|
HC PARATHYROID
|
Facility
OP
|
$1,570.00
|
|
|
Service Code
|
CPT 78071
|
| Hospital Charge Code |
909301309
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$376.80 |
| Max. Negotiated Rate |
$1,953.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,953.50
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$515.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$935.41
|
| Rate for Payer: BCBS Transplant Transplant |
$942.00
|
| Rate for Payer: Blue Shield of California Commercial |
$927.87
|
| Rate for Payer: Blue Shield of California EPN |
$736.33
|
| Rate for Payer: Cash Price |
$706.50
|
| Rate for Payer: Cash Price |
$706.50
|
| Rate for Payer: Cigna of CA HMO |
$1,004.80
|
| Rate for Payer: Cigna of CA PPO |
$1,161.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$772.98
|
| Rate for Payer: Dignity Health Media |
$515.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$566.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$695.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$515.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$515.32
|
| Rate for Payer: Galaxy Health WC |
$1,334.50
|
| Rate for Payer: Global Benefits Group Commercial |
$942.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,177.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$845.12
|
| Rate for Payer: Heritage Provider Network Transplant |
$845.12
|
| Rate for Payer: IEHP Medi-Cal |
$834.82
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$834.82
|
| Rate for Payer: IEHP Medicare Advantage |
$515.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,047.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$592.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$515.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$376.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$649.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$690.53
|
| Rate for Payer: Multiplan Commercial |
$1,256.00
|
| Rate for Payer: Networks By Design Commercial |
$1,020.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,334.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$942.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$942.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$942.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$824.42
|
| Rate for Payer: United Healthcare All Other HMO |
$824.42
|
| Rate for Payer: United Healthcare HMO Rider |
$824.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$824.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Vantage Medical Group Senior |
$515.32
|
|
|
HC PARTIAL AMPUTATION OF TOE
|
Facility
OP
|
$8,006.00
|
|
|
Service Code
|
CPT 28825
|
| Hospital Charge Code |
900501505
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$384.81 |
| Max. Negotiated Rate |
$7,385.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,803.60
|
| Rate for Payer: Cash Price |
$3,602.70
|
| Rate for Payer: Cash Price |
$3,602.70
|
| Rate for Payer: Cash Price |
$3,602.70
|
| Rate for Payer: Cigna of CA PPO |
$5,924.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Dignity Health Media |
$4,044.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
| Rate for Payer: Galaxy Health WC |
$6,805.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,803.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,004.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,632.50
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,632.50
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$4,044.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,340.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$384.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,921.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,095.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
| Rate for Payer: Multiplan Commercial |
$6,404.80
|
| Rate for Payer: Networks By Design Commercial |
$5,203.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,805.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,803.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,803.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,003.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,003.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,003.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,003.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
|
HC PARTIAL AMPUTATION OF TOE
|
Facility
IP
|
$8,006.00
|
|
|
Service Code
|
CPT 28825
|
| Hospital Charge Code |
900501505
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,921.44 |
| Max. Negotiated Rate |
$6,805.10 |
| Rate for Payer: Cash Price |
$3,602.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,202.40
|
| Rate for Payer: Galaxy Health WC |
$6,805.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,803.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,340.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,050.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,921.44
|
| Rate for Payer: Multiplan Commercial |
$6,404.80
|
| Rate for Payer: Networks By Design Commercial |
$5,203.90
|
| Rate for Payer: Prime Health Services Commercial |
$6,805.10
|
|
|
HC PARTIAL RMVL DIST PHALANX FNGR
|
Facility
IP
|
$8,089.00
|
|
|
Service Code
|
CPT 26236
|
| Hospital Charge Code |
900501314
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,941.36 |
| Max. Negotiated Rate |
$6,875.65 |
| Rate for Payer: Cash Price |
$3,640.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,235.60
|
| Rate for Payer: Galaxy Health WC |
$6,875.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,853.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,395.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,081.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,941.36
|
| Rate for Payer: Multiplan Commercial |
$6,471.20
|
| Rate for Payer: Networks By Design Commercial |
$5,257.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,875.65
|
|
|
HC PARTIAL RMVL DIST PHALANX FNGR
|
Facility
OP
|
$8,089.00
|
|
|
Service Code
|
CPT 26236
|
| Hospital Charge Code |
900501314
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$505.06 |
| Max. Negotiated Rate |
$9,590.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,008.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,853.40
|
| Rate for Payer: Cash Price |
$3,640.05
|
| Rate for Payer: Cash Price |
$3,640.05
|
| Rate for Payer: Cash Price |
$3,640.05
|
| Rate for Payer: Cigna of CA PPO |
$5,985.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Dignity Health Media |
