|
HC TRANSCATH MITRAL VALVE REPAIR
|
Facility
|
OP
|
$82,271.00
|
|
|
Service Code
|
CPT 33418
|
| Hospital Charge Code |
906811487
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$542.56 |
| Max. Negotiated Rate |
$69,930.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,473.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69,930.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45,249.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45,249.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: Blue Distinction Transplant |
$49,362.60
|
| Rate for Payer: Blue Shield of California Commercial |
$833.61
|
| Rate for Payer: Blue Shield of California EPN |
$542.56
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cigna of CA PPO |
$60,880.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69,930.35
|
| Rate for Payer: Dignity Health Media |
$69,930.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$69,930.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$61,703.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,029.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,745.04
|
| Rate for Payer: Multiplan Commercial |
$65,816.80
|
| Rate for Payer: Networks By Design Commercial |
$53,476.15
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49,362.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69,930.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69,930.35
|
| Rate for Payer: Vantage Medical Group Senior |
$69,930.35
|
|
|
HC TRANSCATH MITRAL VLVE IMPL/REP
|
Facility
|
OP
|
$78,157.00
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
906800483
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,756.86 |
| Max. Negotiated Rate |
$66,433.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8,882.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$66,433.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42,986.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42,986.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: Blue Distinction Transplant |
$46,894.20
|
| 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 |
$35,170.65
|
| Rate for Payer: Cash Price |
$35,170.65
|
| Rate for Payer: Cigna of CA PPO |
$57,836.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$66,433.45
|
| Rate for Payer: Dignity Health Media |
$66,433.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$66,433.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,262.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$31,262.80
|
| Rate for Payer: Galaxy Health WC |
$66,433.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,894.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$58,617.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52,130.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,777.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,757.68
|
| Rate for Payer: Multiplan Commercial |
$62,525.60
|
| Rate for Payer: Networks By Design Commercial |
$50,802.05
|
| Rate for Payer: Prime Health Services Commercial |
$66,433.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46,894.20
|
| 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 |
$66,433.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$66,433.45
|
| Rate for Payer: Vantage Medical Group Senior |
$66,433.45
|
|
|
HC TRANSCATH MITRAL VLVE IMPL/REP
|
Facility
|
IP
|
$78,157.00
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
906800483
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$18,757.68 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$35,170.65
|
| Rate for Payer: Cash Price |
$35,170.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,262.80
|
| Rate for Payer: Galaxy Health WC |
$66,433.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,894.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52,130.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,777.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,757.68
|
| Rate for Payer: Multiplan Commercial |
$62,525.60
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$66,433.45
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC ADDL ART
|
Facility
|
OP
|
$14,043.00
|
|
|
Service Code
|
CPT 37237
|
| Hospital Charge Code |
906811479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,936.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,723.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,723.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,425.80
|
| Rate for Payer: Blue Shield of California Commercial |
$5,104.87
|
| Rate for Payer: Blue Shield of California EPN |
$3,322.54
|
| Rate for Payer: Cash Price |
$6,319.35
|
| Rate for Payer: Cash Price |
$6,319.35
|
| Rate for Payer: Cigna of CA PPO |
$10,391.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,936.55
|
| Rate for Payer: Dignity Health Media |
$11,936.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,936.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,617.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,617.20
|
| Rate for Payer: Galaxy Health WC |
$11,936.55
|
| Rate for Payer: Global Benefits Group Commercial |
$8,425.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,532.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,366.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$69.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,370.32
|
| Rate for Payer: Multiplan Commercial |
$11,234.40
|
| Rate for Payer: Networks By Design Commercial |
$9,127.95
|
| Rate for Payer: Prime Health Services Commercial |
$11,936.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,425.80
|
| 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 |
$11,936.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,936.55
|
| Rate for Payer: Vantage Medical Group Senior |
$11,936.55
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC ADDL ART
|
Facility
|
IP
|
$14,043.00
|
|
|
Service Code
|
CPT 37237
|
| Hospital Charge Code |
906811479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,370.32 |
| Max. Negotiated Rate |
$11,936.55 |
| Rate for Payer: Cash Price |
$6,319.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,617.20
|
| Rate for Payer: Galaxy Health WC |
$11,936.55
|
| Rate for Payer: Global Benefits Group Commercial |
$8,425.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,366.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,350.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,370.32
|
| Rate for Payer: Multiplan Commercial |
$11,234.40
|
| Rate for Payer: Networks By Design Commercial |
$9,127.95
|
| Rate for Payer: Prime Health Services Commercial |
