|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
IP
|
$527.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
907296374
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$126.48 |
| Max. Negotiated Rate |
$447.95 |
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$210.80
|
| Rate for Payer: Galaxy Health WC |
$447.95
|
| Rate for Payer: Global Benefits Group Commercial |
$316.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$200.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.48
|
| Rate for Payer: Multiplan Commercial |
$421.60
|
| Rate for Payer: Networks By Design Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Commercial |
$447.95
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
OP
|
$527.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
946100111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$94.66 |
| Max. Negotiated Rate |
$914.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$378.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$914.00
|
| Rate for Payer: Blue Distinction Transplant |
$316.20
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cigna of CA HMO |
$337.28
|
| Rate for Payer: Cigna of CA PPO |
$389.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.70
|
| Rate for Payer: Dignity Health Media |
$267.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$267.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$267.80
|
| Rate for Payer: Galaxy Health WC |
$447.95
|
| Rate for Payer: Global Benefits Group Commercial |
$316.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$395.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$439.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$439.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$433.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$433.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$337.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.85
|
| Rate for Payer: Multiplan Commercial |
$421.60
|
| Rate for Payer: Networks By Design Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Commercial |
$447.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$316.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Vantage Medical Group Senior |
$267.80
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
IP
|
$527.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
907296374
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$126.48 |
| Max. Negotiated Rate |
$447.95 |
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$210.80
|
| Rate for Payer: Galaxy Health WC |
$447.95
|
| Rate for Payer: Global Benefits Group Commercial |
$316.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$200.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.48
|
| Rate for Payer: Multiplan Commercial |
$421.60
|
| Rate for Payer: Networks By Design Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Commercial |
$447.95
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
IP
|
$527.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
940100111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$126.48 |
| Max. Negotiated Rate |
$447.95 |
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$210.80
|
| Rate for Payer: Galaxy Health WC |
$447.95
|
| Rate for Payer: Global Benefits Group Commercial |
$316.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$200.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.48
|
| Rate for Payer: Multiplan Commercial |
$421.60
|
| Rate for Payer: Networks By Design Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Commercial |
$447.95
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
OP
|
$527.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
948100111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$94.66 |
| Max. Negotiated Rate |
$914.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$378.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$914.00
|
| Rate for Payer: Blue Distinction Transplant |
$316.20
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cigna of CA HMO |
$337.28
|
| Rate for Payer: Cigna of CA PPO |
$389.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.70
|
| Rate for Payer: Dignity Health Media |
$267.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$267.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$267.80
|
| Rate for Payer: Galaxy Health WC |
$447.95
|
| Rate for Payer: Global Benefits Group Commercial |
$316.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$395.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$439.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$439.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$433.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$433.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$337.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.85
|
| Rate for Payer: Multiplan Commercial |
$421.60
|
| Rate for Payer: Networks By Design Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Commercial |
$447.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$316.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Vantage Medical Group Senior |
$267.80
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
IP
|
$527.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
947200111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$126.48 |
| Max. Negotiated Rate |
$447.95 |
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$210.80
|
| Rate for Payer: Galaxy Health WC |
$447.95
|
| Rate for Payer: Global Benefits Group Commercial |
$316.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$200.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.48
|
| Rate for Payer: Multiplan Commercial |
$421.60
|
| Rate for Payer: Networks By Design Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Commercial |
$447.95
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
IP
|
$527.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
946100111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$126.48 |
| Max. Negotiated Rate |
$447.95 |
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$210.80
|
| Rate for Payer: Galaxy Health WC |
$447.95
|
| Rate for Payer: Global Benefits Group Commercial |
$316.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$200.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.48
|
| Rate for Payer: Multiplan Commercial |
$421.60
|
| Rate for Payer: Networks By Design Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Commercial |
$447.95
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
OP
|
