|
HC TRANSBRONCHIAL LUNG BIOPSY
|
Facility
IP
|
$5,728.00
|
|
|
Service Code
|
CPT 31628
|
| Hospital Charge Code |
900803504
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,374.72 |
| Max. Negotiated Rate |
$4,868.80 |
| Rate for Payer: Cash Price |
$2,577.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,291.20
|
| Rate for Payer: Galaxy Health WC |
$4,868.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,436.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,820.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,182.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,374.72
|
| Rate for Payer: Multiplan Commercial |
$4,582.40
|
| Rate for Payer: Networks By Design Commercial |
$3,723.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,868.80
|
|
|
HC TRANSBRONCHIAL LUNG BIOPSY
|
Facility
OP
|
$5,728.00
|
|
|
Service Code
|
CPT 31628
|
| Hospital Charge Code |
900803504
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$400.37 |
| Max. Negotiated Rate |
$7,673.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,678.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,436.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,221.54
|
| Rate for Payer: Blue Shield of California EPN |
$3,345.15
|
| Rate for Payer: Cash Price |
$2,577.60
|
| Rate for Payer: Cash Price |
$2,577.60
|
| Rate for Payer: Cigna of CA HMO |
$3,665.92
|
| Rate for Payer: Cigna of CA PPO |
$4,238.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Dignity Health Media |
$4,678.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,146.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,316.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,678.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,678.93
|
| Rate for Payer: Galaxy Health WC |
$4,868.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,436.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,296.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,673.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$7,673.45
|
| Rate for Payer: IEHP Medi-Cal |
$7,579.87
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$7,579.87
|
| Rate for Payer: IEHP Medicare Advantage |
$4,678.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,820.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,678.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,374.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,895.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,269.77
|
| Rate for Payer: Multiplan Commercial |
$4,582.40
|
| Rate for Payer: Networks By Design Commercial |
$3,723.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,868.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,436.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,436.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,436.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,864.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,864.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,864.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,864.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4,678.93
|
|
|
HC TRANSBRONCHIAL LUNG BX, ADD'L
|
Facility
OP
|
$4,906.00
|
|
|
Service Code
|
CPT 31632
|
| Hospital Charge Code |
900803507
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.63 |
| 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 |
$4,170.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,698.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,698.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,943.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,615.72
|
| Rate for Payer: Blue Shield of California EPN |
$2,865.10
|
| Rate for Payer: Cash Price |
$2,207.70
|
| Rate for Payer: Cash Price |
$2,207.70
|
| Rate for Payer: Cigna of CA HMO |
$3,139.84
|
| Rate for Payer: Cigna of CA PPO |
$3,630.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,170.10
|
| Rate for Payer: Dignity Health Media |
$4,170.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,170.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,962.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,962.40
|
| Rate for Payer: Galaxy Health WC |
$4,170.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,943.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,679.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,272.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$112.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,177.44
|
| Rate for Payer: Multiplan Commercial |
$3,924.80
|
| Rate for Payer: Networks By Design Commercial |
$3,188.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,170.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,943.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,943.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,943.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,453.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,453.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,453.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,453.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,170.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,170.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,170.10
|
|
|
HC TRANSBRONCHIAL LUNG BX, ADD'L
|
Facility
IP
|
$4,906.00
|
|
|
Service Code
|
CPT 31632
|
| Hospital Charge Code |
900803507
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,177.44 |
| Max. Negotiated Rate |
$4,170.10 |
| Rate for Payer: Cash Price |
$2,207.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,962.40
|
| Rate for Payer: Galaxy Health WC |
$4,170.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,943.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,272.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,869.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,177.44
|
| Rate for Payer: Multiplan Commercial |
$3,924.80
|
| Rate for Payer: Networks By Design Commercial |
$3,188.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,170.10
|
|
|
HC TRANSBRONCHIAL NEEDLE BX ADD'L
|
Facility
IP
|
$4,491.00
|
|
|
Service Code
|
CPT 31633
|
| Hospital Charge Code |
900803509
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,077.84 |
| Max. Negotiated Rate |
$3,817.35 |
| Rate for Payer: Cash Price |
$2,020.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,796.40
|
| Rate for Payer: Galaxy Health WC |
$3,817.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,694.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,995.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,711.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,077.84
|
| Rate for Payer: Multiplan Commercial |
$3,592.80
|
