|
HC ANGIO CORONARY
|
Facility
|
IP
|
$3,116.00
|
|
|
Service Code
|
CPT 93563
|
| Hospital Charge Code |
906811412
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$623.20 |
| Max. Negotiated Rate |
$2,648.60 |
| Rate for Payer: Adventist Health Commercial |
$623.20
|
| Rate for Payer: Cash Price |
$1,402.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,181.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,246.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,246.40
|
| Rate for Payer: Galaxy Health WC |
$2,648.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,869.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,978.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,838.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$747.84
|
| Rate for Payer: Multiplan Commercial |
$2,492.80
|
| Rate for Payer: Networks By Design Commercial |
$2,025.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,648.60
|
|
|
HC ANGIOGRAPH ADRENAL BILAT
|
Facility
|
OP
|
$10,556.00
|
|
|
Service Code
|
CPT 75733
|
| Hospital Charge Code |
909081624
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$260.05 |
| Max. Negotiated Rate |
$8,972.60 |
| Rate for Payer: Adventist Health Commercial |
$2,111.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,466.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,721.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,444.08
|
| Rate for Payer: Blue Shield of California Commercial |
$6,734.73
|
| Rate for Payer: Cash Price |
$4,750.20
|
| Rate for Payer: Cash Price |
$4,750.20
|
| Rate for Payer: Cigna of CA HMO |
$6,755.84
|
| Rate for Payer: Cigna of CA PPO |
$7,811.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,389.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$8,972.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,333.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$260.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,703.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$294.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,533.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$8,444.80
|
| Rate for Payer: Networks By Design Commercial |
$6,861.40
|
| Rate for Payer: Prime Health Services Commercial |
$8,972.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,333.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,333.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC ANGIOGRAPH ADRENAL BILAT
|
Facility
|
IP
|
$10,556.00
|
|
|
Service Code
|
CPT 75733
|
| Hospital Charge Code |
909081624
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,111.20 |
| Max. Negotiated Rate |
$8,972.60 |
| Rate for Payer: Adventist Health Commercial |
$2,111.20
|
| Rate for Payer: Cash Price |
$4,750.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,389.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,222.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,222.40
|
| Rate for Payer: Galaxy Health WC |
$8,972.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,333.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,703.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,228.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,533.44
|
| Rate for Payer: Multiplan Commercial |
$8,444.80
|
| Rate for Payer: Networks By Design Commercial |
$6,861.40
|
| Rate for Payer: Prime Health Services Commercial |
$8,972.60
|
|
|
HC ANGIOGRAPH ADRENAL UNILAT
|
Facility
|
OP
|
$6,915.00
|
|
|
Service Code
|
CPT 75731
|
| Hospital Charge Code |
909081574
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$234.31 |
| Max. Negotiated Rate |
$6,700.73 |
| Rate for Payer: Cigna of CA PPO |
$5,117.10
|
| Rate for Payer: Adventist Health Commercial |
$1,383.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,280.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,700.64
|
| Rate for Payer: Blue Shield of California Commercial |
$2,911.22
|
| Rate for Payer: Blue Shield of California Commercial |
$4,411.77
|
| Rate for Payer: Cash Price |
$3,111.75
|
| Rate for Payer: Cash Price |
$3,111.75
|
| Rate for Payer: Cigna of CA HMO |
$4,425.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,840.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$5,877.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,149.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$234.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,391.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$264.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,659.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$5,532.00
|
| Rate for Payer: Networks By Design Commercial |
$4,494.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,877.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,149.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,149.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC ANGIOGRAPH ADRENAL UNILAT
|
Facility
|
IP
|
$6,915.00
|
|
|
Service Code
|
CPT 75731
|
| Hospital Charge Code |
909081574
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,383.00 |
| Max. Negotiated Rate |
$5,877.75 |
| Rate for Payer: Adventist Health Commercial |
$1,383.00
|
| Rate for Payer: Cash Price |
$3,111.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,840.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,766.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,766.00
|
| Rate for Payer: Galaxy Health WC |
$5,877.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,149.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,391.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,079.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,659.60
|
| Rate for Payer: Multiplan Commercial |
$5,532.00
|
| Rate for Payer: Networks By Design Commercial |
$4,494.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,877.75
|
|
|
HC ANGIOGRAPH EXT CAROTID UNILAT
|
Facility
|
IP
|
$17,988.00
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
909081608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,597.60 |
| Max. Negotiated Rate |
$15,289.80 |
| Rate for Payer: Adventist Health Commercial |
$3,597.60
|
| Rate for Payer: Cash Price |
$8,094.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,591.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,195.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7,195.20
|
| Rate for Payer: Galaxy Health WC |
$15,289.80
|
| Rate for Payer: Global Benefits Group Commercial |
$10,792.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,422.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,612.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,317.12
