|
HC TRANSCATH RENAL DENERVATION BILATERAL
|
Facility
|
IP
|
$18,085.00
|
|
|
Service Code
|
CPT 0339T
|
| Hospital Charge Code |
906811474
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,617.00 |
| Max. Negotiated Rate |
$15,372.25 |
| Rate for Payer: Adventist Health Commercial |
$3,617.00
|
| Rate for Payer: Cash Price |
$8,138.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,659.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,234.00
|
| Rate for Payer: EPIC Health Plan Senior |
$7,234.00
|
| Rate for Payer: Galaxy Health WC |
$15,372.25
|
| Rate for Payer: Global Benefits Group Commercial |
$10,851.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,483.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,670.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,340.40
|
| Rate for Payer: Multiplan Commercial |
$14,468.00
|
| Rate for Payer: Networks By Design Commercial |
$11,755.25
|
| Rate for Payer: Prime Health Services Commercial |
$15,372.25
|
|
|
HC TRANSCATH RENAL DENERVATION BILATERAL
|
Facility
|
OP
|
$18,085.00
|
|
|
Service Code
|
CPT 0339T
|
| Hospital Charge Code |
906811474
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,617.00 |
| Max. Negotiated Rate |
$15,372.25 |
| Rate for Payer: Adventist Health Commercial |
$3,617.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,062.19
|
| 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 |
$7,613.78
|
| Rate for Payer: Blue Shield of California Commercial |
$11,538.23
|
| Rate for Payer: Cash Price |
$8,138.25
|
| Rate for Payer: Cash Price |
$8,138.25
|
| Rate for Payer: Cash Price |
$8,138.25
|
| Rate for Payer: Cigna of CA HMO |
$11,574.40
|
| Rate for Payer: Cigna of CA PPO |
$13,382.90
|
| 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 |
$12,659.50
|
| 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 |
$15,372.25
|
| Rate for Payer: Global Benefits Group Commercial |
$10,851.00
|
| 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 |
$11,483.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,564.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,248.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,340.40
|
| 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 |
$14,468.00
|
| Rate for Payer: Networks By Design Commercial |
$11,755.25
|
| Rate for Payer: Prime Health Services Commercial |
$15,372.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,851.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,851.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,042.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,042.50
|
| Rate for Payer: United Healthcare HMO Rider |
$9,042.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,042.50
|
| 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 RMVL DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
OP
|
$7,149.00
|
|
|
Service Code
|
CPT 0799T
|
| Hospital Charge Code |
906819781
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$594.18 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| 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 |
$4,587.51
|
| 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 |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cigna of CA HMO |
$4,575.36
|
| Rate for Payer: Cigna of CA PPO |
$5,290.26
|
| 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 |
$5,004.30
|
| 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 |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,595.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,715.76
|
| 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 |
$5,719.20
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,289.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,574.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,574.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,574.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,574.50
|
| 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 RMVL DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
IP
|
$7,149.00
|
|
|
Service Code
|
CPT 0799T
|
| Hospital Charge Code |
906819781
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.80 |
| Max. Negotiated Rate |
$6,076.65 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,004.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,859.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,859.60
|
| Rate for Payer: Galaxy Health WC |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,217.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,715.76
|
| Rate for Payer: Multiplan Commercial |
$5,719.20
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV COMP SYS
|
Facility
|
OP
|
$7,149.00
|
|
|
Service Code
|
CPT 0798T
|
| Hospital Charge Code |
906819780
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$594.18 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| 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 |
$4,587.51
|
| 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 |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cigna of CA HMO |
$4,575.36
|
| Rate for Payer: Cigna of CA PPO |
$5,290.26
|
| 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 |
$5,004.30
|
| 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 |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,595.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,715.76
|
| 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 |
$5,719.20
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,289.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,574.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,574.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,574.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,574.50
|
| 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 RMVL DC LEADLESS PMKR RA RV COMP SYS
|
Facility
|
IP
|
$7,149.00
|
|
|
Service Code
|
CPT 0798T
|
| Hospital Charge Code |
906819780
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.80 |
| Max. Negotiated Rate |
$6,076.65 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,004.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,859.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,859.60
|
| Rate for Payer: Galaxy Health WC |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,217.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,715.76
|
| Rate for Payer: Multiplan Commercial |
$5,719.20
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV PM COMPNT
|
Facility
|
IP
|
$7,149.00
|
|
|
Service Code
|
CPT 0800T
|
| Hospital Charge Code |
