|
HC ATHRECTOMY & STENT FEM/POP
|
Facility
|
OP
|
$48,422.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
909020068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$212.65 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$9,684.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| 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 |
$8,922.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,490.94
|
| Rate for Payer: Cash Price |
$21,789.90
|
| Rate for Payer: Cash Price |
$21,789.90
|
| Rate for Payer: Cash Price |
$21,789.90
|
| Rate for Payer: Cigna of CA HMO |
$30,990.08
|
| Rate for Payer: Cigna of CA PPO |
$35,832.28
|
| 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 |
$41,158.70
|
| Rate for Payer: Global Benefits Group Commercial |
$29,053.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$212.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,297.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,621.28
|
| 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 |
$38,737.60
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$31,474.30
|
| Rate for Payer: Prime Health Services Commercial |
$41,158.70
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29,053.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,866.00
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| 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 ATHRECTOMY & STENT FEM/POP
|
Facility
|
IP
|
$48,422.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
909020068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,684.40 |
| Max. Negotiated Rate |
$41,158.70 |
| Rate for Payer: Adventist Health Commercial |
$9,684.40
|
| Rate for Payer: Cash Price |
$21,789.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,368.80
|
| Rate for Payer: EPIC Health Plan Senior |
$19,368.80
|
| Rate for Payer: Galaxy Health WC |
$41,158.70
|
| Rate for Payer: Global Benefits Group Commercial |
$29,053.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,297.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,448.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,973.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,621.28
|
| Rate for Payer: Multiplan Commercial |
$38,737.60
|
| Rate for Payer: Networks By Design Commercial |
$31,474.30
|
| Rate for Payer: Prime Health Services Commercial |
$41,158.70
|
|
|
HC ATHRECTOMY & STENT FEM/POP
|
Facility
|
OP
|
$47,060.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
906820151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$212.65 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$9,412.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| 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 |
$8,922.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,490.94
|
| Rate for Payer: Cash Price |
$21,177.00
|
| Rate for Payer: Cash Price |
$21,177.00
|
| Rate for Payer: Cash Price |
$21,177.00
|
| Rate for Payer: Cigna of CA HMO |
$30,118.40
|
| Rate for Payer: Cigna of CA PPO |
$34,824.40
|
| 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 |
$40,001.00
|
| Rate for Payer: Global Benefits Group Commercial |
$28,236.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$212.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,389.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,294.40
|
| 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 |
$37,648.00
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$30,589.00
|
| Rate for Payer: Prime Health Services Commercial |
$40,001.00
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28,236.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,866.00
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| 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 ATHRECTOMY & STENT TIBIOPER EA
|
Facility
|
OP
|
$15,314.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
906820159
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$112.58 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,062.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,016.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,422.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,485.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,490.94
|
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: Cigna of CA HMO |
$9,800.96
|
| Rate for Payer: Cigna of CA PPO |
$11,332.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,016.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,016.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,016.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,125.60
|
| Rate for Payer: EPIC Health Plan Senior |
$6,125.60
|
| Rate for Payer: Galaxy Health WC |
$13,016.90
|
| Rate for Payer: Global Benefits Group Commercial |
$9,188.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$112.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,214.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$127.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,479.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,675.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,719.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,719.80
|
| Rate for Payer: Multiplan Commercial |
$12,251.20
|
| Rate for Payer: Networks By Design Commercial |
$9,954.10
|
| Rate for Payer: Prime Health Services Commercial |
$13,016.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,188.40
|
| 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 |
$13,016.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,016.90
|
| Rate for Payer: Vantage Medical Group Senior |
$13,016.90
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
|
IP
|
$15,757.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
909020076
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,151.40 |
| Max. Negotiated Rate |
$13,393.45 |
| Rate for Payer: Adventist Health Commercial |
$3,151.40
|
| Rate for Payer: Cash Price |
$7,090.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,302.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6,302.80
|
| Rate for Payer: Galaxy Health WC |
$13,393.45
|
| Rate for Payer: Global Benefits Group Commercial |
$9,454.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,509.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,003.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,753.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,781.68
|
| Rate for Payer: Multiplan Commercial |
$12,605.60
|
| Rate for Payer: Networks By Design Commercial |
$10,242.05
|
| Rate for Payer: Prime Health Services Commercial |
$13,393.45
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
|
OP
|
$15,757.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
