|
HC INSERT NON-INDWEL BLADDER CATH
|
Facility
|
OP
|
$351.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
906811389
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$84.24 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$210.60
|
| Rate for Payer: Blue Shield of California Commercial |
$258.69
|
| Rate for Payer: Blue Shield of California EPN |
$204.98
|
| Rate for Payer: Cash Price |
$157.95
|
| Rate for Payer: Cash Price |
$157.95
|
| Rate for Payer: Cigna of CA HMO |
$224.64
|
| Rate for Payer: Cigna of CA PPO |
$259.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$298.35
|
| Rate for Payer: Global Benefits Group Commercial |
$210.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$263.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$261.74
|
| Rate for Payer: Heritage Provider Network Transplant |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$258.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$258.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$234.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$208.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$280.80
|
| Rate for Payer: Networks By Design Commercial |
$228.15
|
| Rate for Payer: Prime Health Services Commercial |
$298.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.50
|
| Rate for Payer: United Healthcare All Other HMO |
$175.50
|
| Rate for Payer: United Healthcare HMO Rider |
$175.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC INSERT NON-INDWEL BLADDER CATH
|
Facility
|
IP
|
$351.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
906811389
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$84.24 |
| Max. Negotiated Rate |
$298.35 |
| Rate for Payer: Cash Price |
$157.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.40
|
| Rate for Payer: Galaxy Health WC |
$298.35
|
| Rate for Payer: Global Benefits Group Commercial |
$210.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$234.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.24
|
| Rate for Payer: Multiplan Commercial |
$280.80
|
| Rate for Payer: Networks By Design Commercial |
$228.15
|
| Rate for Payer: Prime Health Services Commercial |
$298.35
|
|
|
HC INSERT NON-INDWEL BLADDER CATH
|
Facility
|
IP
|
$391.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
909001904
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$93.84 |
| Max. Negotiated Rate |
$332.35 |
| Rate for Payer: Cash Price |
$175.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.40
|
| Rate for Payer: Galaxy Health WC |
$332.35
|
| Rate for Payer: Global Benefits Group Commercial |
$234.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$260.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.84
|
| Rate for Payer: Multiplan Commercial |
$312.80
|
| Rate for Payer: Networks By Design Commercial |
$254.15
|
| Rate for Payer: Prime Health Services Commercial |
$332.35
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
IP
|
$3,958.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$949.92 |
| Max. Negotiated Rate |
$3,364.30 |
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,583.20
|
| Rate for Payer: Galaxy Health WC |
$3,364.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,374.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,639.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,508.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$949.92
|
| Rate for Payer: Multiplan Commercial |
$3,166.40
|
| Rate for Payer: Networks By Design Commercial |
$2,572.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,364.30
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
IP
|
$3,958.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$949.92 |
| Max. Negotiated Rate |
$3,364.30 |
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,583.20
|
| Rate for Payer: Galaxy Health WC |
$3,364.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,374.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,639.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,508.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$949.92
|
| Rate for Payer: Multiplan Commercial |
$3,166.40
|
| Rate for Payer: Networks By Design Commercial |
$2,572.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,364.30
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
OP
|
$3,958.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$164.35 |
| Max. Negotiated Rate |
$6,531.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,374.80
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: Cigna of CA PPO |
$2,928.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$3,364.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,374.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,968.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,531.38
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,639.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$949.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$3,166.40
|
| Rate for Payer: Networks By Design Commercial |
$2,572.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,364.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,374.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,979.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,979.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,979.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,979.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
OP
|
$3,958.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$164.35 |
| Max. Negotiated Rate |
$6,531.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,374.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: Cigna of CA PPO |
$2,928.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$3,364.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,374.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,968.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,531.38
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6,451.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$6,451.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,639.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$949.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$3,166.40
|
| Rate for Payer: Networks By Design Commercial |
$2,572.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,364.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,374.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,374.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC INSERT NON-TNNL CV CATH LT 5YR
|
Facility
|
IP
|
$3,958.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
909081358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$949.92 |
| Max. Negotiated Rate |
$3,364.30 |
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,583.20
|
| Rate for Payer: Galaxy Health WC |
$3,364.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,374.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,639.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,508.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$949.92
|
| Rate for Payer: Multiplan Commercial |
$3,166.40
|
| Rate for Payer: Networks By Design Commercial |
$2,572.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,364.30
|
|
|
HC INSERT NON-TNNL CV CATH LT 5YR
|
Facility
|
OP
|
$3,958.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
909081358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$164.35 |
| Max. Negotiated Rate |
$6,531.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,374.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: Cigna of CA PPO |
$2,928.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$3,364.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,374.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,968.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,531.38
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6,451.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$6,451.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,639.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$949.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$3,166.40
|
| Rate for Payer: Networks By Design Commercial |
$2,572.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,364.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,374.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$5,741.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$141.00 |
| Max. Negotiated Rate |
$6,531.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,444.60
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Cigna of CA PPO |
$4,248.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$4,879.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,444.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,305.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,531.38
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,829.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,377.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$4,592.80