|
| Rate for Payer: Multiplan Commercial |
$14,390.40
|
| Rate for Payer: Networks By Design Commercial |
$11,692.20
|
| Rate for Payer: Prime Health Services Commercial |
$15,289.80
|
|
|
HC ANGIOGRAPH EXT CAROTID UNILAT
|
Facility
|
OP
|
$17,988.00
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
909081608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$148.86 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$3,597.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,289.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,893.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,491.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Cash Price |
$8,094.60
|
| Rate for Payer: Cash Price |
$8,094.60
|
| Rate for Payer: Cash Price |
$8,094.60
|
| Rate for Payer: Cigna of CA HMO |
$11,512.32
|
| Rate for Payer: Cigna of CA PPO |
$13,311.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,289.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,289.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15,289.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,591.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,195.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7,195.20
|
| Rate for Payer: Galaxy Health WC |
$15,289.80
|
| Rate for Payer: Global Benefits Group Commercial |
$10,792.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$148.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,422.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$168.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,612.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,317.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,591.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,591.60
|
| Rate for Payer: Multiplan Commercial |
$14,390.40
|
| Rate for Payer: Networks By Design Commercial |
$11,692.20
|
| Rate for Payer: Prime Health Services Commercial |
$15,289.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,792.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,994.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,289.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,289.80
|
| Rate for Payer: Vantage Medical Group Senior |
$15,289.80
|
|
|
HC ANGIOGRAPH EXTREMITY BILAT
|
Facility
|
OP
|
$11,166.00
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
909081619
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$246.94 |
| Max. Negotiated Rate |
$9,491.10 |
| Rate for Payer: Adventist Health Commercial |
$2,233.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,471.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,721.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,700.89
|
| Rate for Payer: Blue Shield of California Commercial |
$7,123.91
|
| Rate for Payer: Cash Price |
$5,024.70
|
| Rate for Payer: Cash Price |
$5,024.70
|
| Rate for Payer: Cigna of CA HMO |
$7,146.24
|
| Rate for Payer: Cigna of CA PPO |
$8,262.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,816.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$9,491.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,699.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$246.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,090.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$279.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,679.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$8,932.80
|
| Rate for Payer: Networks By Design Commercial |
$7,257.90
|
| Rate for Payer: Prime Health Services Commercial |
$9,491.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,699.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,699.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC ANGIOGRAPH EXTREMITY BILAT
|
Facility
|
IP
|
$11,166.00
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
909081619
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,233.20 |
| Max. Negotiated Rate |
$9,491.10 |
| Rate for Payer: Adventist Health Commercial |
$2,233.20
|
| Rate for Payer: Cash Price |
$5,024.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,816.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,466.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,466.40
|
| Rate for Payer: Galaxy Health WC |
$9,491.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,699.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,090.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,587.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,679.84
|
| Rate for Payer: Multiplan Commercial |
$8,932.80
|
| Rate for Payer: Networks By Design Commercial |
$7,257.90
|
| Rate for Payer: Prime Health Services Commercial |
$9,491.10
|
|
|
HC ANGIOGRAPH EXTREMITY UNILAT
|
Facility
|
OP
|
$9,590.00
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
909081572
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$228.72 |
| Max. Negotiated Rate |
$8,151.50 |
| Rate for Payer: Adventist Health Commercial |
$1,918.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,280.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,700.64
|
| Rate for Payer: Blue Shield of California Commercial |
$4,037.39
|
| Rate for Payer: Blue Shield of California Commercial |
$6,118.42
|
| Rate for Payer: Cash Price |
$4,315.50
|
| Rate for Payer: Cash Price |
$4,315.50
|
| Rate for Payer: Cigna of CA HMO |
$6,137.60
|
| Rate for Payer: Cigna of CA PPO |
$7,096.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,713.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$8,151.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,754.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$228.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,089.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$258.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,301.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$7,672.00
|
| Rate for Payer: Networks By Design Commercial |
$6,233.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,151.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,754.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,754.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC ANGIOGRAPH EXTREMITY UNILAT
|
Facility
|
IP
|
$9,590.00
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
909081572
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,918.00 |
| Max. Negotiated Rate |
$8,151.50 |
| Rate for Payer: Adventist Health Commercial |
$1,918.00
|
| Rate for Payer: Cash Price |