906819782
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.80 |
| Max. Negotiated Rate |
$6,076.65 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,004.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,859.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,859.60
|
| Rate for Payer: Galaxy Health WC |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,217.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,715.76
|
| Rate for Payer: Multiplan Commercial |
$5,719.20
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV PM COMPNT
|
Facility
|
OP
|
$7,149.00
|
|
|
Service Code
|
CPT 0800T
|
| Hospital Charge Code |
906819782
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$594.18 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| 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 |
$4,587.51
|
| 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 |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cigna of CA HMO |
$4,575.36
|
| Rate for Payer: Cigna of CA PPO |
$5,290.26
|
| 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 |
$5,004.30
|
| 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 |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,595.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,715.76
|
| 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 |
$5,719.20
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,289.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,574.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,574.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,574.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,574.50
|
| 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 RMVL REPL DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0802T
|
| Hospital Charge Code |
906819784
|
|
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 RMVL REPL DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0802T
|
| Hospital Charge Code |
906819784
|
|
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 RMVL REPL DC LEADLESS PMKR RA RV
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0801T
|
| Hospital Charge Code |
906819783
|
|
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 RMVL REPL DC LEADLESS PMKR RA RV
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0801T
|
| Hospital Charge Code |
906819783
|
|
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 RMVL REPL DC LEADLESS PMKR RV PM COMPNT
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0803T
|
| Hospital Charge Code |
906819785
|
|
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 RMVL REPL DC LEADLESS PMKR RV PM COMPNT
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0803T
|
| Hospital Charge Code |
906819785
|
|
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 RMVL REPL SC LEADLESS PMKR RA
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0825T
|
| Hospital Charge Code |
906819775
|
|
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 RMVL REPL SC LEADLESS PMKR RA
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0825T
|
| Hospital Charge Code |
906819775
|
|
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 RMVL SC LEADLESS PMKR RA
|
Facility
|
IP
|
$7,149.00
|
|
|
Service Code
|
CPT 0824T
|
| Hospital Charge Code |
906819774
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.80 |
| Max. Negotiated Rate |
$6,076.65 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,004.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,859.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,859.60
|
| Rate for Payer: Galaxy Health WC |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,217.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,715.76
|
| Rate for Payer: Multiplan Commercial |
$5,719.20
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
|
|
HC TRANSCATH RMVL SC LEADLESS PMKR RA
|
Facility
|
OP
|
$7,149.00
|
|
|
Service Code
|
CPT 0824T
|
| Hospital Charge Code |
906819774
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$594.18 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| 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 |
$4,587.51
|
| 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 |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cigna of CA HMO |
$4,575.36
|
| Rate for Payer: Cigna of CA PPO |
$5,290.26
|
| 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 |
$5,004.30
|
| 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 |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,595.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,715.76
|
| 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 |
$5,719.20
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,289.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,574.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,574.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,574.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,574.50
|
| 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 SEPTAL REDUCT THER
|
Facility
|
IP
|
$24,171.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906803583
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,834.20 |
| Max. Negotiated Rate |
$20,545.35 |
| Rate for Payer: Adventist Health Commercial |
$4,834.20
|
| Rate for Payer: Cash Price |
$10,876.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16,919.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,668.40
|
| Rate for Payer: EPIC Health Plan Senior |
$9,668.40
|
| Rate for Payer: Galaxy Health WC |
$20,545.35
|
| Rate for Payer: Global Benefits Group Commercial |
$14,502.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,348.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,260.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,801.04
|
| Rate for Payer: Multiplan Commercial |
$19,336.80
|
| Rate for Payer: Networks By Design Commercial |
$15,711.15
|
| Rate for Payer: Prime Health Services Commercial |
$20,545.35
|
|
|
HC TRANSCATH SEPTAL REDUCT THER
|
Facility
|
OP
|
$24,171.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906803583
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$845.39 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$4,834.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,545.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,294.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,128.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,759.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$10,876.95
|
| Rate for Payer: Cash Price |
$10,876.95
|