$11,936.55
|
|
|
HC TRANSCATH PLCMT INT STNT OPENPERC ADDL VEIN
|
Facility
|
IP
|
$13,342.00
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
906811481
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,202.08 |
| Max. Negotiated Rate |
$11,340.70 |
| Rate for Payer: Cash Price |
$6,003.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,336.80
|
| Rate for Payer: Galaxy Health WC |
$11,340.70
|
| Rate for Payer: Global Benefits Group Commercial |
$8,005.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,899.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,083.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,202.08
|
| Rate for Payer: Multiplan Commercial |
$10,673.60
|
| Rate for Payer: Networks By Design Commercial |
$8,672.30
|
| Rate for Payer: Prime Health Services Commercial |
$11,340.70
|
|
|
HC TRANSCATH PLCMT INT STNT OPENPERC ADDL VEIN
|
Facility
|
OP
|
$13,342.00
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
906811481
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$48.11 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,340.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,338.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,338.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,005.20
|
| Rate for Payer: Blue Shield of California Commercial |
$5,104.87
|
| Rate for Payer: Blue Shield of California EPN |
$3,322.54
|
| Rate for Payer: Cash Price |
$6,003.90
|
| Rate for Payer: Cash Price |
$6,003.90
|
| Rate for Payer: Cigna of CA PPO |
$9,873.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,340.70
|
| Rate for Payer: Dignity Health Media |
$11,340.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,340.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,336.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,336.80
|
| Rate for Payer: Galaxy Health WC |
$11,340.70
|
| Rate for Payer: Global Benefits Group Commercial |
$8,005.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,006.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,899.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,202.08
|
| Rate for Payer: Multiplan Commercial |
$10,673.60
|
| Rate for Payer: Networks By Design Commercial |
$8,672.30
|
| Rate for Payer: Prime Health Services Commercial |
$11,340.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,005.20
|
| 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 |
$11,340.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,340.70
|
| Rate for Payer: Vantage Medical Group Senior |
$11,340.70
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC INIT ART
|
Facility
|
OP
|
$30,489.00
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
906811478
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$745.56 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: Blue Distinction Transplant |
$18,293.40
|
| Rate for Payer: Blue Shield of California Commercial |
$5,104.87
|
| Rate for Payer: Blue Shield of California EPN |
$3,322.54
|
| Rate for Payer: Cash Price |
$13,720.05
|
| Rate for Payer: Cash Price |
$13,720.05
|
| Rate for Payer: Cigna of CA PPO |
$22,561.86
|
| 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 |
$25,915.65
|
| Rate for Payer: Global Benefits Group Commercial |
$18,293.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$22,866.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$22,542.16
|
| Rate for Payer: Heritage Provider Network Transplant |
$22,542.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22,267.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$22,267.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,336.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$745.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,317.36
|
| 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 |
$24,391.20
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$19,817.85
|
| Rate for Payer: Prime Health Services Commercial |
$25,915.65
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,293.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| 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 TRANSCATH PLCMT INT STNT OPEN PERC INIT ART
|
Facility
|
IP
|
$30,489.00
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
906811478
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,317.36 |
| Max. Negotiated Rate |
$25,915.65 |
| Rate for Payer: Cash Price |
$13,720.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,195.60
|
| Rate for Payer: Galaxy Health WC |
$25,915.65
|
| Rate for Payer: Global Benefits Group Commercial |
$18,293.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,336.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,616.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,317.36
|
| Rate for Payer: Multiplan Commercial |
$24,391.20
|
| Rate for Payer: Networks By Design Commercial |
$19,817.85
|
| Rate for Payer: Prime Health Services Commercial |
$25,915.65
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC INIT VEIN
|
Facility
|
IP
|
$27,586.00
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
906811480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,620.64 |
| Max. Negotiated Rate |
$23,448.10 |
| Rate for Payer: Cash Price |
$12,413.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,034.40
|
| Rate for Payer: Galaxy Health WC |
$23,448.10
|
| Rate for Payer: Global Benefits Group Commercial |
$16,551.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,399.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,510.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,620.64
|
| Rate for Payer: Multiplan Commercial |
$22,068.80
|
| Rate for Payer: Networks By Design Commercial |
$17,930.90
|
| Rate for Payer: Prime Health Services Commercial |
$23,448.10
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC INIT VEIN
|
Facility
|
OP
|
$27,586.00
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
906811480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$522.75 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,049.00
|
| Rate for Payer: Blue Distinction Transplant |
$16,551.60
|
| Rate for Payer: Blue Shield of California Commercial |
$5,104.87
|
| Rate for Payer: Blue Shield of California EPN |
$3,322.54
|
| Rate for Payer: Cash Price |
$12,413.70
|
| Rate for Payer: Cash Price |
$12,413.70
|
| Rate for Payer: Cigna of CA PPO |
$20,413.64
|
| 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 |
$23,448.10
|
| Rate for Payer: Global Benefits Group Commercial |
$16,551.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$20,689.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$22,542.16