909020076
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$112.58 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,151.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,393.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,666.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,817.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,490.94
|
| Rate for Payer: Cash Price |
$7,090.65
|
| Rate for Payer: Cash Price |
$7,090.65
|
| Rate for Payer: Cash Price |
$7,090.65
|
| Rate for Payer: Cigna of CA HMO |
$10,084.48
|
| Rate for Payer: Cigna of CA PPO |
$11,660.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,393.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,393.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,393.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,302.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6,302.80
|
| Rate for Payer: Galaxy Health WC |
$13,393.45
|
| Rate for Payer: Global Benefits Group Commercial |
$9,454.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$112.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,509.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$127.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,753.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,781.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,029.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,029.90
|
| Rate for Payer: Multiplan Commercial |
$12,605.60
|
| Rate for Payer: Networks By Design Commercial |
$10,242.05
|
| Rate for Payer: Prime Health Services Commercial |
$13,393.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,454.20
|
| 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 |
$13,393.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,393.45
|
| Rate for Payer: Vantage Medical Group Senior |
$13,393.45
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
|
IP
|
$15,314.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
906820159
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,062.80 |
| Max. Negotiated Rate |
$13,016.90 |
| Rate for Payer: Adventist Health Commercial |
$3,062.80
|
| Rate for Payer: Cash Price |
$6,891.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,125.60
|
| Rate for Payer: EPIC Health Plan Senior |
$6,125.60
|
| Rate for Payer: Galaxy Health WC |
$13,016.90
|
| Rate for Payer: Global Benefits Group Commercial |
$9,188.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,214.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,834.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,479.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,675.36
|
| Rate for Payer: Multiplan Commercial |
$12,251.20
|
| Rate for Payer: Networks By Design Commercial |
$9,954.10
|
| Rate for Payer: Prime Health Services Commercial |
$13,016.90
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
|
IP
|
$48,422.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
909020072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,684.40 |
| Max. Negotiated Rate |
$41,158.70 |
| Rate for Payer: Adventist Health Commercial |
$9,684.40
|
| Rate for Payer: Cash Price |
$21,789.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,368.80
|
| Rate for Payer: EPIC Health Plan Senior |
$19,368.80
|
| Rate for Payer: Galaxy Health WC |
$41,158.70
|
| Rate for Payer: Global Benefits Group Commercial |
$29,053.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,297.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,448.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,973.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,621.28
|
| Rate for Payer: Multiplan Commercial |
$38,737.60
|
| Rate for Payer: Networks By Design Commercial |
$31,474.30
|
| Rate for Payer: Prime Health Services Commercial |
$41,158.70
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
|
IP
|
$47,060.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
906820155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,412.00 |
| Max. Negotiated Rate |
$40,001.00 |
| Rate for Payer: EPIC Health Plan Senior |
$18,824.00
|
| Rate for Payer: Galaxy Health WC |
$40,001.00
|
| Rate for Payer: Adventist Health Commercial |
$9,412.00
|
| Rate for Payer: Cash Price |
$21,177.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,824.00
|
| Rate for Payer: Global Benefits Group Commercial |
$28,236.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,389.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,929.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,130.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,294.40
|
| Rate for Payer: Multiplan Commercial |
$37,648.00
|
| Rate for Payer: Networks By Design Commercial |
$30,589.00
|
| Rate for Payer: Prime Health Services Commercial |
$40,001.00
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
|
OP
|
$47,060.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
906820155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$217.04 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$9,412.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| 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 |
$8,922.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,490.94
|
| Rate for Payer: Cash Price |
$21,177.00
|
| Rate for Payer: Cash Price |
$21,177.00
|
| Rate for Payer: Cash Price |
$21,177.00
|
| Rate for Payer: Cigna of CA HMO |
$30,118.40
|
| Rate for Payer: Cigna of CA PPO |
$34,824.40
|
| 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 |
$40,001.00
|
| Rate for Payer: Global Benefits Group Commercial |
$28,236.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$217.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,389.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$245.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,294.40
|
| 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 |
$37,648.00
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$30,589.00
|
| Rate for Payer: Prime Health Services Commercial |
$40,001.00
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28,236.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,866.00
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| 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 ATHRECTOMY & STENT TIBIOPERONE
|
Facility
|
OP
|
$48,422.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
909020072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$217.04 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$9,684.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| 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 |
$8,922.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,490.94
|
| Rate for Payer: Cash Price |
