|
HC INSERT NON-INDWEL BLADDER CATH
|
Facility
|
IP
|
$368.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
906811389
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$73.60 |
| Max. Negotiated Rate |
$312.80 |
| Rate for Payer: Adventist Health Commercial |
$73.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$147.20
|
| Rate for Payer: EPIC Health Plan Senior |
$147.20
|
| Rate for Payer: Galaxy Health WC |
$312.80
|
| Rate for Payer: Global Benefits Group Commercial |
$220.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$245.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$227.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.32
|
| Rate for Payer: Multiplan Commercial |
$294.40
|
| Rate for Payer: Networks By Design Commercial |
$239.20
|
| Rate for Payer: Prime Health Services Commercial |
$312.80
|
|
|
HC INSERT NON-INDWEL BLADDER CATH
|
Facility
|
OP
|
$382.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
909001904
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$76.40 |
| Max. Negotiated Rate |
$6,906.11 |
| Rate for Payer: Adventist Health Commercial |
$76.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,906.11
|
| Rate for Payer: Blue Shield of California EPN |
$4,560.14
|
| Rate for Payer: Cash Price |
$171.90
|
| Rate for Payer: Cash Price |
$171.90
|
| Rate for Payer: Cash Price |
$171.90
|
| Rate for Payer: Cigna of CA HMO |
$244.48
|
| Rate for Payer: Cigna of CA PPO |
$282.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$324.70
|
| Rate for Payer: Global Benefits Group Commercial |
$229.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$184.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$254.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$208.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$305.60
|
| Rate for Payer: Multiplan WC |
$260.96
|
| Rate for Payer: Networks By Design Commercial |
$248.30
|
| Rate for Payer: Prime Health Services Commercial |
$324.70
|
| Rate for Payer: Prime Health Services WC |
$258.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$229.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC INSERT NON-INDWEL BLADDER CATH
|
Facility
|
OP
|
$345.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
906820132
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$69.00 |
| Max. Negotiated Rate |
$5,398.00 |
| Rate for Payer: Adventist Health Commercial |
$69.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$163.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Cash Price |
$155.25
|
| Rate for Payer: Cigna of CA HMO |
$220.80
|
| Rate for Payer: Cigna of CA PPO |
$255.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$245.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$180.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$163.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.10
|
| Rate for Payer: EPIC Health Plan Senior |
$163.78
|
| Rate for Payer: Galaxy Health WC |
$293.25
|
| Rate for Payer: Global Benefits Group Commercial |
$207.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$268.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$184.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$163.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$230.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$208.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$82.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$206.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.47
|
| Rate for Payer: Multiplan Commercial |
$276.00
|
| Rate for Payer: Networks By Design Commercial |
$224.25
|
| Rate for Payer: Prime Health Services Commercial |
$293.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$207.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$207.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$172.50
|
| Rate for Payer: United Healthcare All Other HMO |
$172.50
|
| Rate for Payer: United Healthcare HMO Rider |
$172.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$172.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$163.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$245.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$180.16
|
| Rate for Payer: Vantage Medical Group Senior |
$163.78
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
OP
|
$3,868.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$164.10 |
| Max. Negotiated Rate |
$6,558.70 |
| Rate for Payer: Adventist Health Commercial |
$773.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$1,740.60
|
| Rate for Payer: Cash Price |
$1,740.60
|
| Rate for Payer: Cash Price |
$1,740.60
|
| Rate for Payer: Cigna of CA HMO |
$2,475.52
|
| Rate for Payer: Cigna of CA PPO |
$2,862.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$3,287.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,320.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,579.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$928.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$3,094.40
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$2,514.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,287.80
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,320.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,934.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,934.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,934.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,934.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
IP
|
$3,868.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$773.60 |
| Max. Negotiated Rate |
$3,287.80 |
| Rate for Payer: Adventist Health Commercial |
$773.60
|
| Rate for Payer: Cash Price |
$1,740.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,547.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,547.20
|
| Rate for Payer: Galaxy Health WC |
$3,287.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,320.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,579.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,473.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,394.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$928.32
|
| Rate for Payer: Multiplan Commercial |
$3,094.40
|
| Rate for Payer: Networks By Design Commercial |
$2,514.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,287.80
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
IP
|
$3,958.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906820087
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$791.60 |
| Max. Negotiated Rate |
$3,364.30 |
| Rate for Payer: Adventist Health Commercial |
$791.60
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,583.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,583.20
|
| Rate for Payer: Galaxy Health WC |
$3,364.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,374.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,639.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,508.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,450.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$949.92
|
| Rate for Payer: Multiplan Commercial |
$3,166.40
|
| Rate for Payer: Networks By Design Commercial |
$2,572.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,364.30