| Rate for Payer: Networks By Design Commercial |
$2,919.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,817.35
|
|
|
HC TRANSBRONCHIAL NEEDLE BX ADD'L
|
Facility
OP
|
$4,491.00
|
|
|
Service Code
|
CPT 31633
|
| Hospital Charge Code |
900803509
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$138.98 |
| 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 |
$3,817.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,470.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,470.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,984.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,694.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,309.87
|
| Rate for Payer: Blue Shield of California EPN |
$2,622.74
|
| Rate for Payer: Cash Price |
$2,020.95
|
| Rate for Payer: Cash Price |
$2,020.95
|
| Rate for Payer: Cigna of CA HMO |
$2,874.24
|
| Rate for Payer: Cigna of CA PPO |
$3,323.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.35
|
| Rate for Payer: Dignity Health Media |
$3,817.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,817.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,796.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,796.40
|
| Rate for Payer: Galaxy Health WC |
$3,817.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,694.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,368.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,995.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$138.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,077.84
|
| Rate for Payer: Multiplan Commercial |
$3,592.80
|
| Rate for Payer: Networks By Design Commercial |
$2,919.15
|
| Rate for Payer: Prime Health Services Commercial |
$3,817.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,694.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,694.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,694.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,245.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,245.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,245.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,245.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,817.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,817.35
|
| Rate for Payer: Vantage Medical Group Senior |
$3,817.35
|
|
|
HC TRANSBRONCHIAL W/NEEDLE BIOPSY
|
Facility
OP
|
$4,708.00
|
|
|
Service Code
|
CPT 31629
|
| Hospital Charge Code |
900803508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$353.68 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,678.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,938.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,824.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$2,118.60
|
| Rate for Payer: Cash Price |
$2,118.60
|
| Rate for Payer: Cigna of CA PPO |
$3,483.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Dignity Health Media |
$4,678.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,146.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,316.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,678.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,678.93
|
| Rate for Payer: Galaxy Health WC |
$4,001.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,824.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,531.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,673.45
|
| Rate for Payer: Heritage Provider Network Transplant |
$7,673.45
|
| Rate for Payer: IEHP Medi-Cal |
$7,579.87
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$7,579.87
|
| Rate for Payer: IEHP Medicare Advantage |
$4,678.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,140.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$353.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,678.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,129.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,895.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,269.77
|
| Rate for Payer: Multiplan Commercial |
$3,766.40
|
| Rate for Payer: Networks By Design Commercial |
$3,060.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,001.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,824.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,824.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4,678.93
|
|
|
HC TRANSBRONCHIAL W/NEEDLE BIOPSY
|
Facility
IP
|
$4,708.00
|
|
|
Service Code
|
CPT 31629
|
| Hospital Charge Code |
900803508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,129.92 |
| Max. Negotiated Rate |
$4,001.80 |
| Rate for Payer: Cash Price |
$2,118.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,883.20
|
| Rate for Payer: Galaxy Health WC |
$4,001.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,824.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,140.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,793.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,129.92
|
| Rate for Payer: Multiplan Commercial |
$3,766.40
|
| Rate for Payer: Networks By Design Commercial |
$3,060.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,001.80
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
OP
|
$38,623.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906812218
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,147.45 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| 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 |
$8,628.00
|
| Rate for Payer: BCBS Transplant Transplant |
$23,173.80
|
| 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 |
$17,380.35
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Cigna of CA PPO |
$28,581.02
|
| 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 |
$32,829.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,173.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$28,967.25
|
| 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 |
$25,761.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,147.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,269.52
|
| 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 |
$30,898.40
|
| Rate for Payer: Networks By Design Commercial |
$25,104.95
|
| Rate for Payer: Prime Health Services Commercial |
$32,829.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23,173.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,173.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23,173.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| 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 TRANS CATH CLOSURE/ASD
|
Facility
IP
|
$38,623.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906812218
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,269.52 |
| Max. Negotiated Rate |
$32,829.55 |
