|
HC CORO CATH, CORO ANGIO
|
Facility
|
IP
|
$16,451.00
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
906820059
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,290.20 |
| Max. Negotiated Rate |
$13,983.35 |
| Rate for Payer: Adventist Health Commercial |
$3,290.20
|
| Rate for Payer: Cash Price |
$7,402.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,580.40
|
| Rate for Payer: EPIC Health Plan Senior |
$6,580.40
|
| Rate for Payer: Galaxy Health WC |
$13,983.35
|
| Rate for Payer: Global Benefits Group Commercial |
$9,870.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,972.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,267.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,183.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,948.24
|
| Rate for Payer: Multiplan Commercial |
$13,160.80
|
| Rate for Payer: Networks By Design Commercial |
$10,693.15
|
| Rate for Payer: Prime Health Services Commercial |
$13,983.35
|
|
|
HC CORO CATH, CORO ANGIO
|
Facility
|
IP
|
$16,927.00
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
906811401
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,385.40 |
| Max. Negotiated Rate |
$14,387.95 |
| Rate for Payer: Adventist Health Commercial |
$3,385.40
|
| Rate for Payer: Cash Price |
$7,617.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,770.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6,770.80
|
| Rate for Payer: Galaxy Health WC |
$14,387.95
|
| Rate for Payer: Global Benefits Group Commercial |
$10,156.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,290.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,449.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,477.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,062.48
|
| Rate for Payer: Multiplan Commercial |
$13,541.60
|
| Rate for Payer: Networks By Design Commercial |
$11,002.55
|
| Rate for Payer: Prime Health Services Commercial |
$14,387.95
|
|
|
HC CORO CATH, CORO ANGIO
|
Facility
|
OP
|
$16,927.00
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
906811401
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,323.25 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$3,385.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$5,510.17
|
| Rate for Payer: Cash Price |
$7,617.15
|
| Rate for Payer: Cash Price |
$7,617.15
|
| Rate for Payer: Cash Price |
$7,617.15
|
| Rate for Payer: Cigna of CA HMO |
$11,002.55
|
| Rate for Payer: Cigna of CA PPO |
$12,525.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$14,387.95
|
| Rate for Payer: Global Benefits Group Commercial |
$10,156.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,323.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,290.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,496.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,062.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,149.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$13,541.60
|
| Rate for Payer: Networks By Design Commercial |
$11,002.55
|
| Rate for Payer: Prime Health Services Commercial |
$14,387.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,156.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC CORO CATH, CORO ANGIO
|
Facility
|
OP
|
$16,451.00
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
906820059
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,323.25 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$3,290.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$5,510.17
|
| Rate for Payer: Cash Price |
$7,402.95
|
| Rate for Payer: Cash Price |
$7,402.95
|
| Rate for Payer: Cash Price |
$7,402.95
|
| Rate for Payer: Cigna of CA HMO |
$10,693.15
|
| Rate for Payer: Cigna of CA PPO |
$12,173.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$13,983.35
|
| Rate for Payer: Global Benefits Group Commercial |
$9,870.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,323.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,972.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,496.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,948.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,149.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$13,160.80
|
| Rate for Payer: Networks By Design Commercial |
$10,693.15
|
| Rate for Payer: Prime Health Services Commercial |
$13,983.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,870.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC CORO CATH, CORO ANGIO,GRAFT,IM
|
Facility
|
OP
|
$14,487.00
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
906811402
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,544.74 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$2,897.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$5,510.17
|
| Rate for Payer: Cash Price |
$6,519.15
|
| Rate for Payer: Cash Price |
$6,519.15
|
| Rate for Payer: Cash Price |
$6,519.15
|
| Rate for Payer: Cigna of CA HMO |
$9,416.55
|
| Rate for Payer: Cigna of CA PPO |
$10,720.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$12,313.95
|
| Rate for Payer: Global Benefits Group Commercial |
$8,692.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,544.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,662.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,747.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,476.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,149.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$11,589.60
|
| Rate for Payer: Networks By Design Commercial |
$9,416.55
|
| Rate for Payer: Prime Health Services Commercial |
$12,313.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,692.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC CORO CATH, CORO ANGIO,GRAFT,IM
|
Facility
|
OP
|
$14,079.00
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
906820060
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,544.74 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$2,815.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$5,510.17
|
| Rate for Payer: Cash Price |
$6,335.55
|
| Rate for Payer: Cash Price |
$6,335.55
|
| Rate for Payer: Cash Price |
$6,335.55
|
| Rate for Payer: Cigna of CA HMO |
$9,151.35
|
| Rate for Payer: Cigna of CA PPO |
