|
HC THORACENTESIS ASPIRATN W GUID
|
Facility
|
IP
|
$4,358.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
900200007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,045.92 |
| Max. Negotiated Rate |
$3,704.30 |
| Rate for Payer: Cash Price |
$1,961.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,743.20
|
| Rate for Payer: Galaxy Health WC |
$3,704.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,614.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,906.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,660.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,045.92
|
| Rate for Payer: Multiplan Commercial |
$3,486.40
|
| Rate for Payer: Networks By Design Commercial |
$2,832.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,704.30
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
OP
|
$2,974.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
901200036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$140.77 |
| 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 |
$1,177.35
|
| 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 |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,784.40
|
| 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 |
$1,338.30
|
| Rate for Payer: Cash Price |
$1,338.30
|
| Rate for Payer: Cigna of CA PPO |
$2,200.76
|
| 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 |
$2,527.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,784.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,230.50
|
| 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 |
$1,983.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$713.76
|
| 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 |
$2,379.20
|
| Rate for Payer: Networks By Design Commercial |
$1,933.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,527.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,784.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Vantage Medical Group Senior |
$784.90
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
OP
|
$2,974.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.77 |
| 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 |
$1,177.35
|
| 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 |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,784.40
|
| Rate for Payer: Cash Price |
$1,338.30
|
| Rate for Payer: Cash Price |
$1,338.30
|
| Rate for Payer: Cash Price |
$1,338.30
|
| Rate for Payer: Cigna of CA PPO |
$2,200.76
|
| 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 |
$2,527.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,784.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,230.50
|
| 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 |
$1,983.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$713.76
|
| 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 |
$2,379.20
|
| Rate for Payer: Networks By Design Commercial |
$1,933.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,527.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,784.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,487.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,487.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,487.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,487.00
|
| 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 THORACENTESIS ASPIRATN WO GUID
|
Facility
|
OP
|
$2,974.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$140.77 |
| 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 |
$1,177.35
|
| 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 |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,784.40
|
| 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 |
$1,338.30
|
| Rate for Payer: Cash Price |
$1,338.30
|
| Rate for Payer: Cigna of CA PPO |
$2,200.76
|
| 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 |
$2,527.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,784.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,230.50
|
| 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 |
$1,983.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$713.76
|
| 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 |
$2,379.20
|
| Rate for Payer: Networks By Design Commercial |
$1,933.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,527.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,784.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Vantage Medical Group Senior |
$784.90
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
IP
|
$2,974.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$713.76 |
| Max. Negotiated Rate |
$2,527.90 |
| Rate for Payer: Cash Price |
$1,338.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,189.60
|
| Rate for Payer: Galaxy Health WC |
$2,527.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,784.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,983.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,133.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$713.76
|
| Rate for Payer: Multiplan Commercial |
$2,379.20
|
| Rate for Payer: Networks By Design Commercial |
$1,933.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,527.90
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
IP
|
$2,974.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$713.76 |
| Max. Negotiated Rate |
$2,527.90 |
| Rate for Payer: Cash Price |
$1,338.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,189.60
|
| Rate for Payer: Galaxy Health WC |
$2,527.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,784.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,983.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,133.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$713.76
|
| Rate for Payer: Multiplan Commercial |
$2,379.20
|
| Rate for Payer: Networks By Design Commercial |
$1,933.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,527.90
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
IP
|
$2,974.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
901200036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$713.76 |
| Max. Negotiated Rate |
$2,527.90 |
| Rate for Payer: Cash Price |
$1,338.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,189.60
|
| Rate for Payer: Galaxy Health WC |
$2,527.90
|
| Rate for Payer: Global Benefits Group Commercial |
$1,784.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,983.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,133.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$713.76
|
| Rate for Payer: Multiplan Commercial |
$2,379.20
|
| Rate for Payer: Networks By Design Commercial |
$1,933.10
|
| Rate for Payer: Prime Health Services Commercial |
$2,527.90
|
|
|
HC THORACIC FACET JONT INJ,EA ADL
|
Facility
|
OP
|
$2,675.00
|
|
|
Service Code
|
CPT 64491
|
| Hospital Charge Code |
909000231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$151.37 |
| 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 |
$2,273.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,471.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,471.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,605.00
|
| 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 |
$1,203.75
|
| Rate for Payer: Cash Price |
$1,203.75
|
| Rate for Payer: Cigna of CA PPO |
$1,979.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,273.75