$21,789.90
|
| Rate for Payer: Cash Price |
$21,789.90
|
| Rate for Payer: Cash Price |
$21,789.90
|
| Rate for Payer: Cigna of CA HMO |
$30,990.08
|
| Rate for Payer: Cigna of CA PPO |
$35,832.28
|
| 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 |
$41,158.70
|
| Rate for Payer: Global Benefits Group Commercial |
$29,053.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$217.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32,297.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$245.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,621.28
|
| 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 |
$38,737.60
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$31,474.30
|
| Rate for Payer: Prime Health Services Commercial |
$41,158.70
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29,053.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,866.00
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| 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 ATHRECTOMY TIBIOPERONEAL
|
Facility
|
IP
|
$27,371.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
909020070
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,474.20 |
| Max. Negotiated Rate |
$23,265.35 |
| Rate for Payer: Adventist Health Commercial |
$5,474.20
|
| Rate for Payer: Cash Price |
$12,316.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,948.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,948.40
|
| Rate for Payer: Galaxy Health WC |
$23,265.35
|
| Rate for Payer: Global Benefits Group Commercial |
$16,422.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,256.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,428.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,942.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,569.04
|
| Rate for Payer: Multiplan Commercial |
$21,896.80
|
| Rate for Payer: Networks By Design Commercial |
$17,791.15
|
| Rate for Payer: Prime Health Services Commercial |
$23,265.35
|
|
|
HC ATHRECTOMY TIBIOPERONEAL
|
Facility
|
OP
|
$27,371.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
909020070
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$205.78 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,474.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| 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 |
$8,922.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,490.94
|
| Rate for Payer: Cash Price |
$12,316.95
|
| Rate for Payer: Cash Price |
$12,316.95
|
| Rate for Payer: Cash Price |
$12,316.95
|
| Rate for Payer: Cigna of CA HMO |
$17,517.44
|
| Rate for Payer: Cigna of CA PPO |
$20,254.54
|
| 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 |
$23,265.35
|
| Rate for Payer: Global Benefits Group Commercial |
$16,422.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$205.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,256.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,569.04
|
| 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 |
$21,896.80
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$17,791.15
|
| Rate for Payer: Prime Health Services Commercial |
$23,265.35
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,422.60
|
| 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 |
$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 ATHRECTOMY TIBIOPERONEAL
|
Facility
|
OP
|
$26,601.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
906820153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$205.78 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,320.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| 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 |
$8,922.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,490.94
|
| Rate for Payer: Cash Price |
$11,970.45
|
| Rate for Payer: Cash Price |
$11,970.45
|
| Rate for Payer: Cash Price |
$11,970.45
|
| Rate for Payer: Cigna of CA HMO |
$17,024.64
|
| Rate for Payer: Cigna of CA PPO |
$19,684.74
|
| 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 |
$22,610.85
|
| Rate for Payer: Global Benefits Group Commercial |
$15,960.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$205.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,742.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,384.24
|
| 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 |
$21,280.80
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$17,290.65
|
| Rate for Payer: Prime Health Services Commercial |
$22,610.85
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,960.60
|
| 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 |
$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 ATHRECTOMY TIBIOPERONEAL
|
Facility
|
IP
|
$26,601.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
906820153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,320.20 |
| Max. Negotiated Rate |
$22,610.85 |
| Rate for Payer: Adventist Health Commercial |
$5,320.20
|
| Rate for Payer: Cash Price |
$11,970.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,640.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,640.40
|
| Rate for Payer: Galaxy Health WC |
$22,610.85
|
| Rate for Payer: Global Benefits Group Commercial |
$15,960.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,742.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,134.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,466.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,384.24
|
| Rate for Payer: Multiplan Commercial |
$21,280.80
|
| Rate for Payer: Networks By Design Commercial |
$17,290.65
|
| Rate for Payer: Prime Health Services Commercial |
$22,610.85
|
|
|
HC ATHRECTOMY TIBIOPERONEAL EA AD
|
Facility
|
IP
|
$27,371.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
909020074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,474.20 |
| Max. Negotiated Rate |
$23,265.35 |
| Rate for Payer: Adventist Health Commercial |
$5,474.20
|
| Rate for Payer: Cash Price |
$12,316.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,948.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,948.40
|
| Rate for Payer: Galaxy Health WC |
$23,265.35
|
| Rate for Payer: Global Benefits Group Commercial |
$16,422.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,256.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,428.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,942.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,569.04
|
| Rate for Payer: Multiplan Commercial |
$21,896.80
|
| Rate for Payer: Networks By Design Commercial |
$17,791.15
|
| Rate for Payer: Prime Health Services Commercial |
$23,265.35
|
|
|
HC ATHRECTOMY TIBIOPERONEAL EA AD
|
Facility
|
OP
|
$27,371.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
