|
HC INSERT NON-INDWEL BLADDER CATH
|
Facility
|
IP
|
$382.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
909001904
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$76.40 |
| Max. Negotiated Rate |
$324.70 |
| Rate for Payer: Adventist Health Commercial |
$76.40
|
| Rate for Payer: Cash Price |
$171.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$267.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$152.80
|
| Rate for Payer: EPIC Health Plan Senior |
$152.80
|
| Rate for Payer: Galaxy Health WC |
$324.70
|
| Rate for Payer: Global Benefits Group Commercial |
$229.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$242.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$225.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.68
|
| Rate for Payer: Multiplan Commercial |
$305.60
|
| Rate for Payer: Networks By Design Commercial |
$248.30
|
| Rate for Payer: Prime Health Services Commercial |
$324.70
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$257.60
|
| 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 Foundation Hospitals Commercial/Self Funded |
$233.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$217.12
|
| 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$76.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| 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 |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$267.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$324.70
|
| Rate for Payer: Global Benefits Group Commercial |
$229.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$184.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$242.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$208.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$215.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$229.30
|
| 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 |
$191.00
|
| 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 |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC INSERT NON-INDWEL BLADDER CATH
|
Facility
|
OP
|
$368.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
906811389
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$73.60 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$73.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$203.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cash Price |
$165.60
|
| Rate for Payer: Cigna of CA HMO |
$235.52
|
| Rate for Payer: Cigna of CA PPO |
$272.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$257.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$312.80
|
| Rate for Payer: Global Benefits Group Commercial |
$220.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$184.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$233.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$208.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$215.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$229.30
|
| 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
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$220.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$220.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$184.00
|
| Rate for Payer: United Healthcare All Other HMO |
$184.00
|
| Rate for Payer: United Healthcare HMO Rider |
$184.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$184.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$773.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| 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 |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,707.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| 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/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$145.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,456.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$164.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$928.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| 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 |
$1,934.00
|
| 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 |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,707.60
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,456.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,282.12
|
| 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
|
$3,868.00
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,707.60
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,456.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,282.12
|
| 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
|
OP
|
$3,868.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$164.10 |
| Max. Negotiated Rate |
$6,700.73 |
| Rate for Payer: Adventist Health Commercial |
$773.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,707.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| 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/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,456.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$164.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,365.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$928.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| 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 |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,707.60
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,456.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,282.12
|
| 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$773.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| 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 |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,707.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| 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/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$145.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,456.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$164.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$928.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| 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 |
$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 |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,122.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| 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 |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,928.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| 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/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$124.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,563.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,346.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| 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 |
$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 |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
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 |
$6,700.73 |
| Rate for Payer: Adventist Health Commercial |
$1,122.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| 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 |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,928.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| 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/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,563.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,365.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,346.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| 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 |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,122.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| 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 |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,928.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| 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/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$124.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,563.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,346.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| 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 |
$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 |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,928.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$3,563.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,311.08
|
| 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
|
$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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,928.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$3,563.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,311.08
|
| 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
|
$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: Galaxy Health WC |
$4,770.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,244.80
|
| Rate for Payer: Adventist Health Commercial |
$1,122.40
|
| Rate for Payer: Cash Price |
$2,525.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,928.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,367.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,563.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,311.08