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,449.20
|
| Rate for Payer: Galaxy Health WC |
$32,829.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,173.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,761.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,715.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,269.52
|
| Rate for Payer: Multiplan Commercial |
$30,898.40
|
| Rate for Payer: Networks By Design Commercial |
$25,104.95
|
| Rate for Payer: Prime Health Services Commercial |
$32,829.55
|
|
|
HC TRANS CATH CLOSURE/VSD
|
Facility
OP
|
$27,956.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906812219
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,445.37 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| 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 |
$8,628.00
|
| Rate for Payer: BCBS Transplant Transplant |
$16,773.60
|
| 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 |
$12,580.20
|
| Rate for Payer: Cash Price |
$12,580.20
|
| Rate for Payer: Cash Price |
$12,580.20
|
| Rate for Payer: Cigna of CA PPO |
$20,687.44
|
| 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 |
$23,762.60
|
| Rate for Payer: Global Benefits Group Commercial |
$16,773.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20,967.00
|
| 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 |
$18,646.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,445.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,709.44
|
| 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 |
$22,364.80
|
| Rate for Payer: Networks By Design Commercial |
$18,171.40
|
| Rate for Payer: Prime Health Services Commercial |
$23,762.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16,773.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,773.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,773.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| 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 TRANS CATH CLOSURE/VSD
|
Facility
IP
|
$27,956.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906812219
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,709.44 |
| Max. Negotiated Rate |
$23,762.60 |
| Rate for Payer: Cash Price |
$12,580.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,182.40
|
| Rate for Payer: Galaxy Health WC |
$23,762.60
|
| Rate for Payer: Global Benefits Group Commercial |
$16,773.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,646.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,651.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,709.44
|
| Rate for Payer: Multiplan Commercial |
$22,364.80
|
| Rate for Payer: Networks By Design Commercial |
$18,171.40
|
| Rate for Payer: Prime Health Services Commercial |
$23,762.60
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
IP
|
$7,369.00
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
909081664
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,768.56 |
| Max. Negotiated Rate |
$6,263.65 |
| Rate for Payer: Cash Price |
$3,316.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,947.60
|
| Rate for Payer: Galaxy Health WC |
$6,263.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,421.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,915.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,807.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,768.56
|
| Rate for Payer: Multiplan Commercial |
$5,895.20
|
| Rate for Payer: Networks By Design Commercial |
$4,789.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,263.65
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
OP
|
$7,369.00
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
909081664
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,768.56 |
| Max. Negotiated Rate |
$6,263.65 |
| Rate for Payer: Cigna of CA PPO |
$5,453.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,668.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,263.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,052.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,052.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,996.69
|
| Rate for Payer: BCBS Transplant Transplant |
$4,421.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,355.08
|
| Rate for Payer: Blue Shield of California EPN |
$3,456.06
|
| Rate for Payer: Cash Price |
$3,316.05
|
| Rate for Payer: Cash Price |
$3,316.05
|
| Rate for Payer: Cigna of CA HMO |
$4,716.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,263.65
|
| Rate for Payer: Dignity Health Media |
$6,263.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,263.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,947.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,947.60
|
| Rate for Payer: Galaxy Health WC |
$6,263.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,421.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,526.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,915.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,768.56
|
| Rate for Payer: Multiplan Commercial |
$5,895.20
|
| Rate for Payer: Networks By Design Commercial |
$4,789.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,263.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,421.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,421.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,421.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,684.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,684.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,684.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,684.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,263.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,263.65
|
| Rate for Payer: Vantage Medical Group Senior |
$6,263.65
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
IP
|
$8,180.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
909081356
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,963.20 |
| Max. Negotiated Rate |
$6,953.00 |
| Rate for Payer: Cash Price |
$3,681.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,272.00
|
| Rate for Payer: Galaxy Health WC |
$6,953.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,908.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,456.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,116.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,963.20
|
| Rate for Payer: Multiplan Commercial |
$6,544.00
|
| Rate for Payer: Networks By Design Commercial |
$5,317.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,953.00
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
OP
|
$8,180.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
909081356
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$261.72 |