$4,315.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,713.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,836.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,836.00
|
| Rate for Payer: Galaxy Health WC |
$8,151.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,754.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,089.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,658.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,301.60
|
| Rate for Payer: Multiplan Commercial |
$7,672.00
|
| Rate for Payer: Networks By Design Commercial |
$6,233.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,151.50
|
|
|
HC ANGIOGRAPH INTERNAL MAMMARY
|
Facility
|
IP
|
$10,156.00
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
909081576
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,031.20 |
| Max. Negotiated Rate |
$8,632.60 |
| Rate for Payer: Adventist Health Commercial |
$2,031.20
|
| Rate for Payer: Cash Price |
$4,570.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,109.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,062.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,062.40
|
| Rate for Payer: Galaxy Health WC |
$8,632.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,093.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,449.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,992.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,437.44
|
| Rate for Payer: Multiplan Commercial |
$8,124.80
|
| Rate for Payer: Networks By Design Commercial |
$6,601.40
|
| Rate for Payer: Prime Health Services Commercial |
$8,632.60
|
|
|
HC ANGIOGRAPH INTERNAL MAMMARY
|
Facility
|
OP
|
$10,156.00
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
909081576
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$244.26 |
| Max. Negotiated Rate |
$8,632.60 |
| Rate for Payer: Adventist Health Commercial |
$2,031.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,282.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,700.64
|
| Rate for Payer: Blue Shield of California Commercial |
$4,275.68
|
| Rate for Payer: Blue Shield of California Commercial |
$6,479.53
|
| Rate for Payer: Cash Price |
$4,570.20
|
| Rate for Payer: Cash Price |
$4,570.20
|
| Rate for Payer: Cigna of CA HMO |
$6,499.84
|
| Rate for Payer: Cigna of CA PPO |
$7,515.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,109.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$8,632.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,093.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$244.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,449.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$276.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,437.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$8,124.80
|
| Rate for Payer: Networks By Design Commercial |
$6,601.40
|
| Rate for Payer: Prime Health Services Commercial |
$8,632.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,093.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,093.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,688.24
|
| Rate for Payer: United Healthcare All Other HMO |
$1,688.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,688.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,688.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC ANGIOGRAPH PULMONARY BILAT
|
Facility
|
OP
|
$9,857.00
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
909081627
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$226.03 |
| Max. Negotiated Rate |
$8,378.45 |
| Rate for Payer: Adventist Health Commercial |
$1,971.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,169.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,721.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,149.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,288.77
|
| Rate for Payer: Cash Price |
$4,435.65
|
| Rate for Payer: Cash Price |
$4,435.65
|
| Rate for Payer: Cigna of CA HMO |
$6,308.48
|
| Rate for Payer: Cigna of CA PPO |
$7,294.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,899.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$8,378.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,914.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$226.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,259.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$255.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,365.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$7,885.60
|
| Rate for Payer: Networks By Design Commercial |
$6,407.05
|
| Rate for Payer: Prime Health Services Commercial |
$8,378.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,914.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,914.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC ANGIOGRAPH PULMONARY BILAT
|
Facility
|
IP
|
$9,857.00
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
909081627
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,971.40 |
| Max. Negotiated Rate |
$8,378.45 |
| Rate for Payer: Adventist Health Commercial |
$1,971.40
|
| Rate for Payer: Cash Price |
$4,435.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,899.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,942.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,942.80
|
| Rate for Payer: Galaxy Health WC |
$8,378.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,914.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,259.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,815.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,365.68
|
| Rate for Payer: Multiplan Commercial |
$7,885.60
|
| Rate for Payer: Networks By Design Commercial |
$6,407.05
|
| Rate for Payer: Prime Health Services Commercial |
$8,378.45
|
|
|
HC ANGIOGRAPH PULMONARY UNILAT
|
Facility
|
OP
|
$6,571.00
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
909081575
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$199.97 |
| Max. Negotiated Rate |
$6,700.73 |
| Rate for Payer: Adventist Health Commercial |
$1,314.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,108.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,700.57
|
| Rate for Payer: Blue Shield of California Commercial |
$2,766.39
|
| Rate for Payer: Blue Shield of California Commercial |
$4,192.30
|
| Rate for Payer: Cash Price |
$2,956.95
|
| Rate for Payer: Cash Price |
$2,956.95
|
| Rate for Payer: Cigna of CA HMO |
$4,205.44
|
| Rate for Payer: Cigna of CA PPO |
