|
HC ATHERECTOMY, RENAL
|
Facility
|
IP
|
$3,326.00
|
|
|
Service Code
|
CPT 75994
|
| Hospital Charge Code |
909080033
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$665.20 |
| Max. Negotiated Rate |
$2,827.10 |
| Rate for Payer: Adventist Health Commercial |
$665.20
|
| Rate for Payer: Cash Price |
$1,496.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,330.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,330.40
|
| Rate for Payer: Galaxy Health WC |
$2,827.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,995.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,218.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,267.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$798.24
|
| Rate for Payer: Multiplan Commercial |
$2,660.80
|
| Rate for Payer: Networks By Design Commercial |
$2,161.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,827.10
|
|
|
HC ATHERECTOMY RENAL OR VISCERAL
|
Facility
|
IP
|
$25,924.00
|
|
| Hospital Charge Code |
909080028
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,184.80 |
| Max. Negotiated Rate |
$22,035.40 |
| Rate for Payer: Adventist Health Commercial |
$5,184.80
|
| Rate for Payer: Cash Price |
$11,665.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,369.60
|
| Rate for Payer: EPIC Health Plan Senior |
$10,369.60
|
| Rate for Payer: Galaxy Health WC |
$22,035.40
|
| Rate for Payer: Global Benefits Group Commercial |
$15,554.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,291.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,877.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,046.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,221.76
|
| Rate for Payer: Multiplan Commercial |
$20,739.20
|
| Rate for Payer: Networks By Design Commercial |
$16,850.60
|
| Rate for Payer: Prime Health Services Commercial |
$22,035.40
|
|
|
HC ATHERECTOMY RENAL OR VISCERAL
|
Facility
|
OP
|
$25,924.00
|
|
| Hospital Charge Code |
909080028
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,560.14 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$5,184.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,035.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,258.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19,443.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,919.93
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$11,665.80
|
| Rate for Payer: Cash Price |
$11,665.80
|
| Rate for Payer: Cigna of CA HMO |
$16,591.36
|
| Rate for Payer: Cigna of CA PPO |
$19,183.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,035.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,035.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,035.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,369.60
|
| Rate for Payer: EPIC Health Plan Senior |
$10,369.60
|
| Rate for Payer: Galaxy Health WC |
$22,035.40
|
| Rate for Payer: Global Benefits Group Commercial |
$15,554.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,291.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,877.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,046.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,221.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,146.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,146.80
|
| Rate for Payer: Multiplan Commercial |
$20,739.20
|
| Rate for Payer: Networks By Design Commercial |
$16,850.60
|
| Rate for Payer: Prime Health Services Commercial |
$22,035.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,554.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,962.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,962.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,962.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,962.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,035.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22,035.40
|
| Rate for Payer: Vantage Medical Group Senior |
$22,035.40
|
|
|
HC ATHERECTOMY, VISCERAL
|
Facility
|
IP
|
$3,326.00
|
|
|
Service Code
|
CPT 75995
|
| Hospital Charge Code |
909080034
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$665.20 |
| Max. Negotiated Rate |
$2,827.10 |
| Rate for Payer: Adventist Health Commercial |
$665.20
|
| Rate for Payer: Cash Price |
$1,496.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,330.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,330.40
|
| Rate for Payer: Galaxy Health WC |
$2,827.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,995.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,218.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,267.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$798.24
|
| Rate for Payer: Multiplan Commercial |
$2,660.80
|
| Rate for Payer: Networks By Design Commercial |
$2,161.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,827.10
|
|
|
HC ATHERECTOMY, VISCERAL
|
Facility
|
OP
|
$3,326.00
|
|
|
Service Code
|
CPT 75995
|
| Hospital Charge Code |
909080034
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$665.20 |
| Max. Negotiated Rate |
$2,827.10 |
| Rate for Payer: Adventist Health Commercial |
$665.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,181.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,827.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,829.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,494.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,042.50
|
| Rate for Payer: Blue Shield of California Commercial |
$2,035.51
|
| Rate for Payer: Blue Shield of California EPN |
$1,343.70
|
| Rate for Payer: Cash Price |
$1,496.70
|
| Rate for Payer: Cigna of CA HMO |
$2,128.64
|
| Rate for Payer: Cigna of CA PPO |
$2,461.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,827.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,827.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,827.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,330.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,330.40
|
| Rate for Payer: Galaxy Health WC |
$2,827.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,995.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,218.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,267.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$798.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,328.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,328.20
