|
HC INSERT SUPRAPUBIC CATH
|
Facility
|
OP
|
$7,013.00
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
909020122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$523.45 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,544.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,207.80
|
| 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 |
$3,155.85
|
| Rate for Payer: Cash Price |
$3,155.85
|
| Rate for Payer: Cigna of CA PPO |
$5,189.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Dignity Health Media |
$2,544.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,799.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,435.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,544.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,544.87
|
| Rate for Payer: Galaxy Health WC |
$5,961.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,207.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,259.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,173.59
|
| Rate for Payer: Heritage Provider Network Transplant |
$4,173.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4,122.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$4,122.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,544.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,677.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$523.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,544.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,683.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,206.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,410.13
|
| Rate for Payer: Multiplan Commercial |
$5,610.40
|
| Rate for Payer: Networks By Design Commercial |
$4,558.45
|
| Rate for Payer: Prime Health Services Commercial |
$5,961.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,207.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Vantage Medical Group Senior |
$2,544.87
|
|
|
HC INSERT SUPRAPUBIC CATH
|
Facility
|
IP
|
$7,013.00
|
|
|
Service Code
|
CPT 51102
|
| Hospital Charge Code |
909020122
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,683.12 |
| Max. Negotiated Rate |
$5,961.05 |
| Rate for Payer: Cash Price |
$3,155.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,805.20
|
| Rate for Payer: Galaxy Health WC |
$5,961.05
|
| Rate for Payer: Global Benefits Group Commercial |
$4,207.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,677.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,671.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,683.12
|
| Rate for Payer: Multiplan Commercial |
$5,610.40
|
| Rate for Payer: Networks By Design Commercial |
$4,558.45
|
| Rate for Payer: Prime Health Services Commercial |
$5,961.05
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$2,476.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$594.24 |
| Max. Negotiated Rate |
$2,104.60 |
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$990.40
|
| Rate for Payer: Galaxy Health WC |
$2,104.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,485.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,651.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$943.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$594.24
|
| Rate for Payer: Multiplan Commercial |
$1,980.80
|
| Rate for Payer: Networks By Design Commercial |
$1,609.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,104.60
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
IP
|
$2,476.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$594.24 |
| Max. Negotiated Rate |
$2,104.60 |
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$990.40
|
| Rate for Payer: Galaxy Health WC |
$2,104.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,485.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,651.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$943.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$594.24
|
| Rate for Payer: Multiplan Commercial |
$1,980.80
|
| Rate for Payer: Networks By Design Commercial |
$1,609.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,104.60
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
OP
|
$2,476.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$241.26 |
| Max. Negotiated Rate |
$7,282.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,593.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,485.60
|
| 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 |
$1,114.20
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Cigna of CA PPO |
$1,832.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$2,104.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,485.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,857.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,281.66
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,241.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$3,241.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,001.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,651.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$594.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,521.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$1,980.80
|
| Rate for Payer: Networks By Design Commercial |
$1,609.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,104.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,485.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,485.60
|
| 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 |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC INSERT SWAN TYPE CATHETER
|
Facility
|
OP
|
$2,476.00
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
906811388
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$241.26 |
| Max. Negotiated Rate |
$7,282.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,593.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,485.60
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Cash Price |
$1,114.20
|
| Rate for Payer: Cigna of CA PPO |
$1,832.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$2,104.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,485.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,857.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,281.66
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,281.66
|
| 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 |
$2,001.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,651.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$594.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,521.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$1,980.80
|
| Rate for Payer: Networks By Design Commercial |
$1,609.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,104.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,485.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,238.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,238.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,238.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,238.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC INSERT TEMP INDWELLING CATH
|
Facility
|
OP
|
$1,066.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$159.60 |
| 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 |
$639.60
|
| Rate for Payer: Cash Price |
$479.70
|
| Rate for Payer: Cash Price |
$479.70
|
| Rate for Payer: Cash Price |
$479.70