$4,862.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,599.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$5,585.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,942.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$199.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,172.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$226.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,577.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$5,256.80
|
| Rate for Payer: Networks By Design Commercial |
$4,271.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,585.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,942.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,942.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC ANGIOGRAPH PULMONARY UNILAT
|
Facility
|
IP
|
$6,571.00
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
909081575
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,314.20 |
| Max. Negotiated Rate |
$5,585.35 |
| Rate for Payer: Adventist Health Commercial |
$1,314.20
|
| Rate for Payer: Cash Price |
$2,956.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,599.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,628.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,628.40
|
| Rate for Payer: Galaxy Health WC |
$5,585.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,942.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,172.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,876.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,577.04
|
| Rate for Payer: Multiplan Commercial |
$5,256.80
|
| Rate for Payer: Networks By Design Commercial |
$4,271.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,585.35
|
|
|
HC ANGIOGRAPH PULMONARY VENOUS INJ
|
Facility
|
OP
|
$10,156.00
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
909081628
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$206.25 |
| Max. Negotiated Rate |
$8,632.60 |
| Rate for Payer: Adventist Health Commercial |
$2,031.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,206.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,721.07
|
| Rate for Payer: Blue Shield of California Commercial |
$4,275.68
|
| Rate for Payer: Blue Shield of California Commercial |
$6,479.53
|
| Rate for Payer: Cash Price |
$4,570.20
|
| Rate for Payer: Cash Price |
$4,570.20
|
| Rate for Payer: Cigna of CA HMO |
$6,499.84
|
| Rate for Payer: Cigna of CA PPO |
$7,515.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,109.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$8,632.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,093.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$206.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,449.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$233.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,437.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$8,124.80
|
| Rate for Payer: Networks By Design Commercial |
$6,601.40
|
| Rate for Payer: Prime Health Services Commercial |
$8,632.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,093.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,093.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,688.24
|
| Rate for Payer: United Healthcare All Other HMO |
$1,688.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,688.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,688.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC ANGIOGRAPH PULMONARY VENOUS INJ
|
Facility
|
IP
|
$10,156.00
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
909081628
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,031.20 |
| Max. Negotiated Rate |
$8,632.60 |
| Rate for Payer: Adventist Health Commercial |
$2,031.20
|
| Rate for Payer: Cash Price |
$4,570.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,109.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,062.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,062.40
|
| Rate for Payer: Galaxy Health WC |
$8,632.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,093.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,449.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,992.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,437.44
|
| Rate for Payer: Multiplan Commercial |
$8,124.80
|
| Rate for Payer: Networks By Design Commercial |
$6,601.40
|
| Rate for Payer: Prime Health Services Commercial |
$8,632.60
|
|
|
HC ANGIOGRAPH SPINAL
|
Facility
|
OP
|
$13,787.00
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
909081617
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$355.08 |
| Max. Negotiated Rate |
$11,808.82 |
| Rate for Payer: Adventist Health Commercial |
$2,757.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,275.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,156.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,721.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,804.33
|
| Rate for Payer: Blue Shield of California Commercial |
$8,796.11
|
| Rate for Payer: Cash Price |
$6,204.15
|
| Rate for Payer: Cash Price |
$6,204.15
|
| Rate for Payer: Cigna of CA HMO |
$8,823.68
|
| Rate for Payer: Cigna of CA PPO |
$10,202.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,872.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,156.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,650.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,808.82
|
| Rate for Payer: EPIC Health Plan Senior |
$7,872.55
|
| Rate for Payer: Galaxy Health WC |
$11,718.95
|
| Rate for Payer: Global Benefits Group Commercial |
$8,272.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,737.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$355.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,754.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$401.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,019.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,308.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,017.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,590.19
|
| Rate for Payer: Multiplan Commercial |
$11,029.60
|
| Rate for Payer: Networks By Design Commercial |
$8,961.55
|
| Rate for Payer: Prime Health Services Commercial |
$11,718.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,272.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,272.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,156.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,156.86
|
|
|
HC ANGIOGRAPH SPINAL
|
Facility
|
IP
|
$13,787.00
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
909081617
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,757.40 |
| Max. Negotiated Rate |