$2,008.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,208.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,710.92
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,008.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,008.09
|
| Rate for Payer: Galaxy Health WC |
$6,875.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,853.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,066.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,293.27
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,293.27
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,008.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,395.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$505.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,008.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,941.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,530.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,690.84
|
| Rate for Payer: Multiplan Commercial |
$6,471.20
|
| Rate for Payer: Networks By Design Commercial |
$5,257.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,875.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,853.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,853.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,044.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,044.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,044.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,044.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,012.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,208.90
|
| Rate for Payer: Vantage Medical Group Senior |
$2,008.09
|
|
|
HC PARTIAL RMVL OF EYE FLUID
|
Facility
IP
|
$8,151.00
|
|
|
Service Code
|
CPT 67005
|
| Hospital Charge Code |
900501540
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,956.24 |
| Max. Negotiated Rate |
$6,928.35 |
| Rate for Payer: Cash Price |
$3,667.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,260.40
|
| Rate for Payer: Galaxy Health WC |
$6,928.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,890.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,436.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,105.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,956.24
|
| Rate for Payer: Multiplan Commercial |
$6,520.80
|
| Rate for Payer: Networks By Design Commercial |
$5,298.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,928.35
|
|
|
HC PARTIAL RMVL OF EYE FLUID
|
Facility
OP
|
$8,151.00
|
|
|
Service Code
|
CPT 67005
|
| Hospital Charge Code |
900501540
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$212.21 |
| Max. Negotiated Rate |
$12,491.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,367.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,202.79
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,911.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,890.60
|
| Rate for Payer: Cash Price |
$3,667.95
|
| Rate for Payer: Cash Price |
$3,667.95
|
| Rate for Payer: Cash Price |
$3,667.95
|
| Rate for Payer: Cigna of CA PPO |
$6,031.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Dignity Health Media |
$2,911.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,202.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,930.70
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,911.63
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,911.63
|
| Rate for Payer: Galaxy Health WC |
$6,928.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,890.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,113.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,775.07
|
| Rate for Payer: Heritage Provider Network Transplant |
$4,775.07
|
| Rate for Payer: IEHP Medi-Cal |
$936.00
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,911.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,436.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$212.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,911.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,956.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,668.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,901.58
|
| Rate for Payer: Multiplan Commercial |
$6,520.80
|
| Rate for Payer: Networks By Design Commercial |
$5,298.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,928.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,890.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,890.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,075.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,075.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,075.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,075.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,367.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,202.79
|
| Rate for Payer: Vantage Medical Group Senior |
$2,911.63
|
|
|
HC PATH CONSULT SURG ADDL BLOCK P
|
Facility
OP
|
$25.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800220
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$76.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$70.36
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.10
|
| Rate for Payer: BCBS Transplant Transplant |
$15.00
|
| Rate for Payer: Blue Shield of California Commercial |
$16.15
|
| Rate for Payer: Blue Shield of California EPN |
$12.80
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.25
|
| Rate for Payer: Dignity Health Media |
$21.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.90
|
| Rate for Payer: United Healthcare All Other HMO |
$19.90
|
| Rate for Payer: United Healthcare HMO Rider |
$19.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.25
|
| Rate for Payer: Vantage Medical Group Senior |
$21.25
|
|
|
HC PATH CONSULT SURG ADDL BLOCK P
|
Facility
IP
|
$25.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800220
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$21.25 |
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC PATH CONSULT SURGERY FRZN PG
|
Facility
OP
|
$75.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
903800219
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$349.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$202.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$213.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.27
|
| Rate for Payer: BCBS Transplant Transplant |
$45.00
|
| Rate for Payer: Blue Shield of California Commercial |
$48.45
|
| Rate for Payer: Blue Shield of California EPN |
$38.40
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: Cigna of CA HMO |
$48.00
|
