|
HC TRANSABDOMINAL AMNIOINFUSION
|
Facility
|
IP
|
$517.00
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
910400088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$103.40 |
| Max. Negotiated Rate |
$439.45 |
| Rate for Payer: Networks By Design Commercial |
$336.05
|
| Rate for Payer: Adventist Health Commercial |
$103.40
|
| Rate for Payer: Cash Price |
$232.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$361.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$206.80
|
| Rate for Payer: EPIC Health Plan Senior |
$206.80
|
| Rate for Payer: Galaxy Health WC |
$439.45
|
| Rate for Payer: Global Benefits Group Commercial |
$310.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$328.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$305.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.08
|
| Rate for Payer: Multiplan Commercial |
$413.60
|
| Rate for Payer: Prime Health Services Commercial |
$439.45
|
|
|
HC TRANSABDOMINAL AMNIOINFUSION
|
Facility
|
OP
|
$517.00
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
910400088
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$103.40 |
| Max. Negotiated Rate |
$8,240.00 |
| Rate for Payer: Adventist Health Commercial |
$103.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,143.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Cash Price |
$232.65
|
| Rate for Payer: Cash Price |
$232.65
|
| Rate for Payer: Cash Price |
$232.65
|
| Rate for Payer: Cash Price |
$232.65
|
| Rate for Payer: Cigna of CA HMO |
$330.88
|
| Rate for Payer: Cigna of CA PPO |
$382.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$361.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$439.45
|
| Rate for Payer: Global Benefits Group Commercial |
$310.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$556.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$328.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$124.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$493.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$413.60
|
| Rate for Payer: Networks By Design Commercial |
$336.05
|
| Rate for Payer: Prime Health Services Commercial |
$439.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$310.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$310.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$391.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
HC TRANSBRONCHIAL LUNG BIOPSY
|
Facility
|
IP
|
$4,625.00
|
|
|
Service Code
|
CPT 31628
|
| Hospital Charge Code |
900803504
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$925.00 |
| Max. Negotiated Rate |
$3,931.25 |
| Rate for Payer: EPIC Health Plan Senior |
$1,850.00
|
| Rate for Payer: Galaxy Health WC |
$3,931.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,850.00
|
| Rate for Payer: Adventist Health Commercial |
$925.00
|
| Rate for Payer: Cash Price |
$2,081.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,237.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,775.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,936.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,728.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,110.00
|
| Rate for Payer: Multiplan Commercial |
$3,700.00
|
| Rate for Payer: Networks By Design Commercial |
$3,006.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,931.25
|
|
|
HC TRANSBRONCHIAL LUNG BIOPSY
|
Facility
|
OP
|
$4,625.00
|
|
|
Service Code
|
CPT 31628
|
| Hospital Charge Code |
900803504
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$354.01 |
| Max. Negotiated Rate |
$7,912.21 |
| Rate for Payer: Adventist Health Commercial |
$925.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,175.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,192.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,274.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,795.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$2,081.25
|
| Rate for Payer: Cash Price |
$2,081.25
|
| Rate for Payer: Cash Price |
$2,081.25
|
| Rate for Payer: Cigna of CA HMO |
$2,960.00
|
| Rate for Payer: Cigna of CA PPO |
$3,422.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,192.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,274.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,795.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,237.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,912.21
|
| Rate for Payer: EPIC Health Plan Senior |
$5,274.81
|
| Rate for Payer: Galaxy Health WC |
$3,931.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,775.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,864.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$354.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,795.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,936.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,713.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,110.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,042.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,425.68
|
| Rate for Payer: Multiplan Commercial |
$3,700.00
|
| Rate for Payer: Networks By Design Commercial |
$3,006.25
|
| Rate for Payer: Prime Health Services Commercial |
$3,931.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,775.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,775.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,312.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,312.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,312.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,312.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,795.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,192.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,274.81
|
| Rate for Payer: Vantage Medical Group Senior |
$4,795.28
|
|
|
HC TRANSBRONCHIAL LUNG BX, ADD'L
|
Facility
|
IP
|
$3,961.00
|
|
|
Service Code
|
CPT 31632
|
| Hospital Charge Code |
900803507
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$792.20 |
| Max. Negotiated Rate |
$3,366.85 |
| Rate for Payer: Adventist Health Commercial |
$792.20
|
| Rate for Payer: Cash Price |
$1,782.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,772.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,584.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,584.40
|
| Rate for Payer: Galaxy Health WC |
$3,366.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,376.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,515.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,336.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.64
|
| Rate for Payer: Multiplan Commercial |
$3,168.80
|
| Rate for Payer: Networks By Design Commercial |
$2,574.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,366.85
|
|
|
HC TRANSBRONCHIAL LUNG BX, ADD'L
|
Facility
|
OP
|
$3,961.00
|
|
|
Service Code
|
CPT 31632
|
| Hospital Charge Code |
900803507
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$99.46 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$792.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$303.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,366.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,178.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,970.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,782.45