$527.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
907296374
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$94.66 |
| Max. Negotiated Rate |
$914.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$378.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$914.00
|
| Rate for Payer: Blue Distinction Transplant |
$316.20
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cigna of CA HMO |
$337.28
|
| Rate for Payer: Cigna of CA PPO |
$389.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.70
|
| Rate for Payer: Dignity Health Media |
$267.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$267.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$267.80
|
| Rate for Payer: Galaxy Health WC |
$447.95
|
| Rate for Payer: Global Benefits Group Commercial |
$316.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$395.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$439.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$439.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$433.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$433.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$337.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.85
|
| Rate for Payer: Multiplan Commercial |
$421.60
|
| Rate for Payer: Networks By Design Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Commercial |
$447.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$316.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Vantage Medical Group Senior |
$267.80
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
OP
|
$527.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
947200111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$94.66 |
| Max. Negotiated Rate |
$914.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$378.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$914.00
|
| Rate for Payer: Blue Distinction Transplant |
$316.20
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cigna of CA HMO |
$337.28
|
| Rate for Payer: Cigna of CA PPO |
$389.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.70
|
| Rate for Payer: Dignity Health Media |
$267.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$267.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$267.80
|
| Rate for Payer: Galaxy Health WC |
$447.95
|
| Rate for Payer: Global Benefits Group Commercial |
$316.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$395.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$439.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$439.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$433.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$433.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$337.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.85
|
| Rate for Payer: Multiplan Commercial |
$421.60
|
| Rate for Payer: Networks By Design Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Commercial |
$447.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$316.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Vantage Medical Group Senior |
$267.80
|
|
|
HC IV PUSH SINGLE OR INIT DRUG
|
Facility
|
OP
|
$527.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
940100111
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$94.66 |
| Max. Negotiated Rate |
$914.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$378.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$914.00
|
| Rate for Payer: Blue Distinction Transplant |
$316.20
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cigna of CA HMO |
$337.28
|
| Rate for Payer: Cigna of CA PPO |
$389.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.70
|
| Rate for Payer: Dignity Health Media |
$267.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$267.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$267.80
|
| Rate for Payer: Galaxy Health WC |
$447.95
|
| Rate for Payer: Global Benefits Group Commercial |
$316.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$395.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$439.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$439.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$433.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$433.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$337.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.85
|
| Rate for Payer: Multiplan Commercial |
$421.60
|
| Rate for Payer: Networks By Design Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Commercial |
$447.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$316.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Vantage Medical Group Senior |
$267.80
|
|
|
HC IV PUSH SINGLER OR INIT DRUG
|
Facility
|
OP
|
$527.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
910196374
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$94.66 |
| Max. Negotiated Rate |
$914.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$378.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$914.00
|
| Rate for Payer: Blue Distinction Transplant |
$316.20
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: Cigna of CA HMO |
$337.28
|
| Rate for Payer: Cigna of CA PPO |
$389.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.70
|
| Rate for Payer: Dignity Health Media |
$267.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$294.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$267.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$267.80
|
| Rate for Payer: Galaxy Health WC |
$447.95
|
| Rate for Payer: Global Benefits Group Commercial |
$316.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$395.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$439.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$439.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$433.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$433.84
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$267.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$337.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.85
|
| Rate for Payer: Multiplan Commercial |
$421.60
|
| Rate for Payer: Networks By Design Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Commercial |
$447.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$316.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Vantage Medical Group Senior |
$267.80
|
|
|
HC IV PUSH SINGLER OR INIT DRUG
|
Facility
|
IP
|
$527.00
|
|
|
Service Code
|
CPT 96374
|
| Hospital Charge Code |
910196374
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$126.48 |
| Max. Negotiated Rate |
$447.95 |
| Rate for Payer: Cash Price |
