|
HC REPLC COMP NON/TUN CNTRL INSRT
|
Facility
|
IP
|
$4,296.00
|
|
|
Service Code
|
CPT 36580
|
| Hospital Charge Code |
909080018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,031.04 |
| Max. Negotiated Rate |
$3,651.60 |
| Rate for Payer: Cash Price |
$1,933.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,718.40
|
| Rate for Payer: Galaxy Health WC |
$3,651.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,577.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,865.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,636.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,031.04
|
| Rate for Payer: Multiplan Commercial |
$3,436.80
|
| Rate for Payer: Networks By Design Commercial |
$2,792.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,651.60
|
|
|
HC REPLC COMP NON/TUN CNTRL INSRT
|
Facility
|
IP
|
$4,296.00
|
|
|
Service Code
|
CPT 36580
|
| Hospital Charge Code |
909080018
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,031.04 |
| Max. Negotiated Rate |
$3,651.60 |
| Rate for Payer: Cash Price |
$1,933.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,718.40
|
| Rate for Payer: Galaxy Health WC |
$3,651.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,577.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,865.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,636.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,031.04
|
| Rate for Payer: Multiplan Commercial |
$3,436.80
|
| Rate for Payer: Networks By Design Commercial |
$2,792.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,651.60
|
|
|
HC REPLCMNT GJ TUBE WO FLUORO
|
Facility
|
IP
|
$3,452.00
|
|
|
Service Code
|
CPT 43999
|
| Hospital Charge Code |
906743990
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$828.48 |
| Max. Negotiated Rate |
$2,934.20 |
| Rate for Payer: Cash Price |
$1,553.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,380.80
|
| Rate for Payer: Galaxy Health WC |
$2,934.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,071.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,302.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,315.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$828.48
|
| Rate for Payer: Multiplan Commercial |
$2,761.60
|
| Rate for Payer: Networks By Design Commercial |
$2,243.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,934.20
|
|
|
HC REPLCMNT GJ TUBE WO FLUORO
|
Facility
|
OP
|
$3,452.00
|
|
|
Service Code
|
CPT 43999
|
| Hospital Charge Code |
906743990
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$828.48 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,056.70
|
| Rate for Payer: Blue Distinction Transplant |
$2,071.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$1,553.40
|
| Rate for Payer: Cash Price |
$1,553.40
|
| Rate for Payer: Cigna of CA PPO |
$2,554.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$2,934.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,071.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,589.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,857.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,834.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,302.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$828.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,427.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$2,761.60
|
| Rate for Payer: Networks By Design Commercial |
$2,243.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,934.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,071.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,359.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC REPLC PERIPH INSRT CV CATH W/O
|
Facility
|
OP
|
$7,045.00
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
909080020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$120.27 |
| Max. Negotiated Rate |
$5,988.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,227.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$3,170.25
|
| Rate for Payer: Cash Price |
$3,170.25
|
| Rate for Payer: Cigna of CA PPO |
$5,213.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$5,988.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,227.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,283.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,281.66
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,241.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$3,241.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,001.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,699.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,690.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,521.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$5,636.00
|
| Rate for Payer: Networks By Design Commercial |
$4,579.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,988.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,227.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC REPLC PERIPH INSRT CV CATH W/O
|
Facility
|
OP
|
$7,045.00
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
901200086
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$120.27 |
| Max. Negotiated Rate |
$5,988.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,227.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$3,170.25
|
| Rate for Payer: Cash Price |
$3,170.25
|
| Rate for Payer: Cigna of CA PPO |
$5,213.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$5,988.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,227.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,283.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,281.66
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,241.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$3,241.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,001.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,699.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,690.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,521.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$5,636.00
|
| Rate for Payer: Networks By Design Commercial |
$4,579.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,988.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,227.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC REPLC PERIPH INSRT CV CATH W/O
|
Facility
|
OP
|
$7,045.00
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
909080020
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$120.27 |
| Max. Negotiated Rate |
$5,988.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,227.00
|
| Rate for Payer: Cash Price |
$3,170.25
|
| Rate for Payer: Cash Price |
$3,170.25
|
| Rate for Payer: Cash Price |
$3,170.25
|
| Rate for Payer: Cigna of CA PPO |