|
| Rate for Payer: Cash Price |
$1,782.45
|
| Rate for Payer: Cash Price |
$1,782.45
|
| Rate for Payer: Cigna of CA HMO |
$2,535.04
|
| Rate for Payer: Cigna of CA PPO |
$2,931.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,366.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,366.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,366.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,772.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,584.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,584.40
|
| Rate for Payer: Galaxy Health WC |
$3,366.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,376.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$99.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,515.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$112.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,336.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,772.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,772.70
|
| Rate for Payer: Multiplan Commercial |
$3,168.80
|
| Rate for Payer: Networks By Design Commercial |
$2,574.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,366.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,376.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,376.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,980.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,980.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,980.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,980.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,366.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,366.85
|
| Rate for Payer: Vantage Medical Group Senior |
$3,366.85
|
|
|
HC TRANSBRONCHIAL NEEDLE BX ADD'L
|
Facility
|
OP
|
$3,626.00
|
|
|
Service Code
|
CPT 31633
|
| Hospital Charge Code |
900803509
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$122.59 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,082.10
|
| Rate for Payer: Vantage Medical Group Senior |
$3,082.10
|
| Rate for Payer: Adventist Health Commercial |
$725.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,082.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,994.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,719.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$1,631.70
|
| Rate for Payer: Cash Price |
$1,631.70
|
| Rate for Payer: Cash Price |
$1,631.70
|
| Rate for Payer: Cigna of CA HMO |
$2,320.64
|
| Rate for Payer: Cigna of CA PPO |
$2,683.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,082.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,082.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,082.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,538.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,450.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,450.40
|
| Rate for Payer: Galaxy Health WC |
$3,082.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,175.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$122.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,302.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$138.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,139.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$870.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,538.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,538.20
|
| Rate for Payer: Multiplan Commercial |
$2,900.80
|
| Rate for Payer: Networks By Design Commercial |
$2,356.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,082.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,175.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,175.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,813.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,813.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,813.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,082.10
|
|
|
HC TRANSBRONCHIAL NEEDLE BX ADD'L
|
Facility
|
IP
|
$3,626.00
|
|
|
Service Code
|
CPT 31633
|
| Hospital Charge Code |
900803509
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$725.20 |
| Max. Negotiated Rate |
$3,082.10 |
| Rate for Payer: Adventist Health Commercial |
$725.20
|
| Rate for Payer: Cash Price |
$1,631.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,538.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,450.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,450.40
|
| Rate for Payer: Galaxy Health WC |
$3,082.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,175.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,302.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,139.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$870.24
|
| Rate for Payer: Multiplan Commercial |
$2,900.80
|
| Rate for Payer: Networks By Design Commercial |
$2,356.90
|
| Rate for Payer: Prime Health Services Commercial |
$3,082.10
|
|
|
HC TRANSBRONCHIAL W/NEEDLE BIOPSY
|
Facility
|
IP
|
$3,801.00
|
|
|
Service Code
|
CPT 31629
|
| Hospital Charge Code |
900803508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$760.20 |
| Max. Negotiated Rate |
$3,230.85 |
| Rate for Payer: Adventist Health Commercial |
$760.20
|
| Rate for Payer: Cash Price |
$1,710.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,660.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,520.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,520.40
|
| Rate for Payer: Galaxy Health WC |
$3,230.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,280.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,413.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,242.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$912.24
|
| Rate for Payer: Multiplan Commercial |
$3,040.80
|
| Rate for Payer: Networks By Design Commercial |
$2,470.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,230.85
|
|
|
HC TRANSBRONCHIAL W/NEEDLE BIOPSY
|
Facility
|
OP
|
$3,801.00
|
|
|
Service Code
|
CPT 31629
|
| Hospital Charge Code |
900803508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$312.73 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$760.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,192.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,274.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,795.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$1,710.45
|
| Rate for Payer: Cash Price |
$1,710.45
|
| Rate for Payer: Cash Price |
$1,710.45
|
| Rate for Payer: Cigna of CA HMO |
$2,432.64
|
| Rate for Payer: Cigna of CA PPO |
$2,812.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,192.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,274.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,795.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,660.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,912.21
|
| Rate for Payer: EPIC Health Plan Senior |
$5,274.81
|
| Rate for Payer: Galaxy Health WC |