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
OP
|
$3,868.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$145.10 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$773.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,740.60
|
| Rate for Payer: Cash Price |
$1,740.60
|
| Rate for Payer: Cash Price |
$1,740.60
|
| Rate for Payer: Cigna of CA HMO |
$2,514.20
|
| Rate for Payer: Cigna of CA PPO |
$2,862.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$3,287.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,320.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$145.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,579.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$928.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$3,094.40
|
| Rate for Payer: Networks By Design Commercial |
$2,514.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,287.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,320.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,320.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
OP
|
$3,958.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906820087
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$145.10 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$791.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: Cash Price |
$1,781.10
|
| Rate for Payer: Cigna of CA HMO |
$2,572.70
|
| Rate for Payer: Cigna of CA PPO |
$2,928.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$3,364.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,374.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$145.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,639.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$949.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$3,166.40
|
| Rate for Payer: Networks By Design Commercial |
$2,572.70
|
| Rate for Payer: Prime Health Services Commercial |
$3,364.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,374.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,374.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
IP
|
$3,868.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$773.60 |
| Max. Negotiated Rate |
$3,287.80 |
| Rate for Payer: Adventist Health Commercial |
$773.60
|
| Rate for Payer: Cash Price |
$1,740.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,547.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,547.20
|
| Rate for Payer: Galaxy Health WC |
$3,287.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,320.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,579.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,473.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,394.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$928.32
|
| Rate for Payer: Multiplan Commercial |
$3,094.40
|
| Rate for Payer: Networks By Design Commercial |
$2,514.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,287.80
|
|
|
HC INSERT NON-TNNL CV CATH LT 5YR
|
Facility
|
OP
|
$3,868.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
909081358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$145.10 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$773.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,740.60
|
| Rate for Payer: Cash Price |
$1,740.60
|
| Rate for Payer: Cash Price |
$1,740.60
|
| Rate for Payer: Cigna of CA HMO |
$2,475.52
|
| Rate for Payer: Cigna of CA PPO |
$2,862.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$3,287.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,320.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$145.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,579.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$928.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$3,094.40
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$2,514.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,287.80
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,320.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TNNL CV CATH LT 5YR
|
Facility
|
IP
|
$3,868.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
909081358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$773.60 |
| Max. Negotiated Rate |
$3,287.80 |
| Rate for Payer: Adventist Health Commercial |
$773.60
|
| Rate for Payer: Cash Price |
$1,740.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,547.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,547.20
|
| Rate for Payer: Galaxy Health WC |
$3,287.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,320.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,579.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,473.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,394.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$928.32
|
| Rate for Payer: Multiplan Commercial |
$3,094.40
|
| Rate for Payer: Networks By Design Commercial |
$2,514.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,287.80
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$6,602.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906820086
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$124.47 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$1,320.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$2,970.90
|
| Rate for Payer: Cash Price |
$2,970.90
|
| Rate for Payer: Cash Price |
$2,970.90
|
| Rate for Payer: Cigna of CA HMO |
$4,225.28
|
| Rate for Payer: Cigna of CA PPO |
$4,885.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$5,611.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,961.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$124.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,403.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,584.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$5,281.60
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,291.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,611.70
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,961.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$5,612.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$124.47 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$1,122.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$2,525.40
|
| Rate for Payer: Cash Price |
$2,525.40
|
| Rate for Payer: Cash Price |
$2,525.40
|
| Rate for Payer: Cigna of CA HMO |
$3,591.68
|
| Rate for Payer: Cigna of CA PPO |
$4,152.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$4,770.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,367.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$124.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,743.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,346.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$4,489.60
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$3,647.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,770.20
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,367.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$5,612.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,122.40 |
| Max. Negotiated Rate |
$4,770.20 |
| Rate for Payer: Adventist Health Commercial |
$1,122.40
|
| Rate for Payer: Cash Price |