$5,213.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$5,988.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,227.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,283.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,281.66
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,001.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,699.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,690.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,521.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$5,636.00
|
| Rate for Payer: Networks By Design Commercial |
$4,579.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,988.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,227.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,522.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,522.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,522.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,522.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC REPLC PERIPH INSRT CV CATH W/O
|
Facility
|
IP
|
$7,045.00
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
909080020
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,690.80 |
| Max. Negotiated Rate |
$5,988.25 |
| Rate for Payer: Cash Price |
$3,170.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,818.00
|
| Rate for Payer: Galaxy Health WC |
$5,988.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,227.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,699.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,684.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,690.80
|
| Rate for Payer: Multiplan Commercial |
$5,636.00
|
| Rate for Payer: Networks By Design Commercial |
$4,579.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,988.25
|
|
|
HC REPLC PERIPH INSRT CV CATH W/O
|
Facility
|
IP
|
$7,045.00
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
901200086
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,690.80 |
| Max. Negotiated Rate |
$5,988.25 |
| Rate for Payer: Cash Price |
$3,170.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,818.00
|
| Rate for Payer: Galaxy Health WC |
$5,988.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,227.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,699.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,684.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,690.80
|
| Rate for Payer: Multiplan Commercial |
$5,636.00
|
| Rate for Payer: Networks By Design Commercial |
$4,579.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,988.25
|
|
|
HC REPLC PERIPH INSRT CV CATH W/O
|
Facility
|
IP
|
$7,045.00
|
|
|
Service Code
|
CPT 36584
|
| Hospital Charge Code |
909080020
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,690.80 |
| Max. Negotiated Rate |
$5,988.25 |
| Rate for Payer: Cash Price |
$3,170.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,818.00
|
| Rate for Payer: Galaxy Health WC |
$5,988.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,227.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,699.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,684.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,690.80
|
| Rate for Payer: Multiplan Commercial |
$5,636.00
|
| Rate for Payer: Networks By Design Commercial |
$4,579.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,988.25
|
|
|
HC REPLC TUN CNTRL INSRT CATH W/O
|
Facility
|
OP
|
$10,626.00
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
909080019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$332.37 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,375.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$4,781.70
|
| Rate for Payer: Cash Price |
$4,781.70
|
| Rate for Payer: Cigna of CA PPO |
$7,863.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$9,032.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,375.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,969.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,531.38
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6,451.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$6,451.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,087.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,550.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$8,500.80
|
| Rate for Payer: Networks By Design Commercial |
$6,906.90
|
| Rate for Payer: Prime Health Services Commercial |
$9,032.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,375.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC REPLC TUN CNTRL INSRT CATH W/O
|
Facility
|
IP
|
$10,626.00
|
|
|
Service Code
|
CPT 36581
|
| Hospital Charge Code |
909080019
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,550.24 |
| Max. Negotiated Rate |
$9,032.10 |
| Rate for Payer: Cash Price |
$4,781.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,250.40
|
| Rate for Payer: Galaxy Health WC |
$9,032.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,375.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,087.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,048.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,550.24
|
| Rate for Payer: Multiplan Commercial |
$8,500.80
|
| Rate for Payer: Networks By Design Commercial |
$6,906.90
|
| Rate for Payer: Prime Health Services Commercial |
$9,032.10
|
|
|
HC REP LEG TENDON PRIMARY EA
|
Facility
|
OP
|
$10,237.00
|
|
|
Service Code
|
CPT 27664
|
| Hospital Charge Code |
900501603
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$462.61 |
| Max. Negotiated Rate |
$14,659.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,142.20
|
| Rate for Payer: Cash Price |
$4,606.65
|
| Rate for Payer: Cash Price |
$4,606.65
|
| Rate for Payer: Cash Price |
$4,606.65
|
| Rate for Payer: Cigna of CA PPO |
$7,575.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Dignity Health Media |
$8,938.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,832.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,067.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,938.53
|
| Rate for Payer: Galaxy Health WC |
$8,701.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,142.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,677.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,659.19
|
| Rate for Payer: Heritage Provider Network Transplant |
$14,659.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,938.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,828.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$462.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,456.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,262.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,977.63
|
| Rate for Payer: Multiplan Commercial |
$8,189.60
|
| Rate for Payer: Multiplan WC |
$12,220.24
|
| Rate for Payer: Networks By Design Commercial |
$6,654.05
|