| Rate for Payer: Cigna of CA PPO |
$55.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.12
|
| Rate for Payer: Dignity Health Media |
$213.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$234.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$213.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$213.41
|
| Rate for Payer: Galaxy Health WC |
$63.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$56.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$349.99
|
| Rate for Payer: Heritage Provider Network Transplant |
$349.99
|
| Rate for Payer: IEHP Medi-Cal |
$345.72
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$345.72
|
| Rate for Payer: IEHP Medicare Advantage |
$213.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$213.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$268.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$285.97
|
| Rate for Payer: Multiplan Commercial |
$60.00
|
| Rate for Payer: Networks By Design Commercial |
$48.75
|
| Rate for Payer: Prime Health Services Commercial |
$63.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$45.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$234.75
|
| Rate for Payer: Vantage Medical Group Senior |
$213.41
|
|
|
HC PATH CONSULT SURGERY FRZN PG
|
Facility
IP
|
$75.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
903800219
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$63.75 |
| Rate for Payer: Cash Price |
$33.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.00
|
| Rate for Payer: Galaxy Health WC |
$63.75
|
| Rate for Payer: Global Benefits Group Commercial |
$45.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: Multiplan Commercial |
$60.00
|
| Rate for Payer: Networks By Design Commercial |
$48.75
|
| Rate for Payer: Prime Health Services Commercial |
$63.75
|
|
|
HC PCI BYPASS GRAFT
|
Facility
IP
|
$15,662.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
906811440
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,758.88 |
| Max. Negotiated Rate |
$13,312.70 |
| Rate for Payer: Cash Price |
$7,047.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,264.80
|
| Rate for Payer: Galaxy Health WC |
$13,312.70
|
| Rate for Payer: Global Benefits Group Commercial |
$9,397.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,446.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,967.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,758.88
|
| Rate for Payer: Multiplan Commercial |
$12,529.60
|
| Rate for Payer: Networks By Design Commercial |
$10,180.30
|
| Rate for Payer: Prime Health Services Commercial |
$13,312.70
|
|
|
HC PCI BYPASS GRAFT
|
Facility
OP
|
$15,662.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
906811440
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$916.67 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,753.08
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: BCBS Transplant Transplant |
$9,397.20
|
| Rate for Payer: Blue Shield of California Commercial |
$5,803.51
|
| Rate for Payer: Blue Shield of California EPN |
$3,777.25
|
| Rate for Payer: Cash Price |
$7,047.90
|
| Rate for Payer: Cash Price |
$7,047.90
|
| Rate for Payer: Cigna of CA PPO |
$11,589.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$13,312.70
|
| Rate for Payer: Global Benefits Group Commercial |
$9,397.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$11,746.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$22,542.16
|
| Rate for Payer: Heritage Provider Network Transplant |
$22,542.16
|
| Rate for Payer: IEHP Medi-Cal |
$22,267.26
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$22,267.26
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,446.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$916.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,758.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,318.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$12,529.60
|
| Rate for Payer: Networks By Design Commercial |
$10,180.30
|
| Rate for Payer: Prime Health Services Commercial |
$13,312.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9,397.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,397.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,397.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC PCI BYPASS GRAFT ADD
|
Facility
IP
|
$28,104.00
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
906811464
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$6,744.96 |
| Max. Negotiated Rate |
$23,888.40 |
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,241.60
|
| Rate for Payer: Galaxy Health WC |
$23,888.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,862.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,745.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,707.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,744.96
|
| Rate for Payer: Multiplan Commercial |
$22,483.20
|
| Rate for Payer: Networks By Design Commercial |
$18,267.60
|
| Rate for Payer: Prime Health Services Commercial |
$23,888.40
|
|
|
HC PCI BYPASS GRAFT ADD
|
Facility
OP
|
$28,104.00
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
906811464
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$23,888.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,433.41
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$23,888.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,457.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15,457.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: BCBS Transplant Transplant |
$16,862.40
|
| Rate for Payer: Blue Shield of California Commercial |
$5,803.51
|
| Rate for Payer: Blue Shield of California EPN |
$3,777.25
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Cigna of CA HMO |
$17,986.56
|
| Rate for Payer: Cigna of CA PPO |
$20,796.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,888.40
|
| Rate for Payer: Dignity Health Media |
$23,888.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,888.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,241.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$11,241.60
|
| Rate for Payer: Galaxy Health WC |
$23,888.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,862.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21,078.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,745.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,707.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,744.96
|
| Rate for Payer: Multiplan Commercial |
$22,483.20
|
| Rate for Payer: Networks By Design Commercial |