$3,230.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,280.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,864.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$312.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,795.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,413.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$353.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,713.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$912.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,042.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,425.68
|
| Rate for Payer: Multiplan Commercial |
$3,040.80
|
| Rate for Payer: Multiplan WC |
$7,464.14
|
| Rate for Payer: Networks By Design Commercial |
$2,470.65
|
| Rate for Payer: Prime Health Services Commercial |
$3,230.85
|
| Rate for Payer: Prime Health Services WC |
$7,387.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,280.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,900.50
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,795.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,192.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,274.81
|
| Rate for Payer: Vantage Medical Group Senior |
$4,795.28
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
|
IP
|
$37,754.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906812218
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,550.80 |
| Max. Negotiated Rate |
$32,090.90 |
| Rate for Payer: Adventist Health Commercial |
$7,550.80
|
| Rate for Payer: Cash Price |
$16,989.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26,427.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,101.60
|
| Rate for Payer: EPIC Health Plan Senior |
$15,101.60
|
| Rate for Payer: Galaxy Health WC |
$32,090.90
|
| Rate for Payer: Global Benefits Group Commercial |
$22,652.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23,973.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22,274.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,060.96
|
| Rate for Payer: Multiplan Commercial |
$30,203.20
|
| Rate for Payer: Networks By Design Commercial |
$24,540.10
|
| Rate for Payer: Prime Health Services Commercial |
$32,090.90
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
|
OP
|
$37,754.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906812218
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,014.59 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$7,550.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,577.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,759.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Cash Price |
$16,989.30
|
| Rate for Payer: Cash Price |
$16,989.30
|
| Rate for Payer: Cash Price |
$16,989.30
|
| Rate for Payer: Cigna of CA HMO |
$24,540.10
|
| Rate for Payer: Cigna of CA PPO |
$27,937.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,935.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,577.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26,427.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,902.96
|
| Rate for Payer: EPIC Health Plan Senior |
$25,935.31
|
| Rate for Payer: Galaxy Health WC |
$32,090.90
|
| Rate for Payer: Global Benefits Group Commercial |
$22,652.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$38,667.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,014.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23,973.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,147.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33,008.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,060.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,707.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,593.92
|
| Rate for Payer: Multiplan Commercial |
$30,203.20
|
| Rate for Payer: Networks By Design Commercial |
$24,540.10
|
| Rate for Payer: Prime Health Services Commercial |
$32,090.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22,652.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22,652.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$18,877.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$23,577.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Vantage Medical Group Senior |
$23,577.55
|
|
|
HC TRANS CATH CLOSURE/VSD
|
Facility
|
OP
|
$27,327.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906812219
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,278.01 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$5,465.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,577.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,759.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Cash Price |
$12,297.15
|
| Rate for Payer: Cash Price |
$12,297.15
|
| Rate for Payer: Cash Price |
$12,297.15
|
| Rate for Payer: Cigna of CA HMO |
$17,762.55
|
| Rate for Payer: Cigna of CA PPO |
$20,221.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,935.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,577.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,128.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,902.96
|
| Rate for Payer: EPIC Health Plan Senior |
$25,935.31
|
| Rate for Payer: Galaxy Health WC |
$23,227.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16,396.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$38,667.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,278.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,352.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,445.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33,008.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,558.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,707.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,593.92
|
| Rate for Payer: Multiplan Commercial |
$21,861.60
|
| Rate for Payer: Networks By Design Commercial |
$17,762.55
|
| Rate for Payer: Prime Health Services Commercial |
$23,227.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,396.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,396.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,663.50
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$23,577.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Vantage Medical Group Senior |
$23,577.55
|
|
|
HC TRANS CATH CLOSURE/VSD
|
Facility
|
IP
|
$27,327.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906812219
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,465.40 |
| Max. Negotiated Rate |
$23,227.95 |
| Rate for Payer: Adventist Health Commercial |
$5,465.40
|
| Rate for Payer: Cash Price |
$12,297.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,128.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,930.80
|
| Rate for Payer: EPIC Health Plan Senior |
$10,930.80
|
| Rate for Payer: Galaxy Health WC |
$23,227.95
|
| Rate for Payer: Global Benefits Group Commercial |
$16,396.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,352.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16,122.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,558.48
|
| Rate for Payer: Multiplan Commercial |
$21,861.60
|
| Rate for Payer: Networks By Design Commercial |
$17,762.55
|
| Rate for Payer: Prime Health Services Commercial |
$23,227.95
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$14,590.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
906811700