| Rate for Payer: Prime Health Services Commercial |
$8,701.45
|
| Rate for Payer: Prime Health Services WC |
$12,095.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,142.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,118.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,118.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,118.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,118.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
|
HC REP LEG TENDON PRIMARY EA
|
Facility
|
IP
|
$10,237.00
|
|
|
Service Code
|
CPT 27664
|
| Hospital Charge Code |
900501603
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,456.88 |
| Max. Negotiated Rate |
$8,701.45 |
| Rate for Payer: Blue Shield of California Commercial |
$7,288.74
|
| Rate for Payer: Blue Shield of California EPN |
$5,241.34
|
| Rate for Payer: Cash Price |
$4,606.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,094.80
|
| Rate for Payer: Galaxy Health WC |
$8,701.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,142.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,828.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,900.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,456.88
|
| Rate for Payer: Multiplan Commercial |
$8,189.60
|
| Rate for Payer: Networks By Design Commercial |
$6,654.05
|
| Rate for Payer: Prime Health Services Commercial |
$8,701.45
|
|
|
HC REP OF NAIL BED
|
Facility
|
IP
|
$2,078.00
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
900501018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$498.72 |
| Max. Negotiated Rate |
$1,766.30 |
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$831.20
|
| Rate for Payer: Galaxy Health WC |
$1,766.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,246.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,386.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$791.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$498.72
|
| Rate for Payer: Multiplan Commercial |
$1,662.40
|
| Rate for Payer: Networks By Design Commercial |
$1,350.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,766.30
|
|
|
HC REP OF NAIL BED
|
Facility
|
OP
|
$2,078.00
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
900501018
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$191.69 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$784.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,246.80
|
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Cash Price |
$935.10
|
| Rate for Payer: Cigna of CA PPO |
$1,537.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Dignity Health Media |
$784.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$863.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.71
|
| Rate for Payer: Galaxy Health WC |
$1,766.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,246.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,558.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,286.92
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,286.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$784.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,386.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$191.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$498.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$988.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.51
|
| Rate for Payer: Multiplan Commercial |
$1,662.40
|
| Rate for Payer: Networks By Design Commercial |
$1,350.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,766.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,246.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,039.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,039.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,039.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.18
|
| Rate for Payer: Vantage Medical Group Senior |
$784.71
|
|
|
HC REPOSITION CENTRAL CATH PICC
|
Facility
|
IP
|
$3,316.00
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
901200119
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$795.84 |
| Max. Negotiated Rate |
$2,818.60 |
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.40
|
| Rate for Payer: Galaxy Health WC |
$2,818.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,211.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,263.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.84
|
| Rate for Payer: Multiplan Commercial |
$2,652.80
|
| Rate for Payer: Networks By Design Commercial |
$2,155.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,818.60
|
|
|
HC REPOSITION CENTRAL CATH PICC
|
Facility
|
OP
|
$3,316.00
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
901200119
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$784.90 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$784.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,299.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,989.60
|
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: Cigna of CA PPO |
$2,453.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Dignity Health Media |
$784.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$863.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.90
|
| Rate for Payer: Galaxy Health WC |
$2,818.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,487.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,287.24
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,287.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$784.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,211.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$988.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.77
|
| Rate for Payer: Multiplan Commercial |
$2,652.80
|
| Rate for Payer: Networks By Design Commercial |
$2,155.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,818.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,989.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,658.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,658.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,658.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,658.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Vantage Medical Group Senior |
$784.90
|
|
|
HC REPOSITION CENTRAL CATH PICC
|
Facility
|
OP
|
$3,316.00
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
901200119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$784.90 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$784.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,975.67
|
| Rate for Payer: Blue Distinction Transplant |
$1,989.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: Cigna of CA PPO |
$2,453.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Dignity Health Media |
$784.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$863.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.90