$18,267.60
|
| Rate for Payer: Prime Health Services Commercial |
$23,888.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16,862.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,862.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,862.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23,888.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,888.40
|
| Rate for Payer: Vantage Medical Group Senior |
$23,888.40
|
|
|
HC PCI BYPASS GRAFT, ADDN'L
|
Facility
IP
|
$7,831.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
906811441
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,879.44 |
| Max. Negotiated Rate |
$6,656.35 |
| Rate for Payer: Cash Price |
$3,523.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,132.40
|
| Rate for Payer: Galaxy Health WC |
$6,656.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,698.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,223.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,983.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,879.44
|
| Rate for Payer: Multiplan Commercial |
$6,264.80
|
| Rate for Payer: Networks By Design Commercial |
$5,090.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,656.35
|
|
|
HC PCI BYPASS GRAFT, ADDN'L
|
Facility
OP
|
$7,831.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
906811441
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,879.44 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,433.27
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,656.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,307.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,307.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,698.60
|
| Rate for Payer: Blue Shield of California Commercial |
$5,803.51
|
| Rate for Payer: Blue Shield of California EPN |
$3,777.25
|
| Rate for Payer: Cash Price |
$3,523.95
|
| Rate for Payer: Cash Price |
$3,523.95
|
| Rate for Payer: Cigna of CA PPO |
$5,794.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,656.35
|
| Rate for Payer: Dignity Health Media |
$6,656.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,656.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,132.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,132.40
|
| Rate for Payer: Galaxy Health WC |
$6,656.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,698.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,873.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,223.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,879.44
|
| Rate for Payer: Multiplan Commercial |
$6,264.80
|
| Rate for Payer: Networks By Design Commercial |
$5,090.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,656.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,698.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,698.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,698.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,656.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,656.35
|
| Rate for Payer: Vantage Medical Group Senior |
$6,656.35
|
|
|
HC PCI CORO/BYPASS CHRONIC 1 VESL
|
Facility
IP
|
$18,795.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
906811443
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,510.80 |
| Max. Negotiated Rate |
$15,975.75 |
| Rate for Payer: Cash Price |
$8,457.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,518.00
|
| Rate for Payer: Galaxy Health WC |
$15,975.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11,277.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,536.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,160.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,510.80
|
| Rate for Payer: Multiplan Commercial |
$15,036.00
|
| Rate for Payer: Networks By Design Commercial |
$12,216.75
|
| Rate for Payer: Prime Health Services Commercial |
$15,975.75
|
|
|
HC PCI CORO/BYPASS CHRONIC 1 VESL
|
Facility
OP
|
$18,795.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
906811443
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,028.24 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4,209.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: BCBS Transplant Transplant |
$11,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,803.51
|
| Rate for Payer: Blue Shield of California EPN |
$3,777.25
|
| Rate for Payer: Cash Price |
$8,457.75
|
| Rate for Payer: Cash Price |
$8,457.75
|
| Rate for Payer: Cigna of CA PPO |
$13,908.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$15,975.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11,277.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14,096.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$22,542.16
|
| Rate for Payer: Heritage Provider Network Transplant |
$22,542.16
|
| Rate for Payer: IEHP Medi-Cal |
$22,267.26
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$22,267.26
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,536.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,028.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,510.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,318.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$15,036.00
|
| Rate for Payer: Networks By Design Commercial |
$12,216.75
|
| Rate for Payer: Prime Health Services Commercial |
$15,975.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11,277.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,277.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,277.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC PCI CORO BYPASS CHRONIC 1 VSL
|
Facility
IP
|
$38,826.00
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
906811466
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$9,318.24 |
| Max. Negotiated Rate |
$33,002.10 |
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,530.40
|
| Rate for Payer: Galaxy Health WC |
$33,002.10
|
| Rate for Payer: Global Benefits Group Commercial |
$23,295.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,896.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,792.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,318.24
|
| Rate for Payer: Multiplan Commercial |
$31,060.80
|
| Rate for Payer: Networks By Design Commercial |
$25,236.90
|
| Rate for Payer: Prime Health Services Commercial |
$33,002.10
|
|
|
HC PCI CORO BYPASS CHRONIC 1 VSL
|
Facility
OP
|
$38,826.00
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
906811466
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$35,930.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,971.39