|
| 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
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$22,053.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$20,005.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,587.95
|
| 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 |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$22,053.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$20,005.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$573.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,587.95
|
| 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 |
$15,752.50
|
| 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
|
OP
|
$11,711.00
|
|
|
Service Code
|
CPT 49418
|
| Hospital Charge Code |
909000217
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$327.75 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,342.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,604.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| 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 |
$6,907.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,065.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,604.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,197.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,598.23
|
| Rate for Payer: EPIC Health Plan Senior |
$5,065.49
|
| 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/Senior |
$7,552.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$327.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,604.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,436.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$370.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,446.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,810.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,802.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,170.69
|
| 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 |
$5,855.50
|
| 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 |
$4,604.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Vantage Medical Group Senior |
$4,604.99
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,197.70
|
| 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 Foundation Hospitals Commercial/Self Funded |
$7,436.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,909.49
|
| 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 PLEURAL CATH W CUFF
|
Facility
|
OP
|
$13,506.00
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
909020011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,006.99 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,701.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,604.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$6,077.70
|
| Rate for Payer: Cash Price |
$6,077.70
|
| Rate for Payer: Cash Price |
$6,077.70
|
| Rate for Payer: Cigna of CA HMO |
$8,643.84
|
| Rate for Payer: Cigna of CA PPO |
$9,994.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,065.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,604.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,454.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,598.23
|
| Rate for Payer: EPIC Health Plan Senior |
$5,065.49
|
| Rate for Payer: Galaxy Health WC |
$11,480.10
|
| Rate for Payer: Global Benefits Group Commercial |
$8,103.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,552.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,006.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,604.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,576.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,138.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,446.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,241.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,802.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,170.69
|
| Rate for Payer: Multiplan Commercial |
$10,804.80
|
| Rate for Payer: Multiplan WC |
$7,144.49
|
| Rate for Payer: Networks By Design Commercial |
$8,778.90
|
| Rate for Payer: Prime Health Services Commercial |
$11,480.10
|
| Rate for Payer: Prime Health Services WC |
$7,071.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,103.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,753.00
|
| 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 |
$4,604.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,907.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,065.49
|
| Rate for Payer: Vantage Medical Group Senior |
$4,604.99
|
|
|
HC INSERT PLEURAL CATH W CUFF
|
Facility
|
IP
|
$13,506.00
|
|
|
Service Code
|
CPT 32550
|
| Hospital Charge Code |
909020011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,701.20 |
| Max. Negotiated Rate |
$11,480.10 |
| Rate for Payer: Adventist Health Commercial |
$2,701.20
|
| Rate for Payer: Cash Price |
$6,077.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,454.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,402.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,402.40
|
| Rate for Payer: Galaxy Health WC |
$11,480.10
|
| Rate for Payer: Global Benefits Group Commercial |
$8,103.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,576.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,968.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,241.44
|
| Rate for Payer: Multiplan Commercial |
$10,804.80
|
| Rate for Payer: Networks By Design Commercial |
$8,778.90
|
| Rate for Payer: Prime Health Services Commercial |
$11,480.10
|
|
|
HC INSERT & REMOVE BONE PIN/WIRE
|
Facility
|
OP
|
$9,211.00
|
|
|
Service Code
|
CPT 20650
|
| Hospital Charge Code |
900501245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$198.06 |
| Max. Negotiated Rate |
$8,240.00 |
| Rate for Payer: Galaxy Health WC |
$7,829.35
|
| Rate for Payer: Adventist Health Commercial |
$1,842.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Cash Price |
$4,144.95
|
| Rate for Payer: Cash Price |
$4,144.95
|
| Rate for Payer: Cash Price |
$4,144.95
|
| Rate for Payer: Cigna of CA HMO |
$5,895.04
|
| Rate for Payer: Cigna of CA PPO |
$6,816.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,447.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Global Benefits Group Commercial |
$5,526.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,848.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$198.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,523.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,210.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,302.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,639.18
|
| Rate for Payer: Multiplan Commercial |
$7,368.80
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$5,987.15
|
| Rate for Payer: Prime Health Services Commercial |
$7,829.35
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,526.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,605.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,605.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,605.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,605.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
HC INSERT & REMOVE BONE PIN/WIRE
|
Facility
|
IP
|
$9,211.00
|
|
|
Service Code
|
CPT 20650
|
| Hospital Charge Code |
900501245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,842.20 |
| Max. Negotiated Rate |
$7,829.35 |
| Rate for Payer: Adventist Health Commercial |
$1,842.20
|
| Rate for Payer: Cash Price |
$4,144.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,447.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,684.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,684.40
|
| Rate for Payer: Galaxy Health WC |
$7,829.35
|
| Rate for Payer: Global Benefits Group Commercial |
$5,526.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,848.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,434.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,210.64
|
| Rate for Payer: Multiplan Commercial |
$7,368.80
|
| Rate for Payer: Networks By Design Commercial |
$5,987.15
|
| Rate for Payer: Prime Health Services Commercial |
$7,829.35
|
|
|
HC INSERT SUBQ DEFIB WELTRD
|
Facility
|
IP
|
$77,865.00
|
|
|
Service Code
|
CPT 33270
|
| Hospital Charge Code |
906811456
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,573.00 |
| Max. Negotiated Rate |
$66,185.25 |
| Rate for Payer: Adventist Health Commercial |
$15,573.00
|
| Rate for Payer: Cash Price |
$35,039.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54,505.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,146.00
|
| Rate for Payer: EPIC Health Plan Senior |
$31,146.00
|
| Rate for Payer: Galaxy Health WC |
$66,185.25
|
| Rate for Payer: Global Benefits Group Commercial |
$46,719.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49,444.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$45,940.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,687.60
|
| Rate for Payer: Multiplan Commercial |
$62,292.00
|
| Rate for Payer: Networks By Design Commercial |
$50,612.25
|
| Rate for Payer: Prime Health Services Commercial |
$66,185.25
|
|