$237.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$210.80
|
| Rate for Payer: Galaxy Health WC |
$447.95
|
| Rate for Payer: Global Benefits Group Commercial |
$316.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$351.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$200.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.48
|
| Rate for Payer: Multiplan Commercial |
$421.60
|
| Rate for Payer: Networks By Design Commercial |
$342.55
|
| Rate for Payer: Prime Health Services Commercial |
$447.95
|
|
|
HC IVPW ADDL VES PRESSUREWIRE SEN
|
Facility
|
IP
|
$7,611.00
|
|
|
Service Code
|
CPT 93572
|
| Hospital Charge Code |
906812134
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,826.64 |
| Max. Negotiated Rate |
$6,469.35 |
| Rate for Payer: Cash Price |
$3,424.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,044.40
|
| Rate for Payer: Galaxy Health WC |
$6,469.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,566.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,076.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,899.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,826.64
|
| Rate for Payer: Multiplan Commercial |
$6,088.80
|
| Rate for Payer: Networks By Design Commercial |
$4,947.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,469.35
|
|
|
HC IVPW ADDL VES PRESSUREWIRE SEN
|
Facility
|
OP
|
$7,611.00
|
|
|
Service Code
|
CPT 93572
|
| Hospital Charge Code |
906812134
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$427.06 |
| Max. Negotiated Rate |
$6,668.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$577.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,469.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,186.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,186.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,534.63
|
| Rate for Payer: Blue Distinction Transplant |
$4,566.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$3,424.95
|
| Rate for Payer: Cash Price |
$3,424.95
|
| Rate for Payer: Cash Price |
$3,424.95
|
| Rate for Payer: Cigna of CA PPO |
$5,632.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,469.35
|
| Rate for Payer: Dignity Health Media |
$6,469.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,469.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,044.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,044.40
|
| Rate for Payer: Galaxy Health WC |
$6,469.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,566.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,708.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,076.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$427.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,826.64
|
| Rate for Payer: Multiplan Commercial |
$6,088.80
|
| Rate for Payer: Networks By Design Commercial |
$4,947.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,469.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,566.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,566.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,469.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,469.35
|
| Rate for Payer: Vantage Medical Group Senior |
$6,469.35
|
|
|
HC IVPW INIT VES PRESSUREWIRE SEN
|
Facility
|
IP
|
$13,117.00
|
|
|
Service Code
|
CPT 93571
|
| Hospital Charge Code |
906812133
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,148.08 |
| Max. Negotiated Rate |
$11,149.45 |
| Rate for Payer: Cash Price |
$5,902.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,246.80
|
| Rate for Payer: Galaxy Health WC |
$11,149.45
|
| Rate for Payer: Global Benefits Group Commercial |
$7,870.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,749.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,997.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,148.08
|
| Rate for Payer: Multiplan Commercial |
$10,493.60
|
| Rate for Payer: Networks By Design Commercial |
$8,526.05
|
| Rate for Payer: Prime Health Services Commercial |
$11,149.45
|
|
|
HC IVPW INIT VES PRESSUREWIRE SEN
|
Facility
|
OP
|
$13,117.00
|
|
|
Service Code
|
CPT 93571
|
| Hospital Charge Code |
906812133
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$461.34 |
| Max. Negotiated Rate |
$11,149.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,188.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,149.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,214.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,214.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,815.11
|
| Rate for Payer: Blue Distinction Transplant |
$7,870.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$5,902.65
|
| Rate for Payer: Cash Price |
$5,902.65
|
| Rate for Payer: Cash Price |
$5,902.65
|
| Rate for Payer: Cigna of CA PPO |
$9,706.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,149.45
|
| Rate for Payer: Dignity Health Media |
$11,149.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,149.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,246.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,246.80
|
| Rate for Payer: Galaxy Health WC |
$11,149.45
|
| Rate for Payer: Global Benefits Group Commercial |
$7,870.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,837.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,749.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$461.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,148.08
|
| Rate for Payer: Multiplan Commercial |
$10,493.60
|
| Rate for Payer: Networks By Design Commercial |
$8,526.05
|
| Rate for Payer: Prime Health Services Commercial |
$11,149.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,870.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,870.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,149.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,149.45
|
| Rate for Payer: Vantage Medical Group Senior |
$11,149.45
|
|
|
HC IVU EXCRETORY
|
Facility
|
IP
|
$1,463.00
|
|
|
Service Code
|
CPT 74400
|
| Hospital Charge Code |
909001910
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$351.12 |
| Max. Negotiated Rate |
$1,243.55 |
| Rate for Payer: Cash Price |
$658.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$585.20
|
| Rate for Payer: Galaxy Health WC |
$1,243.55
|
| Rate for Payer: Global Benefits Group Commercial |
$877.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$975.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$557.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$351.12
|
| Rate for Payer: Multiplan Commercial |
$1,170.40
|
| Rate for Payer: Networks By Design Commercial |