|
| Rate for Payer: Cigna of CA PPO |
$788.84
|
| 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 |
$906.10
|
| Rate for Payer: Global Benefits Group Commercial |
$639.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$799.50
|
| 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 |
$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 |
$159.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$711.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.84
|
| 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 |
$852.80
|
| Rate for Payer: Networks By Design Commercial |
$692.90
|
| Rate for Payer: Prime Health Services Commercial |
$906.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$639.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$533.00
|
| Rate for Payer: United Healthcare All Other HMO |
$533.00
|
| Rate for Payer: United Healthcare HMO Rider |
$533.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$533.00
|
| 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 TEMP INDWELLING CATH
|
Facility
|
IP
|
$1,066.00
|
|
|
Service Code
|
CPT 51702
|
| Hospital Charge Code |
906811256
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$255.84 |
| Max. Negotiated Rate |
$906.10 |
| Rate for Payer: Cash Price |
$479.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$426.40
|
| Rate for Payer: Galaxy Health WC |
$906.10
|
| Rate for Payer: Global Benefits Group Commercial |
$639.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$711.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$406.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.84
|
| Rate for Payer: Multiplan Commercial |
$852.80
|
| Rate for Payer: Networks By Design Commercial |
$692.90
|
| Rate for Payer: Prime Health Services Commercial |
$906.10
|
|
|
HC INSERT TEMP INTRAPERITONEAL CATH
|
Facility
|
OP
|
$9,140.00
|
|
|
Service Code
|
CPT 49421
|
| Hospital Charge Code |
902100045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$497.29 |
| 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 |
$5,484.00
|
| 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 |
$4,113.00
|
| Rate for Payer: Cash Price |
$4,113.00
|
| Rate for Payer: Cigna of CA PPO |
$6,763.60
|
| 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 |
$7,769.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,484.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,855.00
|
| 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 |
$6,096.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$497.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,322.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,193.60
|
| 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 |
$7,312.00
|
| Rate for Payer: Networks By Design Commercial |
$5,941.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,769.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,484.00
|
| 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 TEMP INTRAPERITONEAL CATH
|
Facility
|
IP
|
$9,140.00
|
|
|
Service Code
|
CPT 49421
|
| Hospital Charge Code |
902100045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,193.60 |
| Max. Negotiated Rate |
$7,769.00 |
| Rate for Payer: Cash Price |
$4,113.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,656.00
|
| Rate for Payer: Galaxy Health WC |
$7,769.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,484.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,096.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,482.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,193.60
|
| Rate for Payer: Multiplan Commercial |
$7,312.00
|
| Rate for Payer: Networks By Design Commercial |
$5,941.00
|
| Rate for Payer: Prime Health Services Commercial |
$7,769.00
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$956.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$195.17 |
| 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 |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$573.60
|
| Rate for Payer: Blue Shield of California Commercial |
$704.57
|
| Rate for Payer: Blue Shield of California EPN |
$558.30
|
| Rate for Payer: Cash Price |
$430.20
|
| Rate for Payer: Cash Price |
$430.20
|
| Rate for Payer: Cigna of CA HMO |
$611.84
|
| Rate for Payer: Cigna of CA PPO |
$707.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$812.60
|
| Rate for Payer: Global Benefits Group Commercial |
$573.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$717.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$320.08
|
| Rate for Payer: Heritage Provider Network Transplant |
$320.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$316.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$316.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$637.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$764.80
|
| Rate for Payer: Networks By Design Commercial |
$621.40
|
| Rate for Payer: Prime Health Services Commercial |
$812.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$573.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$573.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$478.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$478.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$478.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$956.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$229.44 |
| Max. Negotiated Rate |
$812.60 |
| Rate for Payer: Cash Price |
$430.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$382.40
|
| Rate for Payer: Galaxy Health WC |
$812.60
|
| Rate for Payer: Global Benefits Group Commercial |
$573.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$637.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$364.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.44
|
| Rate for Payer: Multiplan Commercial |
$764.80
|
| Rate for Payer: Networks By Design Commercial |
$621.40
|
| Rate for Payer: Prime Health Services Commercial |
$812.60
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$956.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$195.17 |
| 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 |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$573.60
|
| Rate for Payer: Blue Shield of California Commercial |
$704.57
|
| Rate for Payer: Blue Shield of California EPN |
$558.30
|
| Rate for Payer: Cash Price |
$430.20
|
| Rate for Payer: Cash Price |
$430.20
|
| Rate for Payer: Cash Price |
$430.20
|
| Rate for Payer: Cigna of CA HMO |
$611.84
|
| Rate for Payer: Cigna of CA PPO |
$707.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$812.60
|
| Rate for Payer: Global Benefits Group Commercial |
$573.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$717.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$320.08
|
| Rate for Payer: Heritage Provider Network Transplant |
$320.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$316.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$316.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$637.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$764.80
|
| Rate for Payer: Networks By Design Commercial |
$621.40
|
| Rate for Payer: Prime Health Services Commercial |
$812.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$573.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$573.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