|
| Rate for Payer: Networks By Design Commercial |
$3,731.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,879.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,444.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,870.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,870.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,870.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,870.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$5,741.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,377.84 |
| Max. Negotiated Rate |
$4,879.85 |
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,296.40
|
| Rate for Payer: Galaxy Health WC |
$4,879.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,444.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,829.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,187.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,377.84
|
| Rate for Payer: Multiplan Commercial |
$4,592.80
|
| Rate for Payer: Networks By Design Commercial |
$3,731.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,879.85
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$5,741.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
901200045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,377.84 |
| Max. Negotiated Rate |
$4,879.85 |
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,296.40
|
| Rate for Payer: Galaxy Health WC |
$4,879.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,444.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,829.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,187.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,377.84
|
| Rate for Payer: Multiplan Commercial |
$4,592.80
|
| Rate for Payer: Networks By Design Commercial |
$3,731.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,879.85
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$5,741.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
901200045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$141.00 |
| Max. Negotiated Rate |
$6,531.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,444.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Cigna of CA PPO |
$4,248.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$4,879.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,444.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,305.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,531.38
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6,451.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$6,451.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,829.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,377.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$4,592.80
|
| Rate for Payer: Networks By Design Commercial |
$3,731.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,879.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,444.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$5,741.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$141.00 |
| Max. Negotiated Rate |
$6,531.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,444.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Cigna of CA PPO |
$4,248.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$4,879.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,444.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,305.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,531.38
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6,451.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$6,451.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,829.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,377.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$4,592.80
|
| Rate for Payer: Networks By Design Commercial |
$3,731.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,879.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,444.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$5,741.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,377.84 |
| Max. Negotiated Rate |
$4,879.85 |
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,296.40
|
| Rate for Payer: Galaxy Health WC |
$4,879.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,444.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,829.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,187.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,377.84
|
| Rate for Payer: Multiplan Commercial |
$4,592.80
|
| Rate for Payer: Networks By Design Commercial |
$3,731.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,879.85
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
IP
|
$32,231.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906811995
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,735.44 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$14,503.95
|
| Rate for Payer: Cash Price |
$14,503.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,892.40
|
| Rate for Payer: Galaxy Health WC |
$27,396.35
|
| Rate for Payer: Global Benefits Group Commercial |
$19,338.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,498.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,280.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,735.44
|
| Rate for Payer: Multiplan Commercial |
$25,784.80
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$27,396.35
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
OP
|
$32,231.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906811995
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$542.56 |
| Max. Negotiated Rate |
$27,396.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,253.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27,396.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17,727.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17,727.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: Blue Distinction Transplant |
$19,338.60
|
| Rate for Payer: Blue Shield of California Commercial |
$833.61
|
| Rate for Payer: Blue Shield of California EPN |
$542.56
|
| Rate for Payer: Cash Price |
$14,503.95
|
| Rate for Payer: Cash Price |
$14,503.95
|
| Rate for Payer: Cigna of CA PPO |
$23,850.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27,396.35
|
| Rate for Payer: Dignity Health Media |
$27,396.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,396.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,892.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,892.40
|
| Rate for Payer: Galaxy Health WC |
$27,396.35
|
| Rate for Payer: Global Benefits Group Commercial |
$19,338.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24,173.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,498.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$573.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,735.44
|
| Rate for Payer: Multiplan Commercial |
$25,784.80
|
| Rate for Payer: Networks By Design Commercial |
$20,950.15
|
| Rate for Payer: Prime Health Services Commercial |
$27,396.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,338.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27,396.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,396.35
|
| Rate for Payer: Vantage Medical Group Senior |
$27,396.35
|
|
|
HC INSERT PERM INTRAPERITONEAL CATH/DIALYSIS
|
Facility
|
IP
|
$11,981.00
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
909000217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,875.44 |
| Max. Negotiated Rate |
$10,183.85 |
| Rate for Payer: Cash Price |
$5,391.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,792.40
|
| Rate for Payer: Galaxy Health WC |
$10,183.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7,188.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,991.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,564.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,875.44
|
| Rate for Payer: Multiplan Commercial |
$9,584.80
|
| Rate for Payer: Networks By Design Commercial |
$7,787.65
|
| Rate for Payer: Prime Health Services Commercial |
$10,183.85
|
|
|
HC INSERT PERM INTRAPERITONEAL CATH/DIALYSIS
|
Facility
|
OP
|
$11,981.00
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
909000217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$370.37 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,322.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,188.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$5,391.45
|
| Rate for Payer: Cash Price |
$5,391.45
|
| Rate for Payer: Cigna of CA PPO |
$8,865.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Dignity Health Media |
$4,322.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,754.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,835.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,322.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,322.62
|
| Rate for Payer: Galaxy Health WC |
$10,183.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7,188.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,985.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,089.10