|
| Rate for Payer: Heritage Provider Network Transplant |
$22,542.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$22,267.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$22,267.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,399.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$522.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,620.64
|
| 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 |
$22,068.80
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$17,930.90
|
| Rate for Payer: Prime Health Services Commercial |
$23,448.10
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,551.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| 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 TRANSCATH PULM VALVE IMPLANT
|
Facility
|
IP
|
$78,157.00
|
|
|
Service Code
|
CPT 33477
|
| Hospital Charge Code |
906811427
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$18,757.68 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$35,170.65
|
| Rate for Payer: Cash Price |
$35,170.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,262.80
|
| Rate for Payer: Galaxy Health WC |
$66,433.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,894.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52,130.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,777.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,757.68
|
| Rate for Payer: Multiplan Commercial |
$62,525.60
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$66,433.45
|
|
|
HC TRANSCATH PULM VALVE IMPLANT
|
Facility
|
OP
|
$78,157.00
|
|
|
Service Code
|
CPT 33477
|
| Hospital Charge Code |
906811427
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$542.56 |
| Max. Negotiated Rate |
$66,433.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,286.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$66,433.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42,986.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42,986.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: Blue Distinction Transplant |
$46,894.20
|
| Rate for Payer: Blue Shield of California Commercial |
$833.61
|
| Rate for Payer: Blue Shield of California EPN |
$542.56
|
| Rate for Payer: Cash Price |
$35,170.65
|
| Rate for Payer: Cash Price |
$35,170.65
|
| Rate for Payer: Cigna of CA PPO |
$57,836.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$66,433.45
|
| Rate for Payer: Dignity Health Media |
$66,433.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$66,433.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,262.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$31,262.80
|
| Rate for Payer: Galaxy Health WC |
$66,433.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,894.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$58,617.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52,130.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,120.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,757.68
|
| Rate for Payer: Multiplan Commercial |
$62,525.60
|
| Rate for Payer: Networks By Design Commercial |
$50,802.05
|
| Rate for Payer: Prime Health Services Commercial |
$66,433.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46,894.20
|
| 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 |
$66,433.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$66,433.45
|
| Rate for Payer: Vantage Medical Group Senior |
$66,433.45
|
|
|
HC TRANSCATH RENAL DENERVATION
|
Facility
|
OP
|
$12,334.00
|
|
|
Service Code
|
CPT 0338T
|
| Hospital Charge Code |
906811473
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,960.16 |
| Max. Negotiated Rate |
$11,711.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,357.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,141.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,400.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,289.39
|
| Rate for Payer: Blue Shield of California EPN |
$5,784.65
|
| Rate for Payer: Cash Price |
$5,550.30
|
| Rate for Payer: Cash Price |
$5,550.30
|
| Rate for Payer: Cigna of CA HMO |
$7,893.76
|
| Rate for Payer: Cigna of CA PPO |
$9,127.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Dignity Health Media |
$7,141.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,855.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,640.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,141.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,141.35
|
| Rate for Payer: Galaxy Health WC |
$10,483.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,400.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,250.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,711.81
|
| Rate for Payer: Heritage Provider Network Transplant |
$11,711.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11,568.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$11,568.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,141.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,226.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,699.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,141.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,960.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,998.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,569.41
|
| Rate for Payer: Multiplan Commercial |
$9,867.20
|
| Rate for Payer: Networks By Design Commercial |
$8,017.10
|
| Rate for Payer: Prime Health Services Commercial |
$10,483.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,400.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,400.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,167.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,167.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,167.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,167.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7,141.35
|
|
|
HC TRANSCATH RENAL DENERVATION
|
Facility
|
IP
|
$12,334.00
|
|
|
Service Code
|
CPT 0338T
|
| Hospital Charge Code |
906811473
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,960.16 |
| Max. Negotiated Rate |
$10,483.90 |
| Rate for Payer: Cash Price |
$5,550.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,933.60
|
| Rate for Payer: Galaxy Health WC |
$10,483.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,400.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,226.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,699.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,960.16
|
| Rate for Payer: Multiplan Commercial |
$9,867.20
|
| Rate for Payer: Networks By Design Commercial |
$8,017.10
|