$11,718.95 |
| Rate for Payer: Adventist Health Commercial |
$2,757.40
|
| Rate for Payer: Cash Price |
$6,204.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,650.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,514.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,514.80
|
| Rate for Payer: Galaxy Health WC |
$11,718.95
|
| Rate for Payer: Global Benefits Group Commercial |
$8,272.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,754.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,134.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,308.88
|
| Rate for Payer: Multiplan Commercial |
$11,029.60
|
| Rate for Payer: Networks By Design Commercial |
$8,961.55
|
| Rate for Payer: Prime Health Services Commercial |
$11,718.95
|
|
|
HC ANGIOGRAPH VISCERAL BASIC
|
Facility
|
OP
|
$11,987.00
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
909081622
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$218.84 |
| Max. Negotiated Rate |
$11,808.82 |
| Rate for Payer: Adventist Health Commercial |
$2,397.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,260.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,156.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,700.64
|
| Rate for Payer: Blue Shield of California Commercial |
$5,046.53
|
| Rate for Payer: Blue Shield of California Commercial |
$7,647.71
|
| Rate for Payer: Cash Price |
$5,394.15
|
| Rate for Payer: Cash Price |
$5,394.15
|
| Rate for Payer: Cigna of CA HMO |
$7,671.68
|
| Rate for Payer: Cigna of CA PPO |
$8,870.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,872.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,156.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,390.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,808.82
|
| Rate for Payer: EPIC Health Plan Senior |
$7,872.55
|
| Rate for Payer: Galaxy Health WC |
$10,188.95
|
| Rate for Payer: Global Benefits Group Commercial |
$7,192.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,737.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$218.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,611.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$247.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,019.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,876.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,017.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,590.19
|
| Rate for Payer: Multiplan Commercial |
$9,589.60
|
| Rate for Payer: Networks By Design Commercial |
$7,791.55
|
| Rate for Payer: Prime Health Services Commercial |
$10,188.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,192.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,192.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,156.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,156.86
|
|
|
HC ANGIOGRAPH VISCERAL BASIC
|
Facility
|
IP
|
$11,987.00
|
|
|
Service Code
|
CPT 75726
|
| Hospital Charge Code |
909081622
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,397.40 |
| Max. Negotiated Rate |
$10,188.95 |
| Rate for Payer: Adventist Health Commercial |
$2,397.40
|
| Rate for Payer: Cash Price |
$5,394.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,390.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,794.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,794.80
|
| Rate for Payer: Galaxy Health WC |
$10,188.95
|
| Rate for Payer: Global Benefits Group Commercial |
$7,192.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,611.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,072.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,876.88
|
| Rate for Payer: Multiplan Commercial |
$9,589.60
|
| Rate for Payer: Networks By Design Commercial |
$7,791.55
|
| Rate for Payer: Prime Health Services Commercial |
$10,188.95
|
|
|
HC ANGIOJET PUMP SET
|
Facility
|
IP
|
$900.00
|
|
| Hospital Charge Code |
909080038
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Adventist Health Commercial |
$180.00
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$630.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$360.00
|
| Rate for Payer: EPIC Health Plan Senior |
$360.00
|
| Rate for Payer: Galaxy Health WC |
$765.00
|
| Rate for Payer: Global Benefits Group Commercial |
$540.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$571.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$531.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.00
|
| Rate for Payer: Multiplan Commercial |
$720.00
|
| Rate for Payer: Networks By Design Commercial |
$585.00
|
| Rate for Payer: Prime Health Services Commercial |
$765.00
|
|
|
HC ANGIOJET PUMP SET
|
Facility
|
OP
|
$900.00
|
|
| Hospital Charge Code |
909080038
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Adventist Health Commercial |
$180.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$590.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$765.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$495.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$675.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$577.53
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cigna of CA HMO |
$576.00
|
| Rate for Payer: Cigna of CA PPO |
$666.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$765.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$765.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$630.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$360.00
|
| Rate for Payer: EPIC Health Plan Senior |
$360.00
|
| Rate for Payer: Galaxy Health WC |
$765.00
|
| Rate for Payer: Global Benefits Group Commercial |
$540.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$571.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$326.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$531.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$630.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$630.00
|
| Rate for Payer: Multiplan Commercial |
$720.00
|
| Rate for Payer: Networks By Design Commercial |
$585.00
|
| Rate for Payer: Prime Health Services Commercial |
$765.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$540.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$540.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$450.00
|
| Rate for Payer: United Healthcare All Other HMO |
$450.00
|
| Rate for Payer: United Healthcare HMO Rider |
$450.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$450.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$765.00
|
| Rate for Payer: Vantage Medical Group Senior |
$765.00
|
|