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: BCBS Transplant Transplant |
$23,295.60
|
| Rate for Payer: Blue Shield of California Commercial |
$5,803.51
|
| Rate for Payer: Blue Shield of California EPN |
$3,777.25
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Cigna of CA HMO |
$24,848.64
|
| Rate for Payer: Cigna of CA PPO |
$28,731.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Dignity Health Media |
$21,908.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,099.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,577.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,908.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$21,908.96
|
| Rate for Payer: Galaxy Health WC |
$33,002.10
|
| Rate for Payer: Global Benefits Group Commercial |
$23,295.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29,119.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$35,930.69
|
| Rate for Payer: Heritage Provider Network Transplant |
$35,930.69
|
| Rate for Payer: IEHP Medi-Cal |
$35,492.52
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$35,492.52
|
| Rate for Payer: IEHP Medicare Advantage |
$21,908.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,896.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,792.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,318.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,605.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,358.01
|
| Rate for Payer: Multiplan Commercial |
$31,060.80
|
| Rate for Payer: Networks By Design Commercial |
$25,236.90
|
| Rate for Payer: Prime Health Services Commercial |
$33,002.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23,295.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,295.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23,295.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Vantage Medical Group Senior |
$21,908.96
|
|
|
HC PCI CORO BYPASS CHRONIC ADD
|
Facility
IP
|
$36,977.00
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
906811467
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$8,874.48 |
| Max. Negotiated Rate |
$31,430.45 |
| Rate for Payer: Cash Price |
$16,639.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,790.80
|
| Rate for Payer: Galaxy Health WC |
$31,430.45
|
| Rate for Payer: Global Benefits Group Commercial |
$22,186.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,663.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,088.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,874.48
|
| Rate for Payer: Multiplan Commercial |
$29,581.60
|
| Rate for Payer: Networks By Design Commercial |
$24,035.05
|
| Rate for Payer: Prime Health Services Commercial |
$31,430.45
|
|
|
HC PCI CORO BYPASS CHRONIC ADD
|
Facility
OP
|
$36,977.00
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
906811467
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$31,430.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,253.21
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$31,430.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20,337.35
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20,337.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: BCBS Transplant Transplant |
$22,186.20
|
| Rate for Payer: Blue Shield of California Commercial |
$5,803.51
|
| Rate for Payer: Blue Shield of California EPN |
$3,777.25
|
| Rate for Payer: Cash Price |
$16,639.65
|
| Rate for Payer: Cash Price |
$16,639.65
|
| Rate for Payer: Cash Price |
$16,639.65
|
| Rate for Payer: Cigna of CA HMO |
$23,665.28
|
| Rate for Payer: Cigna of CA PPO |
$27,362.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31,430.45
|
| Rate for Payer: Dignity Health Media |
$31,430.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,430.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,790.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$14,790.80
|
| Rate for Payer: Galaxy Health WC |
$31,430.45
|
| Rate for Payer: Global Benefits Group Commercial |
$22,186.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$27,732.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,663.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,088.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,874.48
|
| Rate for Payer: Multiplan Commercial |
$29,581.60
|
| Rate for Payer: Networks By Design Commercial |
$24,035.05
|
| Rate for Payer: Prime Health Services Commercial |
$31,430.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$22,186.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22,186.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22,186.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31,430.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,430.45
|
| Rate for Payer: Vantage Medical Group Senior |
$31,430.45
|
|
|
HC PCI CORO/BYPASS CHRONIC, ADD'L
|
Facility
IP
|
$9,397.00
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
906811444
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,255.28 |
| Max. Negotiated Rate |
$7,987.45 |
| Rate for Payer: Cash Price |
$4,228.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$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: 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 PCI CORO/BYPASS CHRONIC, ADD'L
|
Facility
OP
|
$9,397.00
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
906811444
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,255.28 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,128.49
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,987.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,168.35
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5,168.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: BCBS Transplant Transplant |
$5,638.20
|
| Rate for Payer: Blue Shield of California Commercial |
$5,803.51
|
| Rate for Payer: Blue Shield of California EPN |
$3,777.25
|
| Rate for Payer: Cash Price |
$4,228.65
|
| Rate for Payer: Cash Price |
$4,228.65
|
| 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 Media |
$7,987.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,987.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,758.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$7,047.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,267.80
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,638.20
|
| 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 |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,987.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,987.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,987.45
|
|