| Rate for Payer: Prime Health Services Commercial |
$10,483.90
|
|
|
HC TRANSCATH RENAL DENERVATION BILATERAL
|
Facility
|
IP
|
$18,501.00
|
|
|
Service Code
|
CPT 0339T
|
| Hospital Charge Code |
906811474
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$4,440.24 |
| Max. Negotiated Rate |
$15,725.85 |
| Rate for Payer: Cash Price |
$8,325.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,400.40
|
| Rate for Payer: Galaxy Health WC |
$15,725.85
|
| Rate for Payer: Global Benefits Group Commercial |
$11,100.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,340.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,048.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,440.24
|
| Rate for Payer: Multiplan Commercial |
$14,800.80
|
| Rate for Payer: Networks By Design Commercial |
$12,025.65
|
| Rate for Payer: Prime Health Services Commercial |
$15,725.85
|
|
|
HC TRANSCATH RENAL DENERVATION BILATERAL
|
Facility
|
OP
|
$18,501.00
|
|
|
Service Code
|
CPT 0339T
|
| Hospital Charge Code |
906811474
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$4,440.24 |
| Max. Negotiated Rate |
$15,725.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,637.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,141.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: Blue Distinction Transplant |
$11,100.60
|
| Rate for Payer: Blue Shield of California Commercial |
$10,934.09
|
| Rate for Payer: Blue Shield of California EPN |
$8,676.97
|
| Rate for Payer: Cash Price |
$8,325.45
|
| Rate for Payer: Cash Price |
$8,325.45
|
| Rate for Payer: Cigna of CA HMO |
$11,840.64
|
| Rate for Payer: Cigna of CA PPO |
$13,690.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Dignity Health Media |
$7,141.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,855.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,640.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,141.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,141.35
|
| Rate for Payer: Galaxy Health WC |
$15,725.85
|
| Rate for Payer: Global Benefits Group Commercial |
$11,100.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$13,875.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,711.81
|
| Rate for Payer: Heritage Provider Network Transplant |
$11,711.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11,568.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$11,568.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,141.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,340.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,048.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,141.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,440.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,998.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,569.41
|
| Rate for Payer: Multiplan Commercial |
$14,800.80
|
| Rate for Payer: Networks By Design Commercial |
$12,025.65
|
| Rate for Payer: Prime Health Services Commercial |
$15,725.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,100.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,100.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,250.50
|
| Rate for Payer: United Healthcare All Other HMO |
$9,250.50
|
| Rate for Payer: United Healthcare HMO Rider |
$9,250.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,250.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7,141.35
|
|
|
HC TRANSCATH SEPTAL REDUCT THER
|
Facility
|
IP
|
$24,728.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906803583
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,934.72 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,891.20
|
| Rate for Payer: Galaxy Health WC |
$21,018.80
|
| Rate for Payer: Global Benefits Group Commercial |
$14,836.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,493.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,421.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,934.72
|
| Rate for Payer: Multiplan Commercial |
$19,782.40
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,018.80
|
|
|
HC TRANSCATH SEPTAL REDUCT THER
|
Facility
|
OP
|
$24,728.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906803583
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$956.10 |
| Max. Negotiated Rate |
$21,018.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,018.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,600.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,600.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,628.00
|
| Rate for Payer: Blue Distinction Transplant |
$14,836.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,668.88
|
| Rate for Payer: Blue Shield of California EPN |
$4,340.48
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Cigna of CA PPO |
$18,298.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,018.80
|
| Rate for Payer: Dignity Health Media |
$21,018.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,018.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,891.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,891.20
|
| Rate for Payer: Galaxy Health WC |
$21,018.80
|
| Rate for Payer: Global Benefits Group Commercial |
$14,836.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18,546.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,493.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$956.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,934.72
|
| Rate for Payer: Multiplan Commercial |
$19,782.40
|
| Rate for Payer: Networks By Design Commercial |
$16,073.20
|
| Rate for Payer: Prime Health Services Commercial |
$21,018.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,836.80
|
| 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 |
$21,018.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,018.80
|
| Rate for Payer: Vantage Medical Group Senior |
$21,018.80
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
|
OP
|
$10,086.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906812173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,420.64 |
| Max. Negotiated Rate |
$8,573.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5,637.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,573.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,547.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,547.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,265.13
|
| Rate for Payer: Blue Distinction Transplant |
$6,051.60
|
| Rate for Payer: Blue Shield of California Commercial |
$5,960.83
|
| Rate for Payer: Blue Shield of California EPN |
$4,730.33
|
| Rate for Payer: Cash Price |
$4,538.70
|
| Rate for Payer: Cash Price |