|
| Rate for Payer: Dignity Health Media |
$2,273.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,273.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,070.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,070.00
|
| Rate for Payer: Galaxy Health WC |
$2,273.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,605.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,006.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,784.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$151.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$642.00
|
| Rate for Payer: Multiplan Commercial |
$2,140.00
|
| Rate for Payer: Networks By Design Commercial |
$1,738.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,273.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,605.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,273.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,273.75
|
| Rate for Payer: Vantage Medical Group Senior |
$2,273.75
|
|
|
HC THORACIC FACET JONT INJ,EA ADL
|
Facility
|
IP
|
$2,675.00
|
|
|
Service Code
|
CPT 64491
|
| Hospital Charge Code |
909000231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$642.00 |
| Max. Negotiated Rate |
$2,273.75 |
| Rate for Payer: Cash Price |
$1,203.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,070.00
|
| Rate for Payer: Galaxy Health WC |
$2,273.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,605.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,784.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,019.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$642.00
|
| Rate for Payer: Multiplan Commercial |
$2,140.00
|
| Rate for Payer: Networks By Design Commercial |
$1,738.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,273.75
|
|
|
HC THORACIC SPINE 2VIEWS
|
Facility
|
OP
|
$937.00
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
909001311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.28 |
| Max. Negotiated Rate |
$796.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$146.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$169.71
|
| Rate for Payer: Blue Distinction Transplant |
$562.20
|
| Rate for Payer: Blue Shield of California Commercial |
$553.77
|
| Rate for Payer: Blue Shield of California EPN |
$439.45
|
| Rate for Payer: Cash Price |
$421.65
|
| Rate for Payer: Cash Price |
$421.65
|
| Rate for Payer: Cigna of CA HMO |
$599.68
|
| Rate for Payer: Cigna of CA PPO |
$693.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$796.45
|
| Rate for Payer: Global Benefits Group Commercial |
$562.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$702.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$222.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$222.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$624.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$224.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$749.60
|
| Rate for Payer: Networks By Design Commercial |
$609.05
|
| Rate for Payer: Prime Health Services Commercial |
$796.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$562.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$562.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC THORACIC SPINE 2VIEWS
|
Facility
|
IP
|
$937.00
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
909001311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$224.88 |
| Max. Negotiated Rate |
$796.45 |
| Rate for Payer: Cash Price |
$421.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$374.80
|
| Rate for Payer: Galaxy Health WC |
$796.45
|
| Rate for Payer: Global Benefits Group Commercial |
$562.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$624.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$357.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$224.88
|
| Rate for Payer: Multiplan Commercial |
$749.60
|
| Rate for Payer: Networks By Design Commercial |
$609.05
|
| Rate for Payer: Prime Health Services Commercial |
$796.45
|
|
|
HC THORACIC SPINE 3VIEWS
|
Facility
|
IP
|
$1,027.00
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
909001310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$246.48 |
| Max. Negotiated Rate |
$872.95 |
| Rate for Payer: Cash Price |
$462.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$410.80
|
| Rate for Payer: Galaxy Health WC |
$872.95
|
| Rate for Payer: Global Benefits Group Commercial |
$616.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$685.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$391.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.48
|
| Rate for Payer: Multiplan Commercial |
$821.60
|
| Rate for Payer: Networks By Design Commercial |
$667.55
|
| Rate for Payer: Prime Health Services Commercial |
$872.95
|
|
|
HC THORACIC SPINE 3VIEWS
|
Facility
|
OP
|
$1,027.00
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
909001310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$872.95 |
| Rate for Payer: Aetna of CA HMO/PPO |
$172.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$192.87
|
| Rate for Payer: Blue Distinction Transplant |
$616.20
|
| Rate for Payer: Blue Shield of California Commercial |
$606.96
|
| Rate for Payer: Blue Shield of California EPN |
$481.66
|
| Rate for Payer: Cash Price |
$462.15
|
| Rate for Payer: Cash Price |
$462.15
|
| Rate for Payer: Cigna of CA HMO |
$657.28
|
| Rate for Payer: Cigna of CA PPO |
$759.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$872.95
|
| Rate for Payer: Global Benefits Group Commercial |
$616.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$770.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$222.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$222.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$685.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$246.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$821.60
|
| Rate for Payer: Networks By Design Commercial |
$667.55
|
| Rate for Payer: Prime Health Services Commercial |
$872.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$616.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$616.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC THORACIC SPINE 4 VIEWS
|
Facility
|
IP
|
$1,384.00
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
909001313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$332.16 |
| Max. Negotiated Rate |
$1,176.40 |
| Rate for Payer: Cash Price |
$622.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$553.60
|
| Rate for Payer: Galaxy Health WC |
$1,176.40
|
| Rate for Payer: Global Benefits Group Commercial |
$830.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$923.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$527.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$332.16
|
| Rate for Payer: Multiplan Commercial |
$1,107.20
|
| Rate for Payer: Networks By Design Commercial |
$899.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,176.40
|
|
|
HC THORACIC SPINE 4 VIEWS
|
Facility
|
OP
|
$1,384.00
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
909001313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$66.71 |
| Max. Negotiated Rate |
$1,176.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$215.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$238.20
|