$10,418.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$11,967.15
|
| Rate for Payer: Global Benefits Group Commercial |
$8,447.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,544.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,390.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,747.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,378.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,149.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$11,263.20
|
| Rate for Payer: Networks By Design Commercial |
$9,151.35
|
| Rate for Payer: Prime Health Services Commercial |
$11,967.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,447.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC CORO CATH, CORO ANGIO,GRAFT,IM
|
Facility
|
IP
|
$14,079.00
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
906820060
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,815.80 |
| Max. Negotiated Rate |
$11,967.15 |
| Rate for Payer: Adventist Health Commercial |
$2,815.80
|
| Rate for Payer: Cash Price |
$6,335.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,631.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5,631.60
|
| Rate for Payer: Galaxy Health WC |
$11,967.15
|
| Rate for Payer: Global Benefits Group Commercial |
$8,447.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,390.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,364.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,714.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,378.96
|
| Rate for Payer: Multiplan Commercial |
$11,263.20
|
| Rate for Payer: Networks By Design Commercial |
$9,151.35
|
| Rate for Payer: Prime Health Services Commercial |
$11,967.15
|
|
|
HC CORO CATH, CORO ANGIO,GRAFT,IM
|
Facility
|
IP
|
$14,487.00
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
906811402
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,897.40 |
| Max. Negotiated Rate |
$12,313.95 |
| Rate for Payer: Adventist Health Commercial |
$2,897.40
|
| Rate for Payer: Cash Price |
$6,519.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,794.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,794.80
|
| Rate for Payer: Galaxy Health WC |
$12,313.95
|
| Rate for Payer: Global Benefits Group Commercial |
$8,692.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,662.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,519.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,967.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,476.88
|
| Rate for Payer: Multiplan Commercial |
$11,589.60
|
| Rate for Payer: Networks By Design Commercial |
$9,416.55
|
| Rate for Payer: Prime Health Services Commercial |
$12,313.95
|
|
|
HC CORONARY CTA W/MORPH W/O CCS
|
Facility
|
IP
|
$4,804.00
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
909201402
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$960.80 |
| Max. Negotiated Rate |
$4,083.40 |
| Rate for Payer: Adventist Health Commercial |
$960.80
|
| Rate for Payer: Cash Price |
$2,161.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,921.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,921.60
|
| Rate for Payer: Galaxy Health WC |
$4,083.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,882.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,204.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,830.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,973.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,152.96
|
| Rate for Payer: Multiplan Commercial |
$3,843.20
|
| Rate for Payer: Networks By Design Commercial |
$3,122.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,083.40
|
|
|
HC CORONARY CTA W/MORPH W/O CCS
|
Facility
|
OP
|
$3,218.00
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
909201402
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$453.77 |
| Max. Negotiated Rate |
$2,754.00 |
| Rate for Payer: Adventist Health Commercial |
$643.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,754.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$453.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,976.17
|
| Rate for Payer: Blue Shield of California Commercial |
$1,969.42
|
| Rate for Payer: Blue Shield of California EPN |
$1,300.07
|
| Rate for Payer: Cash Price |
$1,448.10
|
| Rate for Payer: Cash Price |
$1,448.10
|
| Rate for Payer: Cash Price |
$1,448.10
|
| Rate for Payer: Cigna of CA HMO |
$2,059.52
|
| Rate for Payer: Cigna of CA PPO |
$2,381.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$680.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$499.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$453.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$612.59
|
| Rate for Payer: EPIC Health Plan Senior |
$453.77
|
| Rate for Payer: Galaxy Health WC |
$2,735.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,930.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$744.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$524.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$453.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,146.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$593.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$453.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$772.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$571.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.05
|
| Rate for Payer: Multiplan Commercial |
$2,574.40
|
| Rate for Payer: Networks By Design Commercial |
$2,091.70
|
| Rate for Payer: Prime Health Services Commercial |
$2,735.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,930.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,930.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$669.92
|
| Rate for Payer: United Healthcare All Other HMO |
$669.92
|
| Rate for Payer: United Healthcare HMO Rider |
$669.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.92
|
| Rate for Payer: Upland Medical Group Pediatric |
$453.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$680.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$499.15
|
| Rate for Payer: Vantage Medical Group Senior |
$453.77
|
|
|
HC CORONARY STENT ADD'L VESSEL
|
Facility
|
OP
|
$9,397.00