$2,525.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,244.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,244.80
|
| Rate for Payer: Galaxy Health WC |
$4,770.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,367.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,743.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,138.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,473.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,346.88
|
| Rate for Payer: Multiplan Commercial |
$4,489.60
|
| Rate for Payer: Networks By Design Commercial |
$3,647.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,770.20
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$5,612.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
901200045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$124.47 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$1,122.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$2,525.40
|
| Rate for Payer: Cash Price |
$2,525.40
|
| Rate for Payer: Cash Price |
$2,525.40
|
| Rate for Payer: Cigna of CA HMO |
$3,591.68
|
| Rate for Payer: Cigna of CA PPO |
$4,152.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$4,770.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,367.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$124.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,743.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,346.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$4,489.60
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$3,647.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,770.20
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,367.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$5,612.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.77 |
| Max. Negotiated Rate |
$6,558.70 |
| Rate for Payer: Adventist Health Commercial |
$1,122.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Cash Price |
$2,525.40
|
| Rate for Payer: Cash Price |
$2,525.40
|
| Rate for Payer: Cash Price |
$2,525.40
|
| Rate for Payer: Cigna of CA HMO |
$3,591.68
|
| Rate for Payer: Cigna of CA PPO |
$4,152.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$4,770.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,367.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,743.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,346.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$4,489.60
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$3,647.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,770.20
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,367.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,806.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,806.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,806.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,806.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$5,612.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
901200045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,122.40 |
| Max. Negotiated Rate |
$4,770.20 |
| Rate for Payer: Adventist Health Commercial |
$1,122.40
|
| Rate for Payer: Cash Price |
$2,525.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,244.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,244.80
|
| Rate for Payer: Galaxy Health WC |
$4,770.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,367.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,743.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,138.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,473.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,346.88
|
| Rate for Payer: Multiplan Commercial |
$4,489.60
|
| Rate for Payer: Networks By Design Commercial |
$3,647.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,770.20
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$6,602.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906820086
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,320.40 |
| Max. Negotiated Rate |
$5,611.70 |
| Rate for Payer: Adventist Health Commercial |
$1,320.40
|
| Rate for Payer: Cash Price |
$2,970.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,640.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,640.80
|
| Rate for Payer: Galaxy Health WC |
$5,611.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,961.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,403.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,515.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,584.48
|
| Rate for Payer: Multiplan Commercial |
$5,281.60
|
| Rate for Payer: Networks By Design Commercial |
$4,291.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,611.70
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$5,612.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,122.40 |
| Max. Negotiated Rate |
$4,770.20 |
| Rate for Payer: Adventist Health Commercial |
$1,122.40
|
| Rate for Payer: Cash Price |
$2,525.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,244.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,244.80
|
| Rate for Payer: Galaxy Health WC |
$4,770.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,367.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,743.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,138.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,473.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,346.88
|
| Rate for Payer: Multiplan Commercial |
$4,489.60
|
| Rate for Payer: Networks By Design Commercial |
$3,647.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,770.20
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
OP
|
$30,619.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906820320
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$507.26 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$6,123.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26,026.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,840.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,964.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$570.02
|
| Rate for Payer: Cash Price |
$13,778.55
|
| Rate for Payer: Cash Price |
$13,778.55
|
| Rate for Payer: Cash Price |
$13,778.55
|
| Rate for Payer: Cigna of CA HMO |
$19,596.16
|
| Rate for Payer: Cigna of CA PPO |
$22,658.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26,026.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,026.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26,026.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,247.60
|
| Rate for Payer: EPIC Health Plan Senior |
$12,247.60
|
| Rate for Payer: Galaxy Health WC |
$26,026.15
|
| Rate for Payer: Global Benefits Group Commercial |
$18,371.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$507.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,422.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$573.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,953.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,348.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21,433.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21,433.30
|
| Rate for Payer: Multiplan Commercial |
$24,495.20
|
| Rate for Payer: Networks By Design Commercial |
$19,902.35
|