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$231.42 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,918.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,156.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$6,565.50
|
| Rate for Payer: Cash Price |
$6,565.50
|
| Rate for Payer: Cash Price |
$6,565.50
|
| Rate for Payer: Cigna of CA HMO |
$9,337.60
|
| Rate for Payer: Cigna of CA PPO |
$10,796.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,872.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,156.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,213.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,808.82
|
| Rate for Payer: EPIC Health Plan Senior |
$7,872.55
|
| Rate for Payer: Galaxy Health WC |
$12,401.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8,754.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,737.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$231.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,264.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$261.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,019.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,501.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,017.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,590.19
|
| Rate for Payer: Multiplan Commercial |
$11,672.00
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: Networks By Design Commercial |
$9,483.50
|
| Rate for Payer: Prime Health Services Commercial |
$12,401.50
|
| Rate for Payer: Prime Health Services WC |
$10,832.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,754.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,295.00
|
| 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 |
$7,156.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,156.86
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$6,928.00
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
909081664
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,385.60 |
| Max. Negotiated Rate |
$5,888.80 |
| Rate for Payer: Adventist Health Commercial |
$1,385.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,033.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,888.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,810.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,196.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,390.16
|
| Rate for Payer: Blue Shield of California Commercial |
$2,916.69
|
| Rate for Payer: Blue Shield of California Commercial |
$4,420.06
|
| Rate for Payer: Cash Price |
$3,117.60
|
| Rate for Payer: Cash Price |
$3,117.60
|
| Rate for Payer: Cigna of CA HMO |
$4,433.92
|
| Rate for Payer: Cigna of CA PPO |
$5,126.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,888.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,888.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,888.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,849.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,771.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,771.20
|
| Rate for Payer: Galaxy Health WC |
$5,888.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,156.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,399.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,087.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,662.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,849.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,849.60
|
| Rate for Payer: Multiplan Commercial |
$5,542.40
|
| Rate for Payer: Networks By Design Commercial |
$4,503.20
|
| Rate for Payer: Prime Health Services Commercial |
$5,888.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,156.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,156.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,464.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,464.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,464.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,464.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,888.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,888.80
|
| Rate for Payer: Vantage Medical Group Senior |
$5,888.80
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$6,928.00
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
909081664
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,385.60 |
| Max. Negotiated Rate |
$5,888.80 |
| Rate for Payer: Adventist Health Commercial |
$1,385.60
|
| Rate for Payer: Cash Price |
$3,117.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,849.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,771.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,771.20
|
| Rate for Payer: Galaxy Health WC |
$5,888.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,156.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,399.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,087.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,662.72
|
| Rate for Payer: Multiplan Commercial |
$5,542.40
|
| Rate for Payer: Networks By Design Commercial |
$4,503.20
|
| Rate for Payer: Prime Health Services Commercial |
$5,888.80
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$6,605.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
909081356
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,321.00 |
| Max. Negotiated Rate |
$5,614.25 |
| Rate for Payer: Adventist Health Commercial |
$1,321.00
|
| Rate for Payer: Cash Price |
$2,972.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,623.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,642.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,642.00
|
| Rate for Payer: Galaxy Health WC |
$5,614.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,963.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,194.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,896.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,585.20
|
| Rate for Payer: Multiplan Commercial |
$5,284.00
|
| Rate for Payer: Networks By Design Commercial |
$4,293.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,614.25
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$6,605.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
909081356
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$231.42 |
| Max. Negotiated Rate |
$11,808.82 |
| Rate for Payer: Adventist Health Commercial |
$1,321.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,525.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,156.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,213.99
|
| Rate for Payer: Blue Shield of California Commercial |
$2,780.70
|
| Rate for Payer: Cash Price |
$2,972.25
|
| Rate for Payer: Cash Price |
$2,972.25
|
| Rate for Payer: Cash Price |
$2,972.25
|
| Rate for Payer: Cigna of CA HMO |
$4,227.20
|
| Rate for Payer: Cigna of CA PPO |
$4,887.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,872.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,156.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,623.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,808.82
|
| Rate for Payer: EPIC Health Plan Senior |
$7,872.55
|
| Rate for Payer: Galaxy Health WC |