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
906820240
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,879.40 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$1,879.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,987.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,168.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,047.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$4,228.65
|
| Rate for Payer: Cash Price |
$4,228.65
|
| Rate for Payer: Cigna of CA HMO |
$6,108.05
|
| Rate for Payer: Cigna of CA PPO |
$6,953.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,987.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,987.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,987.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,758.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,758.80
|
| Rate for Payer: Galaxy Health WC |
$7,987.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,638.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,267.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,816.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,255.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,577.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,577.90
|
| Rate for Payer: Multiplan Commercial |
$7,517.60
|
| Rate for Payer: Networks By Design Commercial |
$6,108.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,987.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,638.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,638.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,987.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,987.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,987.45
|
|
|
HC CORONARY STENT ADD'L VESSEL
|
Facility
|
IP
|
$9,669.00
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
906811437
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,933.80 |
| Max. Negotiated Rate |
$8,218.65 |
| Rate for Payer: Adventist Health Commercial |
$1,933.80
|
| Rate for Payer: Cash Price |
$4,351.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,867.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,867.60
|
| Rate for Payer: Galaxy Health WC |
$8,218.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,801.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,449.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,683.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,985.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,320.56
|
| Rate for Payer: Multiplan Commercial |
$7,735.20
|
| Rate for Payer: Networks By Design Commercial |
$6,284.85
|
| Rate for Payer: Prime Health Services Commercial |
$8,218.65
|
|
|
HC CORONARY STENT ADD'L VESSEL
|
Facility
|
OP
|
$9,669.00
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
906811437
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,933.80 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$1,933.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,218.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,317.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,251.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$4,351.05
|
| Rate for Payer: Cash Price |
$4,351.05
|
| Rate for Payer: Cigna of CA HMO |
$6,284.85
|
| Rate for Payer: Cigna of CA PPO |
$7,155.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,218.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,218.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,218.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,867.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,867.60
|
| Rate for Payer: Galaxy Health WC |
$8,218.65
|
| Rate for Payer: Global Benefits Group Commercial |
$5,801.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,449.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,985.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,320.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,768.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,768.30
|
| Rate for Payer: Multiplan Commercial |
$7,735.20
|
| Rate for Payer: Networks By Design Commercial |
$6,284.85
|
| Rate for Payer: Prime Health Services Commercial |
$8,218.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,801.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,801.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,218.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,218.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8,218.65
|
|
|
HC CORONARY STENT ADD'L VESSEL
|
Facility
|
IP
|
$9,397.00
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
906820240
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,879.40 |
| Max. Negotiated Rate |
$7,987.45 |
| Rate for Payer: Adventist Health Commercial |
$1,879.40
|
| Rate for Payer: Cash Price |
$4,228.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,758.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,758.80
|
| Rate for Payer: Galaxy Health WC |
$7,987.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,638.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,267.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,580.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,816.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,255.28
|
| Rate for Payer: Multiplan Commercial |
$7,517.60
|
| Rate for Payer: Networks By Design Commercial |
$6,108.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,987.45
|
|
|
HC CORONARY STENT ADD VESSEL
|
Facility
|
IP
|
$18,835.00
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
906811460
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$3,767.00 |
| Max. Negotiated Rate |
$16,009.75 |
| Rate for Payer: Adventist Health Commercial |
$3,767.00
|
| Rate for Payer: Cash Price |
$8,475.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,534.00
|
| Rate for Payer: EPIC Health Plan Senior |
$7,534.00
|
| Rate for Payer: Galaxy Health WC |
$16,009.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11,301.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,562.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,176.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,658.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,520.40
