|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA RV COMP SYS
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0795T
|
| Hospital Charge Code |
906819777
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$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 RV PM COMPNT
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0797T
|
| Hospital Charge Code |
906819779
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,740.80 |
| Max. Negotiated Rate |
$37,148.40 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Cash Price |
$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 RV PM COMPNT
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0797T
|
| Hospital Charge Code |
906819779
|
|
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 SC LEADLESS PMKR RA
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0823T
|
| Hospital Charge Code |
906819773
|
|
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 SC LEADLESS PMKR RA
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0823T
|
| Hospital Charge Code |
906819773
|
|
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 MITRAL VAL REPAIR AD
|
Facility
|
IP
|
$24,898.00
|
|
|
Service Code
|
CPT 33419
|
| Hospital Charge Code |
906811489
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,979.60 |
| Max. Negotiated Rate |
$21,163.30 |
| Rate for Payer: Adventist Health Commercial |
$4,979.60
|
| Rate for Payer: Cash Price |
$11,204.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,428.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,959.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9,959.20
|
| Rate for Payer: Galaxy Health WC |
$21,163.30
|
| Rate for Payer: Global Benefits Group Commercial |
$14,938.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,810.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,689.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,975.52
|
| Rate for Payer: Multiplan Commercial |
$19,918.40
|
| Rate for Payer: Networks By Design Commercial |
$16,183.70
|
| Rate for Payer: Prime Health Services Commercial |
$21,163.30
|
|
|
HC TRANSCATH MITRAL VAL REPAIR AD
|
Facility
|
OP
|
$24,898.00
|
|
|
Service Code
|
CPT 33419
|
| Hospital Charge Code |
906811489
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$125.09 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$4,979.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,163.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,693.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,673.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Cash Price |
$11,204.10
|
| Rate for Payer: Cash Price |
$11,204.10
|
| Rate for Payer: Cash Price |
$11,204.10
|
| Rate for Payer: Cigna of CA HMO |
$15,934.72
|
| Rate for Payer: Cigna of CA PPO |
$18,424.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,163.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,163.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21,163.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,428.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,959.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9,959.20
|
| Rate for Payer: Galaxy Health WC |
$21,163.30
|
| Rate for Payer: Global Benefits Group Commercial |
$14,938.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$125.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,810.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$141.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,689.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,975.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,428.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,428.60
|
| Rate for Payer: Multiplan Commercial |
$19,918.40
|
| Rate for Payer: Networks By Design Commercial |
$16,183.70
|
| Rate for Payer: Prime Health Services Commercial |
$21,163.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,938.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,449.00
|
| 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 |
$21,163.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,163.30
|
| Rate for Payer: Vantage Medical Group Senior |
$21,163.30
|
|
|
HC TRANSCATH MITRAL VALVE ANNUL
|
Facility
|
IP
|
$80,419.00
|
|
|
Service Code
|
CPT 0544T
|
| Hospital Charge Code |
906810544
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$16,083.80 |
| Max. Negotiated Rate |
$68,356.15 |
| Rate for Payer: Adventist Health Commercial |
$16,083.80
|
| Rate for Payer: Cash Price |
$36,188.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56,293.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,167.60
|
| Rate for Payer: EPIC Health Plan Senior |
$32,167.60
|
| Rate for Payer: Galaxy Health WC |
$68,356.15
|
| Rate for Payer: Global Benefits Group Commercial |
$48,251.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$51,066.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47,447.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,300.56
|
| Rate for Payer: Multiplan Commercial |
$64,335.20
|
| Rate for Payer: Networks By Design Commercial |
$52,272.35
|
| Rate for Payer: Prime Health Services Commercial |
$68,356.15
|
|
|
HC TRANSCATH MITRAL VALVE ANNUL
|
Facility
|
OP
|
$80,419.00
|
|
|
Service Code
|
CPT 0544T
|
| Hospital Charge Code |
906810544
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$594.18 |
| Max. Negotiated Rate |
$68,356.15 |
| Rate for Payer: Adventist Health Commercial |
$16,083.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$68,356.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,230.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$60,314.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| 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 |
$36,188.55
|
| Rate for Payer: Cash Price |
$36,188.55
|
| Rate for Payer: Cigna of CA HMO |
$51,468.16
|
| Rate for Payer: Cigna of CA PPO |
$59,510.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$68,356.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$68,356.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$68,356.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56,293.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,167.60
|
| Rate for Payer: EPIC Health Plan Senior |