OP
|
$956.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$195.17 |
| 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 |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$573.60
|
| Rate for Payer: Cash Price |
$430.20
|
| Rate for Payer: Cash Price |
$430.20
|
| Rate for Payer: Cash Price |
$430.20
|
| Rate for Payer: Cigna of CA PPO |
$707.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$812.60
|
| Rate for Payer: Global Benefits Group Commercial |
$573.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$717.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$320.08
|
| Rate for Payer: Heritage Provider Network Transplant |
$320.08
|
| 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 |
$195.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$637.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$205.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$764.80
|
| Rate for Payer: Networks By Design Commercial |
$621.40
|
| Rate for Payer: Prime Health Services Commercial |
$812.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$573.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$478.00
|
| Rate for Payer: United Healthcare All Other HMO |
$478.00
|
| Rate for Payer: United Healthcare HMO Rider |
$478.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$478.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$956.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$229.44 |
| Max. Negotiated Rate |
$812.60 |
| Rate for Payer: Cash Price |
$430.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$382.40
|
| Rate for Payer: Galaxy Health WC |
$812.60
|
| Rate for Payer: Global Benefits Group Commercial |
$573.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$637.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$364.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.44
|
| Rate for Payer: Multiplan Commercial |
$764.80
|
| Rate for Payer: Networks By Design Commercial |
$621.40
|
| Rate for Payer: Prime Health Services Commercial |
$812.60
|
|
|
HC INSERT URINARY CATH COMPLICATED
|
Facility
|
IP
|
$956.00
|
|
|
Service Code
|
CPT 51703
|
| Hospital Charge Code |
902400104
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$229.44 |
| Max. Negotiated Rate |
$812.60 |
| Rate for Payer: Cash Price |
$430.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$382.40
|
| Rate for Payer: Galaxy Health WC |
$812.60
|
| Rate for Payer: Global Benefits Group Commercial |
$573.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$637.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$364.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$229.44
|
| Rate for Payer: Multiplan Commercial |
$764.80
|
| Rate for Payer: Networks By Design Commercial |
$621.40
|
| Rate for Payer: Prime Health Services Commercial |
$812.60
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
IP
|
$15,029.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906811429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,606.96 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,011.60
|
| Rate for Payer: Galaxy Health WC |
$12,774.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9,017.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,024.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,726.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,606.96
|
| Rate for Payer: Multiplan Commercial |
$12,023.20
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$12,774.65
|
|
|
HC INSERT VAD ARTERY ACCESS
|
Facility
|
OP
|
$15,029.00
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
906811429
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$667.05 |
| Max. Negotiated Rate |
$14,375.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,553.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,774.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,265.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,265.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: Blue Distinction Transplant |
$9,017.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,851.81
|
| Rate for Payer: Blue Shield of California EPN |
$5,110.40
|
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Cash Price |
$6,763.05
|
| Rate for Payer: Cigna of CA PPO |
$11,121.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,774.65
|
| Rate for Payer: Dignity Health Media |
$12,774.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,774.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,011.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,011.60
|
| Rate for Payer: Galaxy Health WC |
$12,774.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9,017.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,271.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,024.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$667.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,606.96
|
| Rate for Payer: Multiplan Commercial |
$12,023.20
|
| Rate for Payer: Networks By Design Commercial |
$9,768.85
|
| Rate for Payer: Prime Health Services Commercial |
$12,774.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,017.40
|
| 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 |
$12,774.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,774.65
|
| Rate for Payer: Vantage Medical Group Senior |
$12,774.65
|
|
|
HC INSRT CANN HEMO OTHR VN TO VN
|
Facility
|
IP
|
$15,090.00
|
|
|
Service Code
|
CPT 36800
|
| Hospital Charge Code |
909036800
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,621.60 |
| Max. Negotiated Rate |
$12,826.50 |
| Rate for Payer: Cash Price |
$6,790.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,036.00
|
| Rate for Payer: Galaxy Health WC |
$12,826.50
|
| Rate for Payer: Global Benefits Group Commercial |
$9,054.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,065.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,749.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,621.60
|
| Rate for Payer: Multiplan Commercial |
$12,072.00
|
| Rate for Payer: Networks By Design Commercial |
$9,808.50
|
| Rate for Payer: Prime Health Services Commercial |
$12,826.50
|
|
|
HC INSRT CANN HEMO OTHR VN TO VN
|
Facility
|
OP
|
$15,090.00
|
|
|
Service Code
|
CPT 36800
|
| Hospital Charge Code |
909036800
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$240.50 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$9,054.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,128.35
|
| Rate for Payer: Blue Shield of California EPN |
$2,686.96
|
| Rate for Payer: Cash Price |
$6,790.50
|
| Rate for Payer: Cash Price |
$6,790.50
|
| Rate for Payer: Cigna of CA PPO |
$11,166.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Dignity Health Media |
$6,866.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,552.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,269.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,866.07
|
| Rate for Payer: Galaxy Health WC |
$12,826.50
|
| Rate for Payer: Global Benefits Group Commercial |
$9,054.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,317.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,260.35
|
| Rate for Payer: Heritage Provider Network Transplant |