|
| Rate for Payer: Multiplan Commercial |
$15,068.00
|
| Rate for Payer: Networks By Design Commercial |
$12,242.75
|
| Rate for Payer: Prime Health Services Commercial |
$16,009.75
|
|
|
HC CORONARY STENT ADD VESSEL
|
Facility
|
IP
|
$26,699.00
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
906820258
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5,339.80 |
| Max. Negotiated Rate |
$22,694.15 |
| Rate for Payer: Adventist Health Commercial |
$5,339.80
|
| Rate for Payer: Cash Price |
$12,014.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,679.60
|
| Rate for Payer: EPIC Health Plan Senior |
$10,679.60
|
| Rate for Payer: Galaxy Health WC |
$22,694.15
|
| Rate for Payer: Global Benefits Group Commercial |
$16,019.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,808.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,172.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,526.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,407.76
|
| Rate for Payer: Multiplan Commercial |
$21,359.20
|
| Rate for Payer: Networks By Design Commercial |
$17,354.35
|
| Rate for Payer: Prime Health Services Commercial |
$22,694.15
|
|
|
HC CORONARY STENT ADD VESSEL
|
Facility
|
OP
|
$26,699.00
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
906820258
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$22,694.15 |
| Rate for Payer: Adventist Health Commercial |
$5,339.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,694.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,684.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,024.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$12,014.55
|
| Rate for Payer: Cash Price |
$12,014.55
|
| Rate for Payer: Cigna of CA HMO |
$17,087.36
|
| Rate for Payer: Cigna of CA PPO |
$19,757.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,694.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,694.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,694.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,679.60
|
| Rate for Payer: EPIC Health Plan Senior |
$10,679.60
|
| Rate for Payer: Galaxy Health WC |
$22,694.15
|
| Rate for Payer: Global Benefits Group Commercial |
$16,019.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,808.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,172.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,526.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,407.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,689.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,689.30
|
| Rate for Payer: Multiplan Commercial |
$21,359.20
|
| Rate for Payer: Networks By Design Commercial |
$17,354.35
|
| Rate for Payer: Prime Health Services Commercial |
$22,694.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,019.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,019.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,694.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22,694.15
|
| Rate for Payer: Vantage Medical Group Senior |
$22,694.15
|
|
|
HC CORONARY STENT ADD VESSEL
|
Facility
|
OP
|
$18,835.00
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
906811460
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$16,009.75 |
| Rate for Payer: Adventist Health Commercial |
$3,767.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16,009.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,359.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,126.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$8,475.75
|
| Rate for Payer: Cash Price |
$8,475.75
|
| Rate for Payer: Cigna of CA HMO |
$12,054.40
|
| Rate for Payer: Cigna of CA PPO |
$13,937.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16,009.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,009.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16,009.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,534.00
|
| Rate for Payer: EPIC Health Plan Senior |
$7,534.00
|
| Rate for Payer: Galaxy Health WC |
$16,009.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11,301.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,562.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,176.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,658.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,520.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,184.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,184.50
|
| Rate for Payer: Multiplan Commercial |
$15,068.00
|
| Rate for Payer: Networks By Design Commercial |
$12,242.75
|
| Rate for Payer: Prime Health Services Commercial |
$16,009.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,301.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,301.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16,009.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,009.75
|
| Rate for Payer: Vantage Medical Group Senior |
$16,009.75
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
IP
|
$43,910.00
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
906820257
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$8,782.00 |
| Max. Negotiated Rate |
$37,323.50 |
| Rate for Payer: Adventist Health Commercial |
$8,782.00
|
| Rate for Payer: Cash Price |
$19,759.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,564.00
|
| Rate for Payer: EPIC Health Plan Senior |
$17,564.00
|
| Rate for Payer: Galaxy Health WC |
$37,323.50
|
| Rate for Payer: Global Benefits Group Commercial |
$26,346.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29,287.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,729.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,180.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,538.40
|
| Rate for Payer: Multiplan Commercial |
$35,128.00
|
| Rate for Payer: Networks By Design Commercial |
$28,541.50
|
| Rate for Payer: Prime Health Services Commercial |
$37,323.50
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
OP
|
$43,910.00
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
906820257
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$37,323.50 |
| Rate for Payer: Adventist Health Commercial |
$8,782.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$19,759.50
|