|
| Rate for Payer: Multiplan Commercial |
$2,660.80
|
| Rate for Payer: Networks By Design Commercial |
$2,161.90
|
| Rate for Payer: Prime Health Services Commercial |
$2,827.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,995.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,995.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,663.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,663.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,663.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,827.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,827.10
|
| Rate for Payer: Vantage Medical Group Senior |
$2,827.10
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
IP
|
$33,373.00
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
906820259
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$6,674.60 |
| Max. Negotiated Rate |
$28,367.05 |
| Rate for Payer: Adventist Health Commercial |
$6,674.60
|
| Rate for Payer: Cash Price |
$15,017.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$13,349.20
|
| Rate for Payer: Galaxy Health WC |
$28,367.05
|
| Rate for Payer: Global Benefits Group Commercial |
$20,023.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,259.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,715.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,657.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,009.52
|
| Rate for Payer: Multiplan Commercial |
$26,698.40
|
| Rate for Payer: Networks By Design Commercial |
$21,692.45
|
| Rate for Payer: Prime Health Services Commercial |
$28,367.05
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
OP
|
$52,060.00
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
906811438
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$907.45 |
| Max. Negotiated Rate |
$44,251.00 |
| Rate for Payer: Adventist Health Commercial |
$10,412.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$23,427.00
|
| Rate for Payer: Cash Price |
$23,427.00
|
| Rate for Payer: Cash Price |
$23,427.00
|
| Rate for Payer: Cigna of CA HMO |
$33,839.00
|
| Rate for Payer: Cigna of CA PPO |
$38,524.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$44,251.00
|
| Rate for Payer: Global Benefits Group Commercial |
$31,236.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$907.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34,724.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,026.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,494.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$41,648.00
|
| Rate for Payer: Networks By Design Commercial |
$33,839.00
|
| Rate for Payer: Prime Health Services Commercial |
$44,251.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31,236.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31,236.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
IP
|
$50,596.00
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
906820241
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,119.20 |
| Max. Negotiated Rate |
$43,006.60 |
| Rate for Payer: Adventist Health Commercial |
$10,119.20
|
| Rate for Payer: Cash Price |
$22,768.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,238.40
|
| Rate for Payer: EPIC Health Plan Senior |
$20,238.40
|
| Rate for Payer: Galaxy Health WC |
$43,006.60
|
| Rate for Payer: Global Benefits Group Commercial |
$30,357.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33,747.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19,277.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,318.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,143.04
|
| Rate for Payer: Multiplan Commercial |
$40,476.80
|
| Rate for Payer: Networks By Design Commercial |
$32,887.40
|
| Rate for Payer: Prime Health Services Commercial |
$43,006.60
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
OP
|
$34,338.00
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
906811461
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$37,417.93 |
| Rate for Payer: Adventist Health Commercial |
$6,867.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$15,452.10
|
| Rate for Payer: Cash Price |
$15,452.10
|
| Rate for Payer: Cash Price |
$15,452.10
|
| Rate for Payer: Cigna of CA HMO |
$21,976.32
|
| Rate for Payer: Cigna of CA PPO |
$25,410.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$29,187.30
|
| Rate for Payer: Global Benefits Group Commercial |
$20,602.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,903.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,082.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,241.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$27,470.40
|
| Rate for Payer: Networks By Design Commercial |
$22,319.70
|
| Rate for Payer: Prime Health Services Commercial |
$29,187.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20,602.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20,602.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
IP
|
$34,338.00
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
906811461
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$6,867.60 |
| Max. Negotiated Rate |
$29,187.30 |
| Rate for Payer: Adventist Health Commercial |
$6,867.60
|
| Rate for Payer: Cash Price |
$15,452.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,735.20
|
| Rate for Payer: EPIC Health Plan Senior |
$13,735.20
|
| Rate for Payer: Galaxy Health WC |
$29,187.30
|
| Rate for Payer: Global Benefits Group Commercial |
$20,602.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,903.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,082.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,255.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,241.12
|
| Rate for Payer: Multiplan Commercial |
$27,470.40
|
| Rate for Payer: Networks By Design Commercial |
$22,319.70
|
| Rate for Payer: Prime Health Services Commercial |
$29,187.30
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
OP
|
$50,596.00
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
906820241
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$907.45 |
| Max. Negotiated Rate |
$43,006.60 |
| Rate for Payer: Adventist Health Commercial |
$10,119.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$22,768.20
|
| Rate for Payer: Cash Price |