|
| Rate for Payer: Galaxy Health WC |
$2,818.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,487.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,287.24
|
| Rate for Payer: Heritage Provider Network Transplant |
$1,287.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,271.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$1,271.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$784.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,211.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$988.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.77
|
| Rate for Payer: Multiplan Commercial |
$2,652.80
|
| Rate for Payer: Networks By Design Commercial |
$2,155.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,818.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,989.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Vantage Medical Group Senior |
$784.90
|
|
|
HC REPOSITION CENTRAL CATH PICC
|
Facility
|
IP
|
$3,316.00
|
|
|
Service Code
|
CPT 37799
|
| Hospital Charge Code |
901200119
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$795.84 |
| Max. Negotiated Rate |
$2,818.60 |
| Rate for Payer: Cash Price |
$1,492.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.40
|
| Rate for Payer: Galaxy Health WC |
$2,818.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,989.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,211.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,263.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$795.84
|
| Rate for Payer: Multiplan Commercial |
$2,652.80
|
| Rate for Payer: Networks By Design Commercial |
$2,155.40
|
| Rate for Payer: Prime Health Services Commercial |
$2,818.60
|
|
|
HC REPOSITION CVP CATH W/FLUORO
|
Facility
|
IP
|
$4,296.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
906812250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,031.04 |
| Max. Negotiated Rate |
$3,651.60 |
| Rate for Payer: Cash Price |
$1,933.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,718.40
|
| Rate for Payer: Galaxy Health WC |
$3,651.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,577.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,865.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,636.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,031.04
|
| Rate for Payer: Multiplan Commercial |
$3,436.80
|
| Rate for Payer: Networks By Design Commercial |
$2,792.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,651.60
|
|
|
HC REPOSITION CVP CATH W/FLUORO
|
Facility
|
OP
|
$4,296.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
906812250
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$84.89 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,577.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$1,933.20
|
| Rate for Payer: Cash Price |
$1,933.20
|
| Rate for Payer: Cigna of CA PPO |
$3,179.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$3,651.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,577.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,222.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,281.66
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,241.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$3,241.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,001.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,865.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,031.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,521.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$3,436.80
|
| Rate for Payer: Networks By Design Commercial |
$2,792.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,651.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,577.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,577.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC REPOSITION CVP CATH W/FLUORO
|
Facility
|
OP
|
$4,296.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
906812250
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$84.89 |
| Max. Negotiated Rate |
$4,984.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,577.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,699.31
|
| Rate for Payer: Blue Shield of California EPN |
$1,756.86
|
| Rate for Payer: Cash Price |
$1,933.20
|
| Rate for Payer: Cash Price |
$1,933.20
|
| Rate for Payer: Cigna of CA PPO |
$3,179.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$3,651.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,577.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,222.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,281.66
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,241.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$3,241.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,001.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,865.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,031.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,521.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$3,436.80
|
| Rate for Payer: Networks By Design Commercial |
$2,792.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,651.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,577.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC REPOSITION CVP CATH W/FLUORO
|
Facility
|
IP
|
$4,296.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
906812250
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,031.04 |
| Max. Negotiated Rate |
$3,651.60 |
| Rate for Payer: Cash Price |
$1,933.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,718.40
|
| Rate for Payer: Galaxy Health WC |
$3,651.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2,577.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,865.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,636.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,031.04
|
| Rate for Payer: Multiplan Commercial |
$3,436.80
|
| Rate for Payer: Networks By Design Commercial |
$2,792.40
|
| Rate for Payer: Prime Health Services Commercial |
$3,651.60
|
|
|
HC REPOSITION VAD DIFF SESSION
|
Facility
|
IP
|
$7,597.00
|
|
|
Service Code
|
CPT 33993
|
| Hospital Charge Code |
906811431
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,823.28 |
| Max. Negotiated Rate |
$6,457.45 |
| Rate for Payer: Cash Price |
$3,418.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,038.80
|
| Rate for Payer: Galaxy Health WC |
$6,457.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,558.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,894.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,823.28
|
| Rate for Payer: Multiplan Commercial |
$6,077.60
|
| Rate for Payer: Networks By Design Commercial |
$4,938.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,457.45
|
|