| Rate for Payer: Cash Price |
$19,759.50
|
| Rate for Payer: Cash Price |
$19,759.50
|
| Rate for Payer: Cigna of CA HMO |
$28,102.40
|
| Rate for Payer: Cigna of CA PPO |
$32,493.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$37,323.50
|
| Rate for Payer: Global Benefits Group Commercial |
$26,346.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29,287.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,729.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,538.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$35,128.00
|
| Rate for Payer: Networks By Design Commercial |
$28,541.50
|
| Rate for Payer: Prime Health Services Commercial |
$37,323.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26,346.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26,346.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
OP
|
$45,181.00
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
906811459
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$38,403.85 |
| Rate for Payer: Adventist Health Commercial |
$9,036.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$20,331.45
|
| Rate for Payer: Cash Price |
$20,331.45
|
| Rate for Payer: Cash Price |
$20,331.45
|
| Rate for Payer: Cigna of CA HMO |
$28,915.84
|
| Rate for Payer: Cigna of CA PPO |
$33,433.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$38,403.85
|
| Rate for Payer: Global Benefits Group Commercial |
$27,108.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30,135.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,213.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,843.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$36,144.80
|
| Rate for Payer: Networks By Design Commercial |
$29,367.65
|
| Rate for Payer: Prime Health Services Commercial |
$38,403.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27,108.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27,108.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
OP
|
$24,171.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
906811436
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$811.52 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$4,834.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$10,876.95
|
| Rate for Payer: Cash Price |
$10,876.95
|
| Rate for Payer: Cash Price |
$10,876.95
|
| Rate for Payer: Cigna of CA HMO |
$15,711.15
|
| Rate for Payer: Cigna of CA PPO |
$17,886.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$20,545.35
|
| Rate for Payer: Global Benefits Group Commercial |
$14,502.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$811.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,122.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$917.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,801.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$19,336.80
|
| Rate for Payer: Networks By Design Commercial |
$15,711.15
|
| Rate for Payer: Prime Health Services Commercial |
$20,545.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,502.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14,502.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
IP
|
$24,171.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
906811436
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,834.20 |
| Max. Negotiated Rate |
$20,545.35 |
| Rate for Payer: Adventist Health Commercial |
$4,834.20
|
| Rate for Payer: Cash Price |
$10,876.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,668.40
|
| Rate for Payer: EPIC Health Plan Senior |
$9,668.40
|
| Rate for Payer: Galaxy Health WC |
$20,545.35
|
| Rate for Payer: Global Benefits Group Commercial |
$14,502.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,122.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,209.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,961.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,801.04
|
| Rate for Payer: Multiplan Commercial |
$19,336.80
|
| Rate for Payer: Networks By Design Commercial |
$15,711.15
|
| Rate for Payer: Prime Health Services Commercial |
$20,545.35
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
OP
|
$23,492.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
906820239
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$811.52 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$4,698.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$10,571.40
|
| Rate for Payer: Cash Price |
$10,571.40
|
| Rate for Payer: Cash Price |
$10,571.40
|
| Rate for Payer: Cigna of CA HMO |
$15,269.80
|
| Rate for Payer: Cigna of CA PPO |
$17,384.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$19,968.20
|
| Rate for Payer: Global Benefits Group Commercial |
$14,095.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$811.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,669.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$917.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,638.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$18,793.60
|
| Rate for Payer: Networks By Design Commercial |
$15,269.80
|
| Rate for Payer: Prime Health Services Commercial |
$19,968.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,095.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14,095.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
IP
|
$23,492.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
906820239
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,698.40 |
| Max. Negotiated Rate |
$19,968.20 |
| Rate for Payer: Adventist Health Commercial |
$4,698.40
|
| Rate for Payer: Cash Price |
$10,571.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,396.80
|
| Rate for Payer: EPIC Health Plan Senior |
$9,396.80
|
| Rate for Payer: Galaxy Health WC |
$19,968.20
|
| Rate for Payer: Global Benefits Group Commercial |
$14,095.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,669.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,950.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,541.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,638.08
|
| Rate for Payer: Multiplan Commercial |
$18,793.60
|
| Rate for Payer: Networks By Design Commercial |
$15,269.80
|
| Rate for Payer: Prime Health Services Commercial |
$19,968.20
|
|