$22,768.20
|
| Rate for Payer: Cash Price |
$22,768.20
|
| Rate for Payer: Cigna of CA HMO |
$32,887.40
|
| Rate for Payer: Cigna of CA PPO |
$37,441.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$43,006.60
|
| Rate for Payer: Global Benefits Group Commercial |
$30,357.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$907.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33,747.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,026.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,143.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$40,476.80
|
| Rate for Payer: Networks By Design Commercial |
$32,887.40
|
| Rate for Payer: Prime Health Services Commercial |
$43,006.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30,357.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30,357.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
IP
|
$52,060.00
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
906811438
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,412.00 |
| Max. Negotiated Rate |
$44,251.00 |
| Rate for Payer: Adventist Health Commercial |
$10,412.00
|
| Rate for Payer: Cash Price |
$23,427.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,824.00
|
| Rate for Payer: EPIC Health Plan Senior |
$20,824.00
|
| Rate for Payer: Galaxy Health WC |
$44,251.00
|
| Rate for Payer: Global Benefits Group Commercial |
$31,236.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34,724.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19,834.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,225.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,494.40
|
| Rate for Payer: Multiplan Commercial |
$41,648.00
|
| Rate for Payer: Networks By Design Commercial |
$33,839.00
|
| Rate for Payer: Prime Health Services Commercial |
$44,251.00
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
OP
|
$33,373.00
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
906820259
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$37,417.93 |
| Rate for Payer: Adventist Health Commercial |
$6,674.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$15,017.85
|
| Rate for Payer: Cash Price |
$15,017.85
|
| Rate for Payer: Cash Price |
$15,017.85
|
| Rate for Payer: Cigna of CA HMO |
$21,358.72
|
| Rate for Payer: Cigna of CA PPO |
$24,696.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$28,367.05
|
| Rate for Payer: Global Benefits Group Commercial |
$20,023.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,259.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,715.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,009.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$26,698.40
|
| Rate for Payer: Networks By Design Commercial |
$21,692.45
|
| Rate for Payer: Prime Health Services Commercial |
$28,367.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20,023.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20,023.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC ATHERECTOMY W CORO STENT ADD
|
Facility
|
IP
|
$30,119.00
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
906811462
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$6,023.80 |
| Max. Negotiated Rate |
$25,601.15 |
| Rate for Payer: Adventist Health Commercial |
$6,023.80
|
| Rate for Payer: Cash Price |
$13,553.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,047.60
|
| Rate for Payer: EPIC Health Plan Senior |
$12,047.60
|
| Rate for Payer: Galaxy Health WC |
$25,601.15
|
| Rate for Payer: Global Benefits Group Commercial |
$18,071.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,089.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,475.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,643.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,228.56
|
| Rate for Payer: Multiplan Commercial |
$24,095.20
|
| Rate for Payer: Networks By Design Commercial |
$19,577.35
|
| Rate for Payer: Prime Health Services Commercial |
$25,601.15
|
|
|
HC ATHERECTOMY W CORO STENT ADD
|
Facility
|
OP
|
$29,272.00
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
906820260
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$24,881.20 |
| Rate for Payer: Adventist Health Commercial |
$5,854.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19,199.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24,881.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,099.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,954.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$13,172.40
|
| Rate for Payer: Cash Price |
$13,172.40
|
| Rate for Payer: Cigna of CA HMO |
$18,734.08
|
| Rate for Payer: Cigna of CA PPO |
$21,661.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24,881.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,881.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,881.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,708.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11,708.80
|
| Rate for Payer: Galaxy Health WC |
$24,881.20
|
| Rate for Payer: Global Benefits Group Commercial |
$17,563.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,524.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,152.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,119.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,025.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,490.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,490.40
|
| Rate for Payer: Multiplan Commercial |
$23,417.60
|
| Rate for Payer: Networks By Design Commercial |
$19,026.80
|
| Rate for Payer: Prime Health Services Commercial |
$24,881.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,563.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17,563.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24,881.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,881.20
|
| Rate for Payer: Vantage Medical Group Senior |
$24,881.20
|
|
|
HC ATHERECTOMY W CORO STENT ADD
|
Facility
|
OP
|
$30,119.00
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
906811462
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$25,601.15 |
| Rate for Payer: Adventist Health Commercial |
$6,023.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19,755.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25,601.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,565.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,589.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$13,553.55