| 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 |
$10,299.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: AlphaCare 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: BCBS Transplant Transplant |
$4,908.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,834.38
|
| Rate for Payer: Blue Shield of California EPN |
$3,836.42
|
| Rate for Payer: Cash Price |
$3,681.00
|
| Rate for Payer: Cash Price |
$3,681.00
|
| Rate for Payer: Cigna of CA HMO |
$5,235.20
|
| Rate for Payer: Cigna of CA PPO |
$6,053.20
|
| 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 |
$6,953.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,908.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,135.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,260.35
|
| Rate for Payer: Heritage Provider Network Transplant |
$11,260.35
|
| Rate for Payer: IEHP Medi-Cal |
$11,123.03
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$11,123.03
|
| Rate for Payer: IEHP Medicare Advantage |
$6,866.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,456.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$261.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,963.20
|
| 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 |
$6,544.00
|
| Rate for Payer: Networks By Design Commercial |
$5,317.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,953.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,908.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,908.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,908.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,090.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,090.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,090.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,090.00
|
| 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 TRANSCATHETER RETRIEVAL
|
Facility
IP
|
$17,550.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906811451
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,212.00 |
| Max. Negotiated Rate |
$14,917.50 |
| Rate for Payer: Cash Price |
$7,897.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,020.00
|
| Rate for Payer: Galaxy Health WC |
$14,917.50
|
| Rate for Payer: Global Benefits Group Commercial |
$10,530.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,705.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,686.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,212.00
|
| Rate for Payer: Multiplan Commercial |
$14,040.00
|
| Rate for Payer: Networks By Design Commercial |
$11,407.50
|
| Rate for Payer: Prime Health Services Commercial |
$14,917.50
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
OP
|
$17,550.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906811451
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$481.73 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,282.00
|
| Rate for Payer: BCBS Transplant Transplant |
$10,530.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,612.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,351.09
|
| Rate for Payer: Cash Price |
$7,897.50
|
| Rate for Payer: Cash Price |
$7,897.50
|
| Rate for Payer: Cigna of CA PPO |
$12,987.00
|
| 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 |
$14,917.50
|
| Rate for Payer: Global Benefits Group Commercial |
$10,530.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13,162.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,531.38
|
| Rate for Payer: Heritage Provider Network Transplant |
$6,531.38
|
| Rate for Payer: IEHP Medi-Cal |
$6,451.73
|
| Rate for Payer: IEHP Medi-Cal Transplant |
$6,451.73
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,705.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$481.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,212.00
|
| 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 |
$14,040.00
|
| Rate for Payer: Networks By Design Commercial |
$11,407.50
|
| Rate for Payer: Prime Health Services Commercial |
$14,917.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10,530.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,530.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,530.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC TRANSCATH MITRAL VAL REPAIR AD
|
Facility
IP
|
$25,472.00
|
|
|
Service Code
|
CPT 33419
|
| Hospital Charge Code |
906811489
|
|
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 MITRAL VAL REPAIR AD
|
Facility
OP
|
$25,472.00
|
|
|
Service Code
|
CPT 33419
|
| Hospital Charge Code |
906811489
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$141.47 |
| Max. Negotiated Rate |
$21,651.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,685.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21,651.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,009.60
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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 Transplant 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 |
$141.47
|
| 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: Redlands Yucaipa Medical Group Commercial/Senior |
$15,283.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,283.20
|
| 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 |
$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 MITRAL VALVE ANNUL
|
Facility
IP
|
$82,271.00
|
|
|
Service Code
|
CPT 0544T
|
| Hospital Charge Code |
906810544
|
|
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
|
|
|
HC TRANSCATH MITRAL VALVE ANNUL
|
Facility
OP
|
$82,271.00
|
|
|
Service Code
|
CPT 0544T
|
| Hospital Charge Code |
906810544
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$69,930.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$45,249.05
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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 Transplant 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: Redlands Yucaipa Medical Group Commercial/Senior |
$49,362.60
|
| 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 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: AlphaCare Medical Group Commercial/Exchange |
$69,930.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$45,249.05
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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 Transplant 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: Redlands Yucaipa Medical Group Commercial/Senior |
$49,362.60
|
| 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 VALVE REPAIR
|
Facility
IP
|
$82,271.00
|
|
|
Service Code
|
CPT 33418
|
| Hospital Charge Code |
906811487
|
|
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
|
|
|
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
|
|