| Rate for Payer: Prime Health Services Commercial |
$26,026.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,371.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26,026.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,026.15
|
| Rate for Payer: Vantage Medical Group Senior |
$26,026.15
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
IP
|
$30,619.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906820320
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,123.80 |
| Max. Negotiated Rate |
$26,026.15 |
| Rate for Payer: Adventist Health Commercial |
$6,123.80
|
| Rate for Payer: Cash Price |
$13,778.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,247.60
|
| Rate for Payer: EPIC Health Plan Senior |
$12,247.60
|
| Rate for Payer: Galaxy Health WC |
$26,026.15
|
| Rate for Payer: Global Benefits Group Commercial |
$18,371.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,422.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,665.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,953.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,348.56
|
| Rate for Payer: Multiplan Commercial |
$24,495.20
|
| Rate for Payer: Networks By Design Commercial |
$19,902.35
|
| Rate for Payer: Prime Health Services Commercial |
$26,026.15
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
IP
|
$31,505.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906811995
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,301.00 |
| Max. Negotiated Rate |
$26,779.25 |
| Rate for Payer: Adventist Health Commercial |
$6,301.00
|
| Rate for Payer: Cash Price |
$14,177.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,602.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12,602.00
|
| Rate for Payer: Galaxy Health WC |
$26,779.25
|
| Rate for Payer: Global Benefits Group Commercial |
$18,903.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,013.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,003.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,501.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,561.20
|
| Rate for Payer: Multiplan Commercial |
$25,204.00
|
| Rate for Payer: Networks By Design Commercial |
$20,478.25
|
| Rate for Payer: Prime Health Services Commercial |
$26,779.25
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
OP
|
$31,505.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906811995
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$507.26 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$6,301.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26,779.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17,327.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,628.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$570.02
|
| Rate for Payer: Cash Price |
$14,177.25
|
| Rate for Payer: Cash Price |
$14,177.25
|
| Rate for Payer: Cash Price |
$14,177.25
|
| Rate for Payer: Cigna of CA HMO |
$20,163.20
|
| Rate for Payer: Cigna of CA PPO |
$23,313.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26,779.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,779.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26,779.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,602.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12,602.00
|
| Rate for Payer: Galaxy Health WC |
$26,779.25
|
| Rate for Payer: Global Benefits Group Commercial |
$18,903.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$507.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,013.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$573.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,501.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,561.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,053.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,053.50
|
| Rate for Payer: Multiplan Commercial |
$25,204.00
|
| Rate for Payer: Networks By Design Commercial |
$20,478.25
|
| Rate for Payer: Prime Health Services Commercial |
$26,779.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,903.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26,779.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,779.25
|
| Rate for Payer: Vantage Medical Group Senior |
$26,779.25
|
|
|
HC INSERT PERM INTRAPERITONEAL CATH/DIALYSIS
|
Facility
|
IP
|
$11,711.00
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
909000217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,342.20 |
| Max. Negotiated Rate |
$9,954.35 |
| Rate for Payer: Adventist Health Commercial |
$2,342.20
|
| Rate for Payer: Cash Price |
$5,269.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,684.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,684.40
|
| Rate for Payer: Galaxy Health WC |
$9,954.35
|
| Rate for Payer: Global Benefits Group Commercial |
$7,026.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,811.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,461.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,249.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,810.64
|
| Rate for Payer: Multiplan Commercial |
$9,368.80
|
| Rate for Payer: Networks By Design Commercial |
$7,612.15
|
| Rate for Payer: Prime Health Services Commercial |
$9,954.35
|
|
|
HC INSERT PERM INTRAPERITONEAL CATH/DIALYSIS
|
Facility
|
OP
|
$11,711.00
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
909000217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$327.75 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,342.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,484.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$5,269.95
|
| Rate for Payer: Cash Price |
$5,269.95
|
| Rate for Payer: Cash Price |
$5,269.95
|
| Rate for Payer: Cigna of CA HMO |
$7,495.04
|
| Rate for Payer: Cigna of CA PPO |
$8,666.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,932.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,484.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,053.43
|
| Rate for Payer: EPIC Health Plan Senior |
$4,484.02
|
| Rate for Payer: Galaxy Health WC |
$9,954.35
|
| Rate for Payer: Global Benefits Group Commercial |
$7,026.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,353.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$327.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,484.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,811.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$370.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,484.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,810.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,649.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,008.59
|
| Rate for Payer: Multiplan Commercial |
$9,368.80
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: Networks By Design Commercial |
$7,612.15
|
| Rate for Payer: Prime Health Services Commercial |
$9,954.35
|
| Rate for Payer: Prime Health Services WC |
$7,071.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,026.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,484.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,726.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,932.42
|
| Rate for Payer: Vantage Medical Group Senior |
$4,484.02
|
|