|
| Rate for Payer: Cash Price |
$13,553.55
|
| Rate for Payer: Cigna of CA HMO |
$19,276.16
|
| Rate for Payer: Cigna of CA PPO |
$22,288.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25,601.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,601.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25,601.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,047.60
|
| Rate for Payer: EPIC Health Plan Senior |
$12,047.60
|
| Rate for Payer: Galaxy Health WC |
$25,601.15
|
| Rate for Payer: Global Benefits Group Commercial |
$18,071.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,089.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,475.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,643.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,228.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,083.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,083.30
|
| Rate for Payer: Multiplan Commercial |
$24,095.20
|
| Rate for Payer: Networks By Design Commercial |
$19,577.35
|
| Rate for Payer: Prime Health Services Commercial |
$25,601.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,071.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18,071.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25,601.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,601.15
|
| Rate for Payer: Vantage Medical Group Senior |
$25,601.15
|
|
|
HC ATHERECTOMY W CORO STENT ADD
|
Facility
|
IP
|
$29,272.00
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
906820260
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5,854.40 |
| Max. Negotiated Rate |
$24,881.20 |
| Rate for Payer: Adventist Health Commercial |
$5,854.40
|
| Rate for Payer: Cash Price |
$13,172.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,708.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11,708.80
|
| Rate for Payer: Galaxy Health WC |
$24,881.20
|
| Rate for Payer: Global Benefits Group Commercial |
$17,563.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,524.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,152.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,119.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,025.28
|
| Rate for Payer: Multiplan Commercial |
$23,417.60
|
| Rate for Payer: Networks By Design Commercial |
$19,026.80
|
| Rate for Payer: Prime Health Services Commercial |
$24,881.20
|
|
|
HC ATHERECTOMY W CORO STENT ADD'L
|
Facility
|
OP
|
$21,593.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
906820242
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,429.00 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$4,318.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18,354.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,876.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16,194.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$9,716.85
|
| Rate for Payer: Cash Price |
$9,716.85
|
| Rate for Payer: Cigna of CA HMO |
$14,035.45
|
| Rate for Payer: Cigna of CA PPO |
$15,978.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18,354.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$18,354.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18,354.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,637.20
|
| Rate for Payer: EPIC Health Plan Senior |
$8,637.20
|
| Rate for Payer: Galaxy Health WC |
$18,354.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12,955.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,402.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,366.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,182.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,115.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,115.10
|
| Rate for Payer: Multiplan Commercial |
$17,274.40
|
| Rate for Payer: Networks By Design Commercial |
$14,035.45
|
| Rate for Payer: Prime Health Services Commercial |
$18,354.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,955.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,955.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18,354.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18,354.05
|
| Rate for Payer: Vantage Medical Group Senior |
$18,354.05
|
|
|
HC ATHERECTOMY W CORO STENT ADD'L
|
Facility
|
IP
|
$21,593.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
906820242
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,318.60 |
| Max. Negotiated Rate |
$18,354.05 |
| Rate for Payer: Adventist Health Commercial |
$4,318.60
|
| Rate for Payer: Cash Price |
$9,716.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,637.20
|
| Rate for Payer: EPIC Health Plan Senior |
$8,637.20
|
| Rate for Payer: Galaxy Health WC |
$18,354.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12,955.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,402.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,226.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,366.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,182.32
|
| Rate for Payer: Multiplan Commercial |
$17,274.40
|
| Rate for Payer: Networks By Design Commercial |
$14,035.45
|
| Rate for Payer: Prime Health Services Commercial |
$18,354.05
|
|
|
HC ATHERECTOMY W CORO STENT ADD'L
|
Facility
|
IP
|
$22,217.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
906811439
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,443.40 |
| Max. Negotiated Rate |
$18,884.45 |
| Rate for Payer: Adventist Health Commercial |
$4,443.40
|
| Rate for Payer: Cash Price |
$9,997.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,886.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,886.80
|
| Rate for Payer: Galaxy Health WC |
$18,884.45
|
| Rate for Payer: Global Benefits Group Commercial |
$13,330.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,818.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,464.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,752.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,332.08
|
| Rate for Payer: Multiplan Commercial |
$17,773.60
|
| Rate for Payer: Networks By Design Commercial |
$14,441.05
|
| Rate for Payer: Prime Health Services Commercial |
$18,884.45
|
|
|
HC ATHERECTOMY W CORO STENT ADD'L