$11,260.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11,123.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$11,123.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,866.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,065.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,621.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,651.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,200.53
|
| Rate for Payer: Multiplan Commercial |
$12,072.00
|
| Rate for Payer: Networks By Design Commercial |
$9,808.50
|
| Rate for Payer: Prime Health Services Commercial |
$12,826.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,054.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC INSRT TUN CNTRL VAD W SUB PORT GT 5YR
|
Facility
|
OP
|
$15,988.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
909080012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$494.00 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| 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 |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$9,592.80
|
| Rate for Payer: Blue Shield of California Commercial |
$5,803.51
|
| Rate for Payer: Blue Shield of California EPN |
$3,777.25
|
| Rate for Payer: Cash Price |
$7,194.60
|
| Rate for Payer: Cash Price |
$7,194.60
|
| Rate for Payer: Cigna of CA PPO |
$11,831.12
|
| 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 |
$13,589.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9,592.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,991.00
|
| 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 |
$10,664.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$494.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,837.12
|
| 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 |
$12,790.40
|
| Rate for Payer: Networks By Design Commercial |
$10,392.20
|
| Rate for Payer: Prime Health Services Commercial |
$13,589.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,592.80
|
| 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 |
$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 INSRT TUN CNTRL VAD W SUB PORT GT 5YR
|
Facility
|
IP
|
$15,988.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
909080012
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,837.12 |
| Max. Negotiated Rate |
$13,589.80 |
| Rate for Payer: Cash Price |
$7,194.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,395.20
|
| Rate for Payer: Galaxy Health WC |
$13,589.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9,592.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,664.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,091.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,837.12
|
| Rate for Payer: Multiplan Commercial |
$12,790.40
|
| Rate for Payer: Networks By Design Commercial |
$10,392.20
|
| Rate for Payer: Prime Health Services Commercial |
$13,589.80
|
|
|
HC INSRT TUN CNTRL VAD W/SUB PORT GT 5YR
|
Facility
|
IP
|
$15,988.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
900501569
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,837.12 |
| Max. Negotiated Rate |
$13,589.80 |
| Rate for Payer: Cash Price |
$7,194.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,395.20
|
| Rate for Payer: Galaxy Health WC |
$13,589.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9,592.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,664.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,091.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,837.12
|
| Rate for Payer: Multiplan Commercial |
$12,790.40
|
| Rate for Payer: Networks By Design Commercial |
$10,392.20
|
| Rate for Payer: Prime Health Services Commercial |
$13,589.80
|
|
|
HC INSRT TUN CNTRL VAD W/SUB PORT GT 5YR
|
Facility
|
OP
|
$15,988.00
|
|
|
Service Code
|
CPT 36561
|
| Hospital Charge Code |
900501569
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$494.00 |
| Max. Negotiated Rate |
$13,589.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| 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 |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$9,592.80
|
| Rate for Payer: Cash Price |
$7,194.60
|
| Rate for Payer: Cash Price |
$7,194.60
|
| Rate for Payer: Cash Price |
$7,194.60
|
| Rate for Payer: Cigna of CA PPO |
$11,831.12
|
| 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 |
$13,589.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9,592.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,991.00
|
| 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 |
$10,664.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$494.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,837.12
|
| 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 |
$12,790.40
|
| Rate for Payer: Networks By Design Commercial |
$10,392.20
|
| Rate for Payer: Prime Health Services Commercial |
$13,589.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,592.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,994.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,994.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,994.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,994.00
|
| 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 INS SUBQ CAR RHYTHM MTR W PRGM
|
Facility
|
OP
|
$17,740.00
|
|
|
Service Code
|
CPT 33285
|
| Hospital Charge Code |
906813406
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,322.54 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10,614.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$10,644.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,104.87
|
| Rate for Payer: Blue Shield of California EPN |
$3,322.54
|
| Rate for Payer: Cash Price |
$7,983.00
|
| Rate for Payer: Cash Price |
$7,983.00
|
| Rate for Payer: Cigna of CA PPO |
$13,127.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Dignity Health Media |
$10,614.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,676.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,329.97
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10,614.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,614.79
|
| Rate for Payer: Galaxy Health WC |
$15,079.00
|
| Rate for Payer: Global Benefits Group Commercial |
$10,644.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$13,305.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,408.26
|
| Rate for Payer: Heritage Provider Network Transplant |
$17,408.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17,195.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$17,195.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,614.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,832.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,190.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,614.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,257.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,374.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,223.82
|
| Rate for Payer: Multiplan Commercial |
$14,192.00
|
| Rate for Payer: Multiplan WC |
$14,511.92
|
| Rate for Payer: Networks By Design Commercial |
$11,531.00
|
| Rate for Payer: Prime Health Services Commercial |
$15,079.00
|
| Rate for Payer: Prime Health Services WC |
$14,363.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,644.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,922.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,676.27
|
| Rate for Payer: Vantage Medical Group Senior |
$10,614.79
|
|