| Rate for Payer: Cash Price |
$10,876.95
|
| Rate for Payer: Cigna of CA HMO |
$15,469.44
|
| Rate for Payer: Cigna of CA PPO |
$17,886.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,545.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$20,545.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20,545.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16,919.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,668.40
|
| Rate for Payer: EPIC Health Plan Senior |
$9,668.40
|
| Rate for Payer: Galaxy Health WC |
$20,545.35
|
| Rate for Payer: Global Benefits Group Commercial |
$14,502.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$845.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,348.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$956.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,260.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,801.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,919.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,919.70
|
| Rate for Payer: Multiplan Commercial |
$19,336.80
|
| Rate for Payer: Networks By Design Commercial |
$15,711.15
|
| Rate for Payer: Prime Health Services Commercial |
$20,545.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,502.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,085.50
|
| 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 |
$20,545.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20,545.35
|
| Rate for Payer: Vantage Medical Group Senior |
$20,545.35
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
|
OP
|
$9,482.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906812173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,896.40 |
| Max. Negotiated Rate |
$8,059.70 |
| Rate for Payer: Adventist Health Commercial |
$1,896.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,408.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,059.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,215.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,111.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,087.74
|
| Rate for Payer: Blue Shield of California Commercial |
$3,991.92
|
| Rate for Payer: Blue Shield of California Commercial |
$6,049.52
|
| Rate for Payer: Cash Price |
$4,266.90
|
| Rate for Payer: Cash Price |
$4,266.90
|
| Rate for Payer: Cigna of CA HMO |
$6,068.48
|
| Rate for Payer: Cigna of CA PPO |
$7,016.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,059.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,059.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,059.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,637.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,792.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,792.80
|
| Rate for Payer: Galaxy Health WC |
$8,059.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,689.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,021.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,594.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,275.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,637.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,637.40
|
| Rate for Payer: Multiplan Commercial |
$7,585.60
|
| Rate for Payer: Networks By Design Commercial |
$6,163.30
|
| Rate for Payer: Prime Health Services Commercial |
$8,059.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,689.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,689.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,741.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,741.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,741.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,741.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,059.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,059.70
|
| Rate for Payer: Vantage Medical Group Senior |
$8,059.70
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
|
IP
|
$9,482.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906812173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,896.40 |
| Max. Negotiated Rate |
$8,059.70 |
| Rate for Payer: Adventist Health Commercial |
$1,896.40
|
| Rate for Payer: Cash Price |
$4,266.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,637.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,792.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,792.80
|
| Rate for Payer: Galaxy Health WC |
$8,059.70
|
| Rate for Payer: Global Benefits Group Commercial |
$5,689.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,021.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,594.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,275.68
|
| Rate for Payer: Multiplan Commercial |
$7,585.60
|
| Rate for Payer: Networks By Design Commercial |
$6,163.30
|
| Rate for Payer: Prime Health Services Commercial |
$8,059.70
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
|
OP
|
$24,898.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906810570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$594.18 |
| Max. Negotiated Rate |
$21,163.30 |
| Rate for Payer: Adventist Health Commercial |
$4,979.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,163.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,693.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,673.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$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 |
$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: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,810.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,037.97
|
| 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 |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,163.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,163.30
|
| Rate for Payer: Vantage Medical Group Senior |
$21,163.30
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
|
IP
|
$24,898.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906810570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,979.60 |
| Max. Negotiated Rate |
$21,163.30 |
| Rate for Payer: Adventist Health Commercial |
$4,979.60
|
| Rate for Payer: Cash Price |
$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 TRICUSP VALVE ANNUL
|
Facility
|
IP
|
$80,419.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906810545
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$16,083.80 |
| Max. Negotiated Rate |
$68,356.15 |
| Rate for Payer: Adventist Health Commercial |
$16,083.80
|
| Rate for Payer: Cash Price |
$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
|
|