|
| Rate for Payer: Heritage Provider Network Transplant |
$7,089.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7,002.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$7,002.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,322.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,991.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$370.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,322.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,875.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,446.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,792.31
|
| Rate for Payer: Multiplan Commercial |
$9,584.80
|
| Rate for Payer: Networks By Design Commercial |
$7,787.65
|
| Rate for Payer: Prime Health Services Commercial |
$10,183.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,188.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,322.62
|
|
|
HC INSERT PLEURAL CATH W CUFF
|
Facility
|
OP
|
$13,818.00
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
909020011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,138.86 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,322.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,290.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$6,218.10
|
| Rate for Payer: Cash Price |
$6,218.10
|
| Rate for Payer: Cigna of CA PPO |
$10,225.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Dignity Health Media |
$4,322.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,754.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,835.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,322.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,322.62
|
| Rate for Payer: Galaxy Health WC |
$11,745.30
|
| Rate for Payer: Global Benefits Group Commercial |
$8,290.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,363.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,089.10
|
| Rate for Payer: Heritage Provider Network Transplant |
$7,089.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7,002.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$7,002.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,322.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,216.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,138.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,322.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,316.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,446.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,792.31
|
| Rate for Payer: Multiplan Commercial |
$11,054.40
|
| Rate for Payer: Networks By Design Commercial |
$8,981.70
|
| Rate for Payer: Prime Health Services Commercial |
$11,745.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,290.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,483.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,754.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,322.62
|
|
|
HC INSERT PLEURAL CATH W CUFF
|
Facility
|
IP
|
$13,818.00
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
909020011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,316.32 |
| Max. Negotiated Rate |
$11,745.30 |
| Rate for Payer: Cash Price |
$6,218.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,527.20
|
| Rate for Payer: Galaxy Health WC |
$11,745.30
|
| Rate for Payer: Global Benefits Group Commercial |
$8,290.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,216.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,264.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,316.32
|
| Rate for Payer: Multiplan Commercial |
$11,054.40
|
| Rate for Payer: Networks By Design Commercial |
$8,981.70
|
| Rate for Payer: Prime Health Services Commercial |
$11,745.30
|
|
|
HC INSERT & REMOVE BONE PIN/WIRE
|
Facility
|
IP
|
$9,424.00
|
|
|
Service Code
|
CPT 20650
|
| Hospital Charge Code |
900501245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,261.76 |
| Max. Negotiated Rate |
$8,010.40 |
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,769.60
|
| Rate for Payer: Galaxy Health WC |
$8,010.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,654.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,285.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,590.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,261.76
|
| Rate for Payer: Multiplan Commercial |
$7,539.20
|
| Rate for Payer: Networks By Design Commercial |
$6,125.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,010.40
|
|
|
HC INSERT & REMOVE BONE PIN/WIRE
|
Facility
|
OP
|
$9,424.00
|
|
|
Service Code
|
CPT 20650
|
| Hospital Charge Code |
900501245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$198.06 |
| Max. Negotiated Rate |
$9,590.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,654.40
|
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Cash Price |
$4,240.80
|
| Rate for Payer: Cigna of CA PPO |
$6,973.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$8,010.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,654.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,068.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,632.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,632.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,285.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$198.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,261.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$7,539.20
|
| Rate for Payer: Networks By Design Commercial |
$6,125.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,010.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,654.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,712.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,712.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,712.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC INSERT SUBQ DEFIB WELTRD
|
Facility
|
IP
|
$79,658.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
906811456
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$19,117.92 |
| Max. Negotiated Rate |
$67,709.30 |
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,863.20
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30,349.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,117.92
|
| Rate for Payer: Multiplan Commercial |
$63,726.40
|
| Rate for Payer: Networks By Design Commercial |
$51,777.70
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
|
|
HC INSERT SUBQ DEFIB WELTRD
|
Facility
|
OP
|
$79,658.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
906811456
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$966.97 |
| Max. Negotiated Rate |
$103,995.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45,215.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$41,105.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41,690.00
|
| Rate for Payer: Blue Distinction Transplant |
$47,794.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cash Price |
$35,846.10
|
| Rate for Payer: Cigna of CA PPO |
$58,946.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Dignity Health Media |
$41,105.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$45,215.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,492.07
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$41,105.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$41,105.24
|
| Rate for Payer: Galaxy Health WC |
$67,709.30
|
| Rate for Payer: Global Benefits Group Commercial |
$47,794.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$59,743.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$67,412.59
|
| Rate for Payer: Heritage Provider Network Transplant |
$67,412.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$66,590.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$66,590.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,105.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53,131.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$966.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,105.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,117.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$51,792.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,081.02
|
| Rate for Payer: Multiplan Commercial |
$63,726.40
|
| Rate for Payer: Multiplan WC |
$56,196.73
|
| Rate for Payer: Networks By Design Commercial |
$51,777.70
|
| Rate for Payer: Prime Health Services Commercial |
$67,709.30
|
| Rate for Payer: Prime Health Services WC |
$55,623.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$47,794.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$103,995.00
|
| Rate for Payer: United Healthcare All Other HMO |
$92,797.00
|
| Rate for Payer: United Healthcare HMO Rider |
$80,182.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$73,321.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$61,657.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45,215.76
|
| Rate for Payer: Vantage Medical Group Senior |
$41,105.24
|
|