| Rate for Payer: Blue Distinction Transplant |
$830.40
|
| Rate for Payer: Blue Shield of California Commercial |
$817.94
|
| Rate for Payer: Blue Shield of California EPN |
$649.10
|
| Rate for Payer: Cash Price |
$622.80
|
| Rate for Payer: Cash Price |
$622.80
|
| Rate for Payer: Cigna of CA HMO |
$885.76
|
| Rate for Payer: Cigna of CA PPO |
$1,024.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$1,176.40
|
| Rate for Payer: Global Benefits Group Commercial |
$830.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,038.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$225.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$225.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$222.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$222.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$923.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$332.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$1,107.20
|
| Rate for Payer: Networks By Design Commercial |
$899.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,176.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$830.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$830.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC THORACOTOMY CARDIAC
|
Facility
|
IP
|
$4,332.00
|
|
|
Service Code
|
CPT 32160
|
| Hospital Charge Code |
900501127
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,039.68 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$1,949.40
|
| Rate for Payer: Cash Price |
$1,949.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,732.80
|
| Rate for Payer: Galaxy Health WC |
$3,682.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,599.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,889.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,650.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,039.68
|
| Rate for Payer: Multiplan Commercial |
$3,465.60
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,682.20
|
|
|
HC THORACOTOMY CARDIAC
|
Facility
|
OP
|
$4,332.00
|
|
|
Service Code
|
CPT 32160
|
| Hospital Charge Code |
900501127
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$212.21 |
| Max. Negotiated Rate |
$8,241.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4,485.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,682.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,382.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,382.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,241.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,599.20
|
| 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 |
$1,949.40
|
| Rate for Payer: Cash Price |
$1,949.40
|
| Rate for Payer: Cigna of CA PPO |
$3,205.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,682.20
|
| Rate for Payer: Dignity Health Media |
$3,682.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,682.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,732.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,732.80
|
| Rate for Payer: Galaxy Health WC |
$3,682.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,599.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,249.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,889.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$212.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,039.68
|
| Rate for Payer: Multiplan Commercial |
$3,465.60
|
| Rate for Payer: Networks By Design Commercial |
$2,815.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,682.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,599.20
|
| 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 |
$3,682.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,682.20
|
| Rate for Payer: Vantage Medical Group Senior |
$3,682.20
|
|
|
HC THORACOTOMY; WITH EXPLORATION
|
Facility
|
OP
|
$2,270.00
|
|
|
Service Code
|
CPT 32100
|
| Hospital Charge Code |
900502100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$192.41 |
| Max. Negotiated Rate |
$14,375.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5,538.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,929.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,248.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,248.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,362.00
|
| 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 |
$1,021.50
|
| Rate for Payer: Cash Price |
$1,021.50
|
| Rate for Payer: Cigna of CA PPO |
$1,679.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,929.50
|
| Rate for Payer: Dignity Health Media |
$1,929.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,929.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$908.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$908.00
|
| Rate for Payer: Galaxy Health WC |
$1,929.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,362.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,702.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,514.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$192.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$544.80
|
| Rate for Payer: Multiplan Commercial |
$1,816.00
|
| Rate for Payer: Networks By Design Commercial |
$1,475.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,929.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,362.00
|
| 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 |
$1,929.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,929.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1,929.50
|
|
|
HC THORACOTOMY; WITH EXPLORATION
|
Facility
|
IP
|
$2,270.00
|
|
|
Service Code
|
CPT 32100
|
| Hospital Charge Code |
900502100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$544.80 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$1,021.50
|
| Rate for Payer: Cash Price |
$1,021.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$908.00
|
| Rate for Payer: Galaxy Health WC |
$1,929.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,362.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,514.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$864.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$544.80
|
| Rate for Payer: Multiplan Commercial |
$1,816.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,929.50
|
|
|
HC THROMBIN TIME
|
Facility
|
OP
|
$22.00
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
900910021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$52.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.76
|
| Rate for Payer: Blue Distinction Transplant |
$13.20
|
| Rate for Payer: Blue Shield of California Commercial |
$14.21
|
| Rate for Payer: Blue Shield of California EPN |
$11.26
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cigna of CA HMO |
$14.08
|
| Rate for Payer: Cigna of CA PPO |
$16.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.66
|
| Rate for Payer: Dignity Health Media |
$5.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.77
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$16.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.46
|
| Rate for Payer: Heritage Provider Network Transplant |
$9.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$9.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.73
|
| Rate for Payer: Multiplan Commercial |
$17.60
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.67