$4,538.70
|
| Rate for Payer: Cigna of CA HMO |
$6,455.04
|
| Rate for Payer: Cigna of CA PPO |
$7,463.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,573.10
|
| Rate for Payer: Dignity Health Media |
$8,573.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,573.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,034.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,034.40
|
| Rate for Payer: Galaxy Health WC |
$8,573.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,051.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,564.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,727.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,420.64
|
| Rate for Payer: Multiplan Commercial |
$8,068.80
|
| Rate for Payer: Networks By Design Commercial |
$6,555.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,573.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,051.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,051.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,043.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,043.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,043.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,043.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,573.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,573.10
|
| Rate for Payer: Vantage Medical Group Senior |
$8,573.10
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
|
IP
|
$10,086.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906812173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,420.64 |
| Max. Negotiated Rate |
$8,573.10 |
| Rate for Payer: Cash Price |
$4,538.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,034.40
|
| Rate for Payer: Galaxy Health WC |
$8,573.10
|
| Rate for Payer: Global Benefits Group Commercial |
$6,051.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,727.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,842.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,420.64
|
| Rate for Payer: Multiplan Commercial |
$8,068.80
|
| Rate for Payer: Networks By Design Commercial |
$6,555.90
|
| Rate for Payer: Prime Health Services Commercial |
$8,573.10
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
|
OP
|
$25,472.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906810570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$542.56 |
| Max. Negotiated Rate |
$21,651.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,388.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,651.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,009.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,009.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: Blue Distinction Transplant |
$15,283.20
|
| Rate for Payer: Blue Shield of California Commercial |
$833.61
|
| Rate for Payer: Blue Shield of California EPN |
$542.56
|
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: Cigna of CA PPO |
$18,849.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,651.20
|
| Rate for Payer: Dignity Health Media |
$21,651.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,651.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,188.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,188.80
|
| Rate for Payer: Galaxy Health WC |
$21,651.20
|
| Rate for Payer: Global Benefits Group Commercial |
$15,283.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19,104.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,989.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,704.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,113.28
|
| Rate for Payer: Multiplan Commercial |
$20,377.60
|
| Rate for Payer: Networks By Design Commercial |
$16,556.80
|
| Rate for Payer: Prime Health Services Commercial |
$21,651.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,283.20
|
| 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 |
$21,651.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,651.20
|
| Rate for Payer: Vantage Medical Group Senior |
$21,651.20
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
|
IP
|
$25,472.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906810570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,113.28 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,188.80
|
| Rate for Payer: Galaxy Health WC |
$21,651.20
|
| Rate for Payer: Global Benefits Group Commercial |
$15,283.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,989.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,704.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,113.28
|
| Rate for Payer: Multiplan Commercial |
$20,377.60
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$21,651.20
|
|
|
HC TRANSCATH TRICUSP VALVE ANNUL
|
Facility
|
OP
|
$82,271.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906810545
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$542.56 |
| Max. Negotiated Rate |
$69,930.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,933.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69,930.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45,249.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45,249.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,375.00
|
| Rate for Payer: Blue Distinction Transplant |
$49,362.60
|
| Rate for Payer: Blue Shield of California Commercial |
$833.61
|
| Rate for Payer: Blue Shield of California EPN |
$542.56
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cigna of CA PPO |
$60,880.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69,930.35
|
| Rate for Payer: Dignity Health Media |
$69,930.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$69,930.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$61,703.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31,345.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,745.04
|
| Rate for Payer: Multiplan Commercial |
$65,816.80
|
| Rate for Payer: Networks By Design Commercial |
$53,476.15
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49,362.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69,930.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69,930.35
|
| Rate for Payer: Vantage Medical Group Senior |
$69,930.35
|
|
|
HC TRANSCATH TRICUSP VALVE ANNUL
|
Facility
|
IP
|
$82,271.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906810545
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$19,745.04 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31,345.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19,745.04
|
| Rate for Payer: Multiplan Commercial |
$65,816.80
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
|