$5,614.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,963.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,737.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$231.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,194.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$261.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,019.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,585.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,017.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,590.19
|
| Rate for Payer: Multiplan Commercial |
$5,284.00
|
| Rate for Payer: Networks By Design Commercial |
$4,293.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,614.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,963.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,963.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,302.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,302.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,302.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,302.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,156.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,156.86
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$14,590.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
906811700
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,918.00 |
| Max. Negotiated Rate |
$12,401.50 |
| Rate for Payer: Adventist Health Commercial |
$2,918.00
|
| Rate for Payer: Cash Price |
$6,565.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,213.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,836.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,836.00
|
| Rate for Payer: Galaxy Health WC |
$12,401.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8,754.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,264.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,608.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,501.60
|
| Rate for Payer: Multiplan Commercial |
$11,672.00
|
| Rate for Payer: Networks By Design Commercial |
$9,483.50
|
| Rate for Payer: Prime Health Services Commercial |
$12,401.50
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
|
IP
|
$14,171.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906811451
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,834.20 |
| Max. Negotiated Rate |
$12,045.35 |
| Rate for Payer: Adventist Health Commercial |
$2,834.20
|
| Rate for Payer: Cash Price |
$6,376.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,919.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,668.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,668.40
|
| Rate for Payer: Galaxy Health WC |
$12,045.35
|
| Rate for Payer: Global Benefits Group Commercial |
$8,502.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,998.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,360.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,401.04
|
| Rate for Payer: Multiplan Commercial |
$11,336.80
|
| Rate for Payer: Networks By Design Commercial |
$9,211.15
|
| Rate for Payer: Prime Health Services Commercial |
$12,045.35
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
|
OP
|
$14,171.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906811451
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$425.95 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,834.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$6,376.95
|
| Rate for Payer: Cash Price |
$6,376.95
|
| Rate for Payer: Cash Price |
$6,376.95
|
| Rate for Payer: Cigna of CA HMO |
$9,211.15
|
| Rate for Payer: Cigna of CA PPO |
$10,486.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,919.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$12,045.35
|
| Rate for Payer: Global Benefits Group Commercial |
$8,502.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$425.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,998.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$481.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,401.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$11,336.80
|
| Rate for Payer: Networks By Design Commercial |
$9,211.15
|
| Rate for Payer: Prime Health Services Commercial |
$12,045.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,502.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,502.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,085.50
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0796T
|
| Hospital Charge Code |
906819778
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$594.18 |
| Max. Negotiated Rate |
$40,876.69 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,773.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28,044.86
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Cigna of CA HMO |
$27,970.56
|
| Rate for Payer: Cigna of CA PPO |
$32,340.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,251.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,773.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,876.69
|
| Rate for Payer: EPIC Health Plan Senior |
$27,251.12
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$40,628.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,752.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15,864.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34,683.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,488.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31,214.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,196.82
|
| Rate for Payer: Multiplan Commercial |
$34,963.20
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
| Rate for Payer: Prime Health Services WC |
$38,215.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26,222.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,852.00
|
| Rate for Payer: United Healthcare All Other HMO |
$21,852.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,852.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,852.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$24,773.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Vantage Medical Group Senior |
$24,773.75
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0796T
|
| Hospital Charge Code |
906819778
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,740.80 |
| Max. Negotiated Rate |
$37,148.40 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,481.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,481.60
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,752.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25,785.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,488.96
|
| Rate for Payer: Multiplan Commercial |
$34,963.20
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA RV COMP SYS
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0795T
|
| Hospital Charge Code |
906819777
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,740.80 |
| Max. Negotiated Rate |
$37,148.40 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,481.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,481.60
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,752.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25,785.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,488.96
|
| Rate for Payer: Multiplan Commercial |
$34,963.20
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
|