|
| Rate for Payer: United Healthcare All Other HMO |
$4.67
|
| Rate for Payer: United Healthcare HMO Rider |
$4.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.35
|
| Rate for Payer: Vantage Medical Group Senior |
$5.77
|
|
|
HC THROMBOELASTOGRAPH
|
Facility
|
OP
|
$74.00
|
|
|
Service Code
|
CPT 85396
|
| Hospital Charge Code |
900912024
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$146.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$113.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$62.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$40.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$146.31
|
| Rate for Payer: Blue Distinction Transplant |
$44.40
|
| Rate for Payer: Blue Shield of California Commercial |
$47.80
|
| Rate for Payer: Blue Shield of California EPN |
$37.89
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cigna of CA HMO |
$47.36
|
| Rate for Payer: Cigna of CA PPO |
$54.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$62.90
|
| Rate for Payer: Dignity Health Media |
$62.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$62.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$29.60
|
| Rate for Payer: Galaxy Health WC |
$62.90
|
| Rate for Payer: Global Benefits Group Commercial |
$44.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$55.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$49.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.76
|
| Rate for Payer: Multiplan Commercial |
$59.20
|
| Rate for Payer: Networks By Design Commercial |
$48.10
|
| Rate for Payer: Prime Health Services Commercial |
$62.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$44.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$44.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.98
|
| Rate for Payer: United Healthcare All Other HMO |
$15.98
|
| Rate for Payer: United Healthcare HMO Rider |
$15.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$62.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$62.90
|
| Rate for Payer: Vantage Medical Group Senior |
$62.90
|
|
|
HC THROMBOLYSIS ART
|
Facility
|
OP
|
$4,074.00
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
909020164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$623.90 |
| Max. Negotiated Rate |
$11,260.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,444.40
|
| Rate for Payer: Blue Shield of California Commercial |
$2,407.73
|
| Rate for Payer: Blue Shield of California EPN |
$1,910.71
|
| Rate for Payer: Cash Price |
$1,833.30
|
| Rate for Payer: Cash Price |
$1,833.30
|
| Rate for Payer: Cigna of CA HMO |
$2,607.36
|
| Rate for Payer: Cigna of CA PPO |
$3,014.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Dignity Health Media |
$6,866.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,552.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,269.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,866.07
|
| Rate for Payer: Galaxy Health WC |
$3,462.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,444.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,055.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,260.35
|
| Rate for Payer: Heritage Provider Network Transplant |
$11,260.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11,123.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$11,123.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,866.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,717.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$623.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$977.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,651.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,200.53
|
| Rate for Payer: Multiplan Commercial |
$3,259.20
|
| Rate for Payer: Networks By Design Commercial |
$2,648.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,462.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,444.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,444.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,037.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,037.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,037.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,037.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC THROMBOLYSIS ART
|
Facility
|
IP
|
$4,074.00
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
909020164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$977.76 |
| Max. Negotiated Rate |
$3,462.90 |
| Rate for Payer: Cash Price |
$1,833.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,629.60
|
| Rate for Payer: Galaxy Health WC |
$3,462.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,444.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,717.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,552.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$977.76
|
| Rate for Payer: Multiplan Commercial |
$3,259.20
|
| Rate for Payer: Networks By Design Commercial |
$2,648.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,462.90
|
|
|
HC THROMBOLYSIS COMPLETE
|
Facility
|
IP
|
$8,519.00
|
|
|
Service Code
|
CPT 37214
|
| Hospital Charge Code |
909020157
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,044.56 |
| Max. Negotiated Rate |
$7,241.15 |
| Rate for Payer: Cash Price |
$3,833.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,407.60
|
| Rate for Payer: Galaxy Health WC |
$7,241.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,111.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,682.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,245.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,044.56
|
| Rate for Payer: Multiplan Commercial |
$6,815.20
|
| Rate for Payer: Networks By Design Commercial |
$5,537.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,241.15
|
|
|
HC THROMBOLYSIS COMPLETE
|
Facility
|
OP
|
$8,519.00
|
|
|
Service Code
|
CPT 37214
|
| Hospital Charge Code |
909020157
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$227.07 |
| Max. Negotiated Rate |
$9,590.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,111.40
|
| Rate for Payer: Blue Shield of California Commercial |
$5,034.73
|
| Rate for Payer: Blue Shield of California EPN |
$3,995.41
|
| Rate for Payer: Cash Price |
$3,833.55
|
| Rate for Payer: Cash Price |
$3,833.55
|
| Rate for Payer: Cigna of CA HMO |
$5,452.16
|
| Rate for Payer: Cigna of CA PPO |
$6,304.06
|
| 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 |
$7,241.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,111.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,389.25
|
| 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 |
$5,682.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,044.56
|
| 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 |
$6,815.20
|
| Rate for Payer: Networks By Design Commercial |
$5,537.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,241.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,111.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,111.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,259.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,259.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,259.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,259.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