$32,167.60
|
| Rate for Payer: Galaxy Health WC |
$68,356.15
|
| Rate for Payer: Global Benefits Group Commercial |
$48,251.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$51,066.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29,192.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47,447.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,300.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,293.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,293.30
|
| Rate for Payer: Multiplan Commercial |
$64,335.20
|
| Rate for Payer: Networks By Design Commercial |
$52,272.35
|
| Rate for Payer: Prime Health Services Commercial |
$68,356.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48,251.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$40,209.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$68,356.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68,356.15
|
| Rate for Payer: Vantage Medical Group Senior |
$68,356.15
|
|
|
HC TRANSCATH MITRAL VALVE REPAIR
|
Facility
|
IP
|
$80,419.00
|
|
|
Service Code
|
CPT 33418
|
| Hospital Charge Code |
906811487
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$16,083.80 |
| Max. Negotiated Rate |
$68,356.15 |
| Rate for Payer: Adventist Health Commercial |
$16,083.80
|
| Rate for Payer: Cash Price |
$36,188.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56,293.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,167.60
|
| Rate for Payer: EPIC Health Plan Senior |
$32,167.60
|
| Rate for Payer: Galaxy Health WC |
$68,356.15
|
| Rate for Payer: Global Benefits Group Commercial |
$48,251.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$51,066.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47,447.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,300.56
|
| Rate for Payer: Multiplan Commercial |
$64,335.20
|
| Rate for Payer: Networks By Design Commercial |
$52,272.35
|
| Rate for Payer: Prime Health Services Commercial |
$68,356.15
|
|
|
HC TRANSCATH MITRAL VALVE REPAIR
|
Facility
|
OP
|
$80,419.00
|
|
|
Service Code
|
CPT 33418
|
| Hospital Charge Code |
906811487
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$594.18 |
| Max. Negotiated Rate |
$68,356.15 |
| Rate for Payer: Adventist Health Commercial |
$16,083.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$68,356.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44,230.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$60,314.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Cash Price |
$36,188.55
|
| Rate for Payer: Cash Price |
$36,188.55
|
| Rate for Payer: Cash Price |
$36,188.55
|
| Rate for Payer: Cigna of CA HMO |
$51,468.16
|
| Rate for Payer: Cigna of CA PPO |
$59,510.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$68,356.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$68,356.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$68,356.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$56,293.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,167.60
|
| Rate for Payer: EPIC Health Plan Senior |
$32,167.60
|
| Rate for Payer: Galaxy Health WC |
$68,356.15
|
| Rate for Payer: Global Benefits Group Commercial |
$48,251.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,678.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$51,066.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,029.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47,447.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,300.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56,293.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,293.30
|
| Rate for Payer: Multiplan Commercial |
$64,335.20
|
| Rate for Payer: Networks By Design Commercial |
$52,272.35
|
| Rate for Payer: Prime Health Services Commercial |
$68,356.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48,251.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$40,209.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$68,356.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68,356.15
|
| Rate for Payer: Vantage Medical Group Senior |
$68,356.15
|
|
|
HC TRANSCATH MITRAL VLVE IMPL/REP
|
Facility
|
OP
|
$76,398.00
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
906800483
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,924.01 |
| Max. Negotiated Rate |
$64,938.30 |
| Rate for Payer: Adventist Health Commercial |
$15,279.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64,938.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42,018.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$57,298.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| 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 |
$34,379.10
|
| Rate for Payer: Cash Price |
$34,379.10
|
| Rate for Payer: Cigna of CA HMO |
$48,894.72
|
| Rate for Payer: Cigna of CA PPO |
$56,534.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64,938.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$64,938.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64,938.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53,478.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,559.20
|
| Rate for Payer: EPIC Health Plan Senior |
$30,559.20
|
| Rate for Payer: Galaxy Health WC |
$64,938.30
|
| Rate for Payer: Global Benefits Group Commercial |
$45,838.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48,512.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27,732.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$45,074.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,335.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53,478.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,478.60
|
| Rate for Payer: Multiplan Commercial |
$61,118.40
|
| Rate for Payer: Networks By Design Commercial |
$49,658.70
|
| Rate for Payer: Prime Health Services Commercial |
$64,938.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45,838.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$38,199.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64,938.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64,938.30
|
| Rate for Payer: Vantage Medical Group Senior |
$64,938.30
|
|
|
HC TRANSCATH MITRAL VLVE IMPL/REP
|
Facility
|
IP
|