909020074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$95.07 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,474.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23,265.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,054.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,528.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,490.94
|
| Rate for Payer: Cash Price |
$12,316.95
|
| Rate for Payer: Cash Price |
$12,316.95
|
| Rate for Payer: Cash Price |
$12,316.95
|
| Rate for Payer: Cigna of CA HMO |
$17,517.44
|
| Rate for Payer: Cigna of CA PPO |
$20,254.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,265.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,265.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,265.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,948.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,948.40
|
| Rate for Payer: Galaxy Health WC |
$23,265.35
|
| Rate for Payer: Global Benefits Group Commercial |
$16,422.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$95.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,256.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,942.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,569.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,159.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,159.70
|
| Rate for Payer: Multiplan Commercial |
$21,896.80
|
| Rate for Payer: Networks By Design Commercial |
$17,791.15
|
| Rate for Payer: Prime Health Services Commercial |
$23,265.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,422.60
|
| 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: Vantage Medical Group Commercial/Exchange |
$23,265.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,265.35
|
| Rate for Payer: Vantage Medical Group Senior |
$23,265.35
|
|
|
HC ATHRECTOMY TIBIOPERONEAL EA AD
|
Facility
|
OP
|
$26,601.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
906820157
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$95.07 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,320.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,610.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,630.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19,950.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,490.94
|
| Rate for Payer: Cash Price |
$11,970.45
|
| Rate for Payer: Cash Price |
$11,970.45
|
| Rate for Payer: Cash Price |
$11,970.45
|
| Rate for Payer: Cigna of CA HMO |
$17,024.64
|
| Rate for Payer: Cigna of CA PPO |
$19,684.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,610.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,610.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,610.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,640.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,640.40
|
| Rate for Payer: Galaxy Health WC |
$22,610.85
|
| Rate for Payer: Global Benefits Group Commercial |
$15,960.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$95.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,742.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,466.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,384.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,620.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,620.70
|
| Rate for Payer: Multiplan Commercial |
$21,280.80
|
| Rate for Payer: Networks By Design Commercial |
$17,290.65
|
| Rate for Payer: Prime Health Services Commercial |
$22,610.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,960.60
|
| 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: Vantage Medical Group Commercial/Exchange |
$22,610.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22,610.85
|
| Rate for Payer: Vantage Medical Group Senior |
$22,610.85
|
|
|
HC ATHRECTOMY TIBIOPERONEAL EA AD
|
Facility
|
IP
|
$26,601.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
906820157
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,320.20 |
| Max. Negotiated Rate |
$22,610.85 |
| Rate for Payer: Adventist Health Commercial |
$5,320.20
|
| Rate for Payer: Cash Price |
$11,970.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,640.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,640.40
|
| Rate for Payer: Galaxy Health WC |
$22,610.85
|
| Rate for Payer: Global Benefits Group Commercial |
$15,960.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,742.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,134.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,466.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,384.24
|
| Rate for Payer: Multiplan Commercial |
$21,280.80
|
| Rate for Payer: Networks By Design Commercial |
$17,290.65
|
| Rate for Payer: Prime Health Services Commercial |
$22,610.85
|
|
|
HC ATHRECTOMY VISCERAL
|
Facility
|
OP
|
$37,221.00
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
906820161
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,374.00 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$7,444.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31,637.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20,471.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27,915.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,712.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$5,510.17
|
| Rate for Payer: Cash Price |
$16,749.45
|
| Rate for Payer: Cash Price |
$16,749.45
|
| Rate for Payer: Cigna of CA HMO |
$23,821.44
|
| Rate for Payer: Cigna of CA PPO |
$27,543.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31,637.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,637.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31,637.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,888.40
|
| Rate for Payer: EPIC Health Plan Senior |
$14,888.40
|
| Rate for Payer: Galaxy Health WC |
$31,637.85
|
| Rate for Payer: Global Benefits Group Commercial |
$22,332.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,826.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,181.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,039.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,933.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,054.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26,054.70
|
| Rate for Payer: Multiplan Commercial |
$29,776.80
|
| Rate for Payer: Networks By Design Commercial |
$24,193.65
|
| Rate for Payer: Prime Health Services Commercial |
$31,637.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22,332.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$31,637.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,637.85
|
| Rate for Payer: Vantage Medical Group Senior |
$31,637.85
|
|
|
HC ATHRECTOMY VISCERAL
|
Facility
|
OP
|