|
Facility
|
OP
|
$22,217.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
906811439
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,429.00 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$4,443.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18,884.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12,219.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16,662.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$9,997.65
|
| Rate for Payer: Cash Price |
$9,997.65
|
| Rate for Payer: Cigna of CA HMO |
$14,441.05
|
| Rate for Payer: Cigna of CA PPO |
$16,440.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18,884.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$18,884.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18,884.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,886.80
|
| Rate for Payer: EPIC Health Plan Senior |
$8,886.80
|
| Rate for Payer: Galaxy Health WC |
$18,884.45
|
| Rate for Payer: Global Benefits Group Commercial |
$13,330.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,818.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,752.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,332.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,551.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,551.90
|
| Rate for Payer: Multiplan Commercial |
$17,773.60
|
| Rate for Payer: Networks By Design Commercial |
$14,441.05
|
| Rate for Payer: Prime Health Services Commercial |
$18,884.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,330.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13,330.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18,884.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18,884.45
|
| Rate for Payer: Vantage Medical Group Senior |
$18,884.45
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
|
OP
|
$25,407.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906820237
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$869.00 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,081.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$11,433.15
|
| Rate for Payer: Cash Price |
$11,433.15
|
| Rate for Payer: Cash Price |
$11,433.15
|
| Rate for Payer: Cigna of CA HMO |
$16,514.55
|
| Rate for Payer: Cigna of CA PPO |
$18,801.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$21,595.95
|
| Rate for Payer: Global Benefits Group Commercial |
$15,244.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$869.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,946.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$982.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,097.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$20,325.60
|
| Rate for Payer: Networks By Design Commercial |
$16,514.55
|
| Rate for Payer: Prime Health Services Commercial |
$21,595.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,244.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,244.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| 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 |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
|
IP
|
$25,407.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906820237
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,081.40 |
| Max. Negotiated Rate |
$21,595.95 |
| Rate for Payer: Adventist Health Commercial |
$5,081.40
|
| Rate for Payer: Cash Price |
$11,433.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,162.80
|
| Rate for Payer: EPIC Health Plan Senior |
$10,162.80
|
| Rate for Payer: Galaxy Health WC |
$21,595.95
|
| Rate for Payer: Global Benefits Group Commercial |
$15,244.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,946.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,680.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,726.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,097.68
|
| Rate for Payer: Multiplan Commercial |
$20,325.60
|
| Rate for Payer: Networks By Design Commercial |
$16,514.55
|
| Rate for Payer: Prime Health Services Commercial |
$21,595.95
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
|
OP
|
$26,142.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906811434
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$869.00 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,228.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$11,763.90
|
| Rate for Payer: Cash Price |
$11,763.90
|
| Rate for Payer: Cash Price |
$11,763.90
|
| Rate for Payer: Cigna of CA HMO |
$16,992.30
|
| Rate for Payer: Cigna of CA PPO |
$19,345.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$22,220.70
|
| Rate for Payer: Global Benefits Group Commercial |
$15,685.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$869.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,436.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$982.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,274.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$20,913.60
|
| Rate for Payer: Networks By Design Commercial |
$16,992.30
|
| Rate for Payer: Prime Health Services Commercial |
$22,220.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,685.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,685.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| 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 |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
|
IP
|
$26,142.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906811434
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,228.40 |
| Max. Negotiated Rate |
$22,220.70 |
| Rate for Payer: Adventist Health Commercial |
$5,228.40
|
| Rate for Payer: Cash Price |
$11,763.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,456.80
|
| Rate for Payer: EPIC Health Plan Senior |
$10,456.80
|
| Rate for Payer: Galaxy Health WC |
$22,220.70
|
| Rate for Payer: Global Benefits Group Commercial |
$15,685.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,436.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,960.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,181.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,274.08
|
| Rate for Payer: Multiplan Commercial |
$20,913.60
|
| Rate for Payer: Networks By Design Commercial |
$16,992.30
|
| Rate for Payer: Prime Health Services Commercial |
$22,220.70
|
|