$950.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,243.55
|
|
|
HC IVU EXCRETORY
|
Facility
|
OP
|
$1,463.00
|
|
|
Service Code
|
CPT 74400
|
| Hospital Charge Code |
909001910
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$124.91 |
| Max. Negotiated Rate |
$1,243.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$559.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$229.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$439.12
|
| Rate for Payer: Blue Distinction Transplant |
$877.80
|
| Rate for Payer: Blue Shield of California Commercial |
$864.63
|
| Rate for Payer: Blue Shield of California EPN |
$686.15
|
| Rate for Payer: Cash Price |
$658.35
|
| Rate for Payer: Cash Price |
$658.35
|
| Rate for Payer: Cigna of CA HMO |
$936.32
|
| Rate for Payer: Cigna of CA PPO |
$1,082.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.34
|
| Rate for Payer: Dignity Health Media |
$229.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$252.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$229.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$229.56
|
| Rate for Payer: Galaxy Health WC |
$1,243.55
|
| Rate for Payer: Global Benefits Group Commercial |
$877.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,097.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$376.48
|
| Rate for Payer: Heritage Provider Network Transplant |
$376.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$371.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$371.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$229.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$975.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$229.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$351.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$289.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$307.61
|
| Rate for Payer: Multiplan Commercial |
$1,170.40
|
| Rate for Payer: Networks By Design Commercial |
$950.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,243.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$877.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$877.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$470.69
|
| Rate for Payer: United Healthcare All Other HMO |
$470.69
|
| Rate for Payer: United Healthcare HMO Rider |
$470.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$470.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Vantage Medical Group Senior |
$229.56
|
|
|
HC IVU HYPERTENSIVE
|
Facility
|
IP
|
$934.00
|
|
|
Service Code
|
CPT 74415
|
| Hospital Charge Code |
909001911
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$224.16 |
| Max. Negotiated Rate |
$793.90 |
| Rate for Payer: Cash Price |
$420.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$373.60
|
| Rate for Payer: Galaxy Health WC |
$793.90
|
| Rate for Payer: Global Benefits Group Commercial |
$560.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$622.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$355.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$224.16
|
| Rate for Payer: Multiplan Commercial |
$747.20
|
| Rate for Payer: Networks By Design Commercial |
$607.10
|
| Rate for Payer: Prime Health Services Commercial |
$793.90
|
|
|
HC IVU HYPERTENSIVE
|
Facility
|
OP
|
$934.00
|
|
|
Service Code
|
CPT 74415
|
| Hospital Charge Code |
909001911
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$188.71 |
| Max. Negotiated Rate |
$793.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$715.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$229.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$550.05
|
| Rate for Payer: Blue Distinction Transplant |
$560.40
|
| Rate for Payer: Blue Shield of California Commercial |
$551.99
|
| Rate for Payer: Blue Shield of California EPN |
$438.05
|
| Rate for Payer: Cash Price |
$420.30
|
| Rate for Payer: Cash Price |
$420.30
|
| Rate for Payer: Cigna of CA HMO |
$597.76
|
| Rate for Payer: Cigna of CA PPO |
$691.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$344.34
|
| Rate for Payer: Dignity Health Media |
$229.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$252.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$229.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$229.56
|
| Rate for Payer: Galaxy Health WC |
$793.90
|
| Rate for Payer: Global Benefits Group Commercial |
$560.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$700.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$376.48
|
| Rate for Payer: Heritage Provider Network Transplant |
$376.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$371.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$371.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$229.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$622.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$188.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$229.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$224.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$289.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$307.61
|
| Rate for Payer: Multiplan Commercial |
$747.20
|
| Rate for Payer: Networks By Design Commercial |
$607.10
|
| Rate for Payer: Prime Health Services Commercial |
$793.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$560.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$560.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$470.69
|
| Rate for Payer: United Healthcare All Other HMO |
$470.69
|
| Rate for Payer: United Healthcare HMO Rider |
$470.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$470.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$344.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$252.52
|
| Rate for Payer: Vantage Medical Group Senior |
$229.56
|
|
|
HC IVUS ADD'L VESSEL
|
Facility
|
IP
|
$8,413.00
|
|
|
Service Code
|
CPT 92979
|
| Hospital Charge Code |
906811210
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,019.12 |
| Max. Negotiated Rate |
$7,151.05 |
| Rate for Payer: Cash Price |
$3,785.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,365.20
|
| Rate for Payer: Galaxy Health WC |
$7,151.05
|
| Rate for Payer: Global Benefits Group Commercial |
$5,047.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,611.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,205.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,019.12
|
| Rate for Payer: Multiplan Commercial |
$6,730.40
|
| Rate for Payer: Networks By Design Commercial |
$5,468.45
|
| Rate for Payer: Prime Health Services Commercial |