$76,398.00
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
906800483
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,279.60 |
| Max. Negotiated Rate |
$64,938.30 |
| Rate for Payer: Adventist Health Commercial |
$15,279.60
|
| Rate for Payer: Cash Price |
$34,379.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53,478.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,559.20
|
| Rate for Payer: EPIC Health Plan Senior |
$30,559.20
|
| Rate for Payer: Galaxy Health WC |
$64,938.30
|
| Rate for Payer: Global Benefits Group Commercial |
$45,838.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48,512.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$45,074.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,335.52
|
| Rate for Payer: Multiplan Commercial |
$61,118.40
|
| Rate for Payer: Networks By Design Commercial |
$49,658.70
|
| Rate for Payer: Prime Health Services Commercial |
$64,938.30
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC ADDL ART
|
Facility
|
OP
|
$13,727.00
|
|
|
Service Code
|
CPT 37237
|
| Hospital Charge Code |
906811479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$61.30 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,745.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,667.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,549.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,295.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,508.41
|
| Rate for Payer: Blue Shield of California Commercial |
$3,638.65
|
| Rate for Payer: Cash Price |
$6,177.15
|
| Rate for Payer: Cash Price |
$6,177.15
|
| Rate for Payer: Cash Price |
$6,177.15
|
| Rate for Payer: Cigna of CA HMO |
$8,785.28
|
| Rate for Payer: Cigna of CA PPO |
$10,157.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,667.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,667.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,667.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,608.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,490.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,490.80
|
| Rate for Payer: Galaxy Health WC |
$11,667.95
|
| Rate for Payer: Global Benefits Group Commercial |
$8,236.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$61.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,716.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$69.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,098.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,294.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,608.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,608.90
|
| Rate for Payer: Multiplan Commercial |
$10,981.60
|
| Rate for Payer: Networks By Design Commercial |
$8,922.55
|
| Rate for Payer: Prime Health Services Commercial |
$11,667.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,236.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,863.50
|
| 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: Vantage Medical Group Commercial/Exchange |
$11,667.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,667.95
|
| Rate for Payer: Vantage Medical Group Senior |
$11,667.95
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC ADDL ART
|
Facility
|
IP
|
$13,727.00
|
|
|
Service Code
|
CPT 37237
|
| Hospital Charge Code |
906811479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,745.40 |
| Max. Negotiated Rate |
$11,667.95 |
| Rate for Payer: Adventist Health Commercial |
$2,745.40
|
| Rate for Payer: Cash Price |
$6,177.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,608.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,490.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,490.80
|
| Rate for Payer: Galaxy Health WC |
$11,667.95
|
| Rate for Payer: Global Benefits Group Commercial |
$8,236.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,716.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,098.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,294.48
|
| Rate for Payer: Multiplan Commercial |
$10,981.60
|
| Rate for Payer: Networks By Design Commercial |
$8,922.55
|
| Rate for Payer: Prime Health Services Commercial |
$11,667.95
|
|
|
HC TRANSCATH PLCMT INT STNT OPENPERC ADDL VEIN
|
Facility
|
IP
|
$13,042.00
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
906811481
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,608.40 |
| Max. Negotiated Rate |
$11,085.70 |
| Rate for Payer: Adventist Health Commercial |
$2,608.40
|
| Rate for Payer: Cash Price |
$5,868.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,129.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,216.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,216.80
|
| Rate for Payer: Galaxy Health WC |
$11,085.70
|
| Rate for Payer: Global Benefits Group Commercial |
$7,825.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,281.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,694.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,130.08
|
| Rate for Payer: Multiplan Commercial |
$10,433.60
|
| Rate for Payer: Networks By Design Commercial |
$8,477.30
|
| Rate for Payer: Prime Health Services Commercial |
$11,085.70
|
|
|
HC TRANSCATH PLCMT INT STNT OPENPERC ADDL VEIN
|
Facility
|
OP
|
$13,042.00
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
906811481
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$42.54 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,608.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,085.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,173.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,781.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,508.41
|
| Rate for Payer: Blue Shield of California Commercial |
$3,638.65
|
| Rate for Payer: Cash Price |
$5,868.90
|
| Rate for Payer: Cash Price |
$5,868.90
|
| Rate for Payer: Cash Price |
$5,868.90
|
| Rate for Payer: Cigna of CA HMO |
$8,346.88
|
| Rate for Payer: Cigna of CA PPO |
$9,651.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,085.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,085.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,085.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,129.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,216.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,216.80
