| Rate for Payer: Multiplan Commercial |
$196.80
|
| Rate for Payer: Networks By Design Commercial |
$159.90
|
| Rate for Payer: Prime Health Services Commercial |
$209.10
|
|
|
HC TRMNT STRESS MANAGEMENT
|
Facility
|
OP
|
$246.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
907804066
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$49.20 |
| Max. Negotiated Rate |
$3,171.00 |
| Rate for Payer: Adventist Health Commercial |
$49.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,489.00
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cigna of CA HMO |
$157.44
|
| Rate for Payer: Cigna of CA PPO |
$182.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$306.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$224.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$275.60
|
| Rate for Payer: EPIC Health Plan Senior |
$204.15
|
| Rate for Payer: Galaxy Health WC |
$209.10
|
| Rate for Payer: Global Benefits Group Commercial |
$147.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$334.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$204.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$164.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$127.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$204.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$257.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$273.56
|
| Rate for Payer: Multiplan Commercial |
$196.80
|
| Rate for Payer: Multiplan WC |
$325.28
|
| Rate for Payer: Networks By Design Commercial |
$159.90
|
| Rate for Payer: Prime Health Services Commercial |
$209.10
|
| Rate for Payer: Prime Health Services WC |
$321.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$147.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.00
|
| Rate for Payer: United Healthcare All Other HMO |
$123.00
|
| Rate for Payer: United Healthcare HMO Rider |
$123.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$204.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Vantage Medical Group Senior |
$204.15
|
|
|
HC TROPONIN - I
|
Facility
|
IP
|
$1,014.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900910994
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$202.80 |
| Max. Negotiated Rate |
$861.90 |
| Rate for Payer: Adventist Health Commercial |
$202.80
|
| Rate for Payer: Cash Price |
$557.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$405.60
|
| Rate for Payer: EPIC Health Plan Senior |
$405.60
|
| Rate for Payer: Galaxy Health WC |
$861.90
|
| Rate for Payer: Global Benefits Group Commercial |
$608.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$676.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$386.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$627.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$243.36
|
| Rate for Payer: Multiplan Commercial |
$811.20
|
| Rate for Payer: Networks By Design Commercial |
$659.10
|
| Rate for Payer: Prime Health Services Commercial |
$861.90
|
|
|
HC TROPONIN - I
|
Facility
|
OP
|
$1,014.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900910994
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.10 |
| Max. Negotiated Rate |
$861.90 |
| Rate for Payer: Adventist Health Commercial |
$202.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$665.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.45
|
| Rate for Payer: Blue Shield of California Commercial |
$678.37
|
| Rate for Payer: Blue Shield of California EPN |
$448.19
|
| Rate for Payer: Cash Price |
$557.70
|
| Rate for Payer: Cash Price |
$557.70
|
| Rate for Payer: Cigna of CA HMO |
$648.96
|
| Rate for Payer: Cigna of CA PPO |
$750.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.83
|
| Rate for Payer: EPIC Health Plan Senior |
$12.47
|
| Rate for Payer: Galaxy Health WC |
$861.90
|
| Rate for Payer: Global Benefits Group Commercial |
$608.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$20.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$676.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$243.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.71
|
| Rate for Payer: Multiplan Commercial |
$811.20
|
| Rate for Payer: Networks By Design Commercial |
$659.10
|
| Rate for Payer: Prime Health Services Commercial |
$861.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$608.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$608.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.10
|
| Rate for Payer: United Healthcare All Other HMO |
$10.10
|
| Rate for Payer: United Healthcare HMO Rider |
$10.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.10
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Vantage Medical Group Senior |
$12.47
|
|
|
HC TROPONIN-T
|
Facility
|
OP
|
$315.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900912119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.10 |
| Max. Negotiated Rate |
$267.75 |
| Rate for Payer: Adventist Health Commercial |
$63.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$206.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.45
|
| Rate for Payer: Blue Shield of California Commercial |
$210.74
|
| Rate for Payer: Blue Shield of California EPN |
$139.23
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Cigna of CA HMO |
$201.60
|
| Rate for Payer: Cigna of CA PPO |
$233.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.83
|
| Rate for Payer: EPIC Health Plan Senior |
$12.47
|
| Rate for Payer: Galaxy Health WC |
$267.75
|
| Rate for Payer: Global Benefits Group Commercial |
$189.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$20.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$210.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.71
|
| Rate for Payer: Multiplan Commercial |
$252.00
|
| Rate for Payer: Networks By Design Commercial |
$204.75
|
| Rate for Payer: Prime Health Services Commercial |
$267.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$189.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$189.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.10
|
| Rate for Payer: United Healthcare All Other HMO |
$10.10
|
| Rate for Payer: United Healthcare HMO Rider |
$10.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.10
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.72
|
| Rate for Payer: Vantage Medical Group Senior |
$12.47
|
|
|
HC TROPONIN-T
|
Facility
|
IP
|
$315.00
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
900912119
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$267.75 |
| Rate for Payer: Adventist Health Commercial |
$63.00
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$126.00
|
| Rate for Payer: EPIC Health Plan Senior |
$126.00
|
| Rate for Payer: Galaxy Health WC |
$267.75
|
| Rate for Payer: Global Benefits Group Commercial |
$189.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$210.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$194.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.60
|
| Rate for Payer: Multiplan Commercial |
$252.00
|
| Rate for Payer: Networks By Design Commercial |
$204.75
|
| Rate for Payer: Prime Health Services Commercial |
$267.75
|
|
|
HC TRSNCATH INS/REPL LEADLESS PCR
|
Facility
|
IP
|
$53,844.00
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
906820022
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,768.80 |
| Max. Negotiated Rate |
$45,767.40 |
| Rate for Payer: Adventist Health Commercial |
$10,768.80
|
| Rate for Payer: Cash Price |
$29,614.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,537.60
|
| Rate for Payer: EPIC Health Plan Senior |
$21,537.60
|
| Rate for Payer: Galaxy Health WC |
$45,767.40
|
| Rate for Payer: Global Benefits Group Commercial |
$32,306.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35,913.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20,514.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,329.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,922.56
|
| Rate for Payer: Multiplan Commercial |
$43,075.20
|
| Rate for Payer: Networks By Design Commercial |
$34,998.60
|
| Rate for Payer: Prime Health Services Commercial |
$45,767.40
|
|