$31,637.00
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
909020078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,374.00 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$6,327.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26,891.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17,400.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,727.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,712.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$5,510.17
|
| Rate for Payer: Cash Price |
$14,236.65
|
| Rate for Payer: Cash Price |
$14,236.65
|
| Rate for Payer: Cigna of CA HMO |
$20,247.68
|
| Rate for Payer: Cigna of CA PPO |
$23,411.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26,891.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,891.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26,891.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,654.80
|
| Rate for Payer: EPIC Health Plan Senior |
$12,654.80
|
| Rate for Payer: Galaxy Health WC |
$26,891.45
|
| Rate for Payer: Global Benefits Group Commercial |
$18,982.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,101.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,053.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,583.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,592.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,145.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,145.90
|
| Rate for Payer: Multiplan Commercial |
$25,309.60
|
| Rate for Payer: Networks By Design Commercial |
$20,564.05
|
| Rate for Payer: Prime Health Services Commercial |
$26,891.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,982.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$26,891.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,891.45
|
| Rate for Payer: Vantage Medical Group Senior |
$26,891.45
|
|
|
HC ATHRECTOMY VISCERAL
|
Facility
|
IP
|
$31,637.00
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
909020078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,327.40 |
| Max. Negotiated Rate |
$26,891.45 |
| Rate for Payer: Adventist Health Commercial |
$6,327.40
|
| Rate for Payer: Cash Price |
$14,236.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,654.80
|
| Rate for Payer: EPIC Health Plan Senior |
$12,654.80
|
| Rate for Payer: Galaxy Health WC |
$26,891.45
|
| Rate for Payer: Global Benefits Group Commercial |
$18,982.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,101.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,053.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,583.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,592.88
|
| Rate for Payer: Multiplan Commercial |
$25,309.60
|
| Rate for Payer: Networks By Design Commercial |
$20,564.05
|
| Rate for Payer: Prime Health Services Commercial |
$26,891.45
|
|
|
HC ATHRECTOMY VISCERAL
|
Facility
|
IP
|
$37,221.00
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
906820161
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,444.20 |
| Max. Negotiated Rate |
$31,637.85 |
| Rate for Payer: Adventist Health Commercial |
$7,444.20
|
| Rate for Payer: Cash Price |
$16,749.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,888.40
|
| Rate for Payer: EPIC Health Plan Senior |
$14,888.40
|
| Rate for Payer: Galaxy Health WC |
$31,637.85
|
| Rate for Payer: Global Benefits Group Commercial |
$22,332.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,826.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,181.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23,039.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,933.04
|
| Rate for Payer: Multiplan Commercial |
$29,776.80
|
| Rate for Payer: Networks By Design Commercial |
$24,193.65
|
| Rate for Payer: Prime Health Services Commercial |
$31,637.85
|
|
|
HC ATRIAL BALLOON SEPTOSTOMY
|
Facility
|
IP
|
$9,939.00
|
|
|
Service Code
|
CPT 33741
|
| Hospital Charge Code |
906820317
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,987.80 |
| Max. Negotiated Rate |
$8,448.15 |
| Rate for Payer: Adventist Health Commercial |
$1,987.80
|
| Rate for Payer: Cash Price |
$4,472.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,975.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,975.60
|
| Rate for Payer: Galaxy Health WC |
$8,448.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,963.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,629.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,786.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,152.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,385.36
|
| Rate for Payer: Multiplan Commercial |
$7,951.20
|
| Rate for Payer: Networks By Design Commercial |
$6,460.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,448.15
|
|
|
HC ATRIAL BALLOON SEPTOSTOMY
|
Facility
|
OP
|
$10,226.00
|
|
|
Service Code
|
CPT 33741
|
| Hospital Charge Code |
906811741
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,053.91 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,045.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,692.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,624.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,669.50
|
| 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 |
$1,845.77
|
| Rate for Payer: Cash Price |
$4,601.70
|
| Rate for Payer: Cash Price |
$4,601.70
|
| Rate for Payer: Cash Price |
$4,601.70
|
| Rate for Payer: Cigna of CA HMO |
$6,544.64
|
| Rate for Payer: Cigna of CA PPO |
$7,567.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,692.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,692.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,692.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,090.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,090.40
|
| Rate for Payer: Galaxy Health WC |
$8,692.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,135.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,053.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,820.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,191.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,329.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,454.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,158.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,158.20
|
| Rate for Payer: Multiplan Commercial |
$8,180.80
|
| Rate for Payer: Networks By Design Commercial |
$6,646.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,692.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,135.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$8,692.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,692.10
|
| Rate for Payer: Vantage Medical Group Senior |
$8,692.10
|
|