$7,151.05
|
|
|
HC IVUS ADD'L VESSEL
|
Facility
|
OP
|
$8,413.00
|
|
|
Service Code
|
CPT 92979
|
| Hospital Charge Code |
906811210
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$261.80 |
| Max. Negotiated Rate |
$7,151.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$605.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,151.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,627.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,627.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,047.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$3,785.85
|
| Rate for Payer: Cash Price |
$3,785.85
|
| Rate for Payer: Cash Price |
$3,785.85
|
| Rate for Payer: Cigna of CA PPO |
$6,225.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,151.05
|
| Rate for Payer: Dignity Health Media |
$7,151.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,151.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,365.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,365.20
|
| Rate for Payer: Galaxy Health WC |
$7,151.05
|
| Rate for Payer: Global Benefits Group Commercial |
$5,047.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,309.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,611.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$261.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,019.12
|
| Rate for Payer: Multiplan Commercial |
$6,730.40
|
| Rate for Payer: Networks By Design Commercial |
$5,468.45
|
| Rate for Payer: Prime Health Services Commercial |
$7,151.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,047.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,047.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,151.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,151.05
|
| Rate for Payer: Vantage Medical Group Senior |
$7,151.05
|
|
|
HC IVUS INITIAL VESSEL
|
Facility
|
IP
|
$11,826.00
|
|
|
Service Code
|
CPT 92978
|
| Hospital Charge Code |
906811200
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,838.24 |
| Max. Negotiated Rate |
$10,052.10 |
| Rate for Payer: Cash Price |
$5,321.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,730.40
|
| Rate for Payer: Galaxy Health WC |
$10,052.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,095.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,887.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,505.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,838.24
|
| Rate for Payer: Multiplan Commercial |
$9,460.80
|
| Rate for Payer: Networks By Design Commercial |
$7,686.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,052.10
|
|
|
HC IVUS INITIAL VESSEL
|
Facility
|
OP
|
$11,826.00
|
|
|
Service Code
|
CPT 92978
|
| Hospital Charge Code |
906811200
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$427.86 |
| Max. Negotiated Rate |
$10,052.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,197.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,052.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,504.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,504.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,095.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$5,321.70
|
| Rate for Payer: Cash Price |
$5,321.70
|
| Rate for Payer: Cash Price |
$5,321.70
|
| Rate for Payer: Cigna of CA PPO |
$8,751.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,052.10
|
| Rate for Payer: Dignity Health Media |
$10,052.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,052.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,730.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,730.40
|
| Rate for Payer: Galaxy Health WC |
$10,052.10
|
| Rate for Payer: Global Benefits Group Commercial |
$7,095.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,869.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,887.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$427.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,838.24
|
| Rate for Payer: Multiplan Commercial |
$9,460.80
|
| Rate for Payer: Networks By Design Commercial |
$7,686.90
|
| Rate for Payer: Prime Health Services Commercial |
$10,052.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,095.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,095.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,052.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,052.10
|
| Rate for Payer: Vantage Medical Group Senior |
$10,052.10
|
|
|
HC JEJUNOSTOMY PERC
|
Facility
|
OP
|
$1,249.00
|
|
|
Service Code
|
CPT 74355
|
| Hospital Charge Code |
909001868
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$195.81 |
| Max. Negotiated Rate |
$1,061.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$662.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,061.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$686.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$686.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$684.14
|
| Rate for Payer: Blue Distinction Transplant |
$749.40
|
| Rate for Payer: Blue Shield of California Commercial |
$738.16
|
| Rate for Payer: Blue Shield of California EPN |
$585.78
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Cash Price |
$562.05
|
| Rate for Payer: Cigna of CA HMO |
$799.36
|
| Rate for Payer: Cigna of CA PPO |
$924.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,061.65
|
| Rate for Payer: Dignity Health Media |
$1,061.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,061.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$499.60
|
| Rate for Payer: Galaxy Health WC |
$1,061.65
|
| Rate for Payer: Global Benefits Group Commercial |
$749.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$936.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$833.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$195.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$299.76
|
| Rate for Payer: Multiplan Commercial |
$999.20
|
| Rate for Payer: Networks By Design Commercial |
$811.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,061.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$749.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$749.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$624.50
|
| Rate for Payer: United Healthcare All Other HMO |
$624.50
|
| Rate for Payer: United Healthcare HMO Rider |
$624.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$624.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,061.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,061.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,061.65
|
|