|
| Rate for Payer: Galaxy Health WC |
$11,085.70
|
| Rate for Payer: Global Benefits Group Commercial |
$7,825.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$42.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,281.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,694.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,130.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,129.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,129.40
|
| Rate for Payer: Multiplan Commercial |
$10,433.60
|
| Rate for Payer: Networks By Design Commercial |
$8,477.30
|
| Rate for Payer: Prime Health Services Commercial |
$11,085.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,825.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,521.00
|
| 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: Vantage Medical Group Commercial/Exchange |
$11,085.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,085.70
|
| Rate for Payer: Vantage Medical Group Senior |
$11,085.70
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC INIT ART
|
Facility
|
IP
|
$29,803.00
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
906811478
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,960.60 |
| Max. Negotiated Rate |
$25,332.55 |
| Rate for Payer: Adventist Health Commercial |
$5,960.60
|
| Rate for Payer: Cash Price |
$13,411.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20,862.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,921.20
|
| Rate for Payer: EPIC Health Plan Senior |
$11,921.20
|
| Rate for Payer: Galaxy Health WC |
$25,332.55
|
| Rate for Payer: Global Benefits Group Commercial |
$17,881.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18,924.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17,583.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,152.72
|
| Rate for Payer: Multiplan Commercial |
$23,842.40
|
| Rate for Payer: Networks By Design Commercial |
$19,371.95
|
| Rate for Payer: Prime Health Services Commercial |
$25,332.55
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC INIT ART
|
Facility
|
OP
|
$29,803.00
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
906811478
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$659.23 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,960.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,104.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,638.65
|
| Rate for Payer: Blue Shield of California Commercial |
$5,508.41
|
| Rate for Payer: Cash Price |
$13,411.35
|
| Rate for Payer: Cash Price |
$13,411.35
|
| Rate for Payer: Cash Price |
$13,411.35
|
| Rate for Payer: Cigna of CA HMO |
$19,073.92
|
| Rate for Payer: Cigna of CA PPO |
$22,054.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20,862.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$25,332.55
|
| Rate for Payer: Global Benefits Group Commercial |
$17,881.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$659.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18,924.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$745.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,152.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,708.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$23,842.40
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$19,371.95
|
| Rate for Payer: Prime Health Services Commercial |
$25,332.55
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,881.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,901.50
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC INIT VEIN
|
Facility
|
IP
|
$26,965.00
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
906811480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,393.00 |
| Max. Negotiated Rate |
$22,920.25 |
| Rate for Payer: Adventist Health Commercial |
$5,393.00
|
| Rate for Payer: Cash Price |
$12,134.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,875.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,786.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,786.00
|
| Rate for Payer: Galaxy Health WC |
$22,920.25
|
| Rate for Payer: Global Benefits Group Commercial |
$16,179.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,122.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,909.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,471.60
|
| Rate for Payer: Multiplan Commercial |
$21,572.00
|
| Rate for Payer: Networks By Design Commercial |
$17,527.25
|
| Rate for Payer: Prime Health Services Commercial |
$22,920.25
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC INIT VEIN
|
Facility
|
OP
|
$26,965.00
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
906811480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$462.22 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,393.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,104.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,638.65
|
| Rate for Payer: Blue Shield of California Commercial |
$5,508.41
|
| Rate for Payer: Cash Price |
$12,134.25
|
| Rate for Payer: Cash Price |
$12,134.25
|
| Rate for Payer: Cash Price |
$12,134.25
|
| Rate for Payer: Cigna of CA HMO |
$17,257.60
|
| Rate for Payer: Cigna of CA PPO |
$19,954.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18,875.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$22,920.25
|
| Rate for Payer: Global Benefits Group Commercial |
$16,179.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$462.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,122.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$522.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,471.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,708.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$21,572.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$17,527.25
|
| Rate for Payer: Prime Health Services Commercial |
$22,920.25
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,179.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,482.50
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC TRANSCATH PULM VALVE IMPLANT
|
Facility
|
OP
|
$76,398.00
|
|
|
Service Code
|
CPT 33477
|
| Hospital Charge Code |
906811427
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$594.18 |
| Max. Negotiated Rate |
$64,938.30 |
| Rate for Payer: Adventist Health Commercial |
$15,279.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64,938.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42,018.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$57,298.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Cash Price |
$34,379.10
|
| Rate for Payer: Cash Price |
$34,379.10
|
| Rate for Payer: Cash Price |
$34,379.10
|
| Rate for Payer: Cigna of CA HMO |
$48,894.72
|
| Rate for Payer: Cigna of CA PPO |
$56,534.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64,938.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$64,938.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64,938.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53,478.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,559.20
|
| Rate for Payer: EPIC Health Plan Senior |
$30,559.20
|
| Rate for Payer: Galaxy Health WC |
$64,938.30
|
| Rate for Payer: Global Benefits Group Commercial |
$45,838.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,875.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48,512.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,120.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$45,074.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,335.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53,478.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,478.60
|
| Rate for Payer: Multiplan Commercial |
$61,118.40
|
| Rate for Payer: Networks By Design Commercial |
$49,658.70
|
| Rate for Payer: Prime Health Services Commercial |
$64,938.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45,838.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$38,199.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64,938.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64,938.30
|
| Rate for Payer: Vantage Medical Group Senior |
$64,938.30
|
|
|
HC TRANSCATH PULM VALVE IMPLANT
|
Facility
|
IP
|
$76,398.00
|
|
|
Service Code
|
CPT 33477
|
| Hospital Charge Code |
906811427
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,279.60 |
| Max. Negotiated Rate |
$64,938.30 |
| Rate for Payer: Adventist Health Commercial |
$15,279.60
|
| Rate for Payer: Cash Price |
$34,379.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53,478.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,559.20
|
| Rate for Payer: EPIC Health Plan Senior |
$30,559.20
|
| Rate for Payer: Galaxy Health WC |
$64,938.30
|
| Rate for Payer: Global Benefits Group Commercial |
$45,838.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48,512.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$45,074.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,335.52
|
| Rate for Payer: Multiplan Commercial |
$61,118.40
|
| Rate for Payer: Networks By Design Commercial |
$49,658.70
|
| Rate for Payer: Prime Health Services Commercial |
$64,938.30
|
|
|
HC TRANSCATH RENAL DENERVATION
|
Facility
|
OP
|
$12,056.00
|
|
|
Service Code
|
CPT 0338T
|
| Hospital Charge Code |
906811473
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,411.20 |
| Max. Negotiated Rate |
$12,078.50 |
| Rate for Payer: Adventist Health Commercial |
$2,411.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,710.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,320.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,691.73
|
| Rate for Payer: Blue Shield of California Commercial |
$5,075.58
|
| Rate for Payer: Cash Price |
$5,425.20
|
| Rate for Payer: Cash Price |
$5,425.20
|
| Rate for Payer: Cash Price |
$5,425.20
|
| Rate for Payer: Cigna of CA HMO |
$7,715.84
|
| Rate for Payer: Cigna of CA PPO |
$8,921.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,052.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,320.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,439.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,078.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8,052.33
|
| Rate for Payer: Galaxy Health WC |
$10,247.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,233.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,005.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,655.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,376.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,248.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,893.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,223.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,809.20
|
| Rate for Payer: Multiplan Commercial |
$9,644.80
|
| Rate for Payer: Networks By Design Commercial |
$7,836.40
|
| Rate for Payer: Prime Health Services Commercial |
$10,247.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,233.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,233.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,028.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,028.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,028.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,028.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,320.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Vantage Medical Group Senior |
$7,320.30
|
|
|
HC TRANSCATH RENAL DENERVATION
|
Facility
|
IP
|
$12,056.00
|
|
|
Service Code
|
CPT 0338T
|
| Hospital Charge Code |
906811473
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,411.20 |
| Max. Negotiated Rate |
$10,247.60 |
| Rate for Payer: Adventist Health Commercial |
$2,411.20
|
| Rate for Payer: Cash Price |
$5,425.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,439.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,822.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,822.40
|
| Rate for Payer: Galaxy Health WC |
$10,247.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,233.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,655.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,113.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,893.44
|
| Rate for Payer: Multiplan Commercial |
$9,644.80
|
| Rate for Payer: Networks By Design Commercial |
$7,836.40
|
| Rate for Payer: Prime Health Services Commercial |
$10,247.60
|
|
