|
HC MP CONTROL LE PROS
|
Facility
|
IP
|
$50,000.00
|
|
|
Service Code
|
CPT L5999
|
| Hospital Charge Code |
915380021
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$42,500.00 |
| Rate for Payer: Adventist Health Commercial |
$10,000.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$22,500.00
|
| Rate for Payer: Cash Price |
$22,500.00
|
| Rate for Payer: Cigna of CA HMO |
$35,000.00
|
| Rate for Payer: Cigna of CA PPO |
$35,000.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$20,000.00
|
| Rate for Payer: Galaxy Health WC |
$42,500.00
|
| Rate for Payer: Global Benefits Group Commercial |
$30,000.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31,750.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29,500.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,000.00
|
| Rate for Payer: Multiplan Commercial |
$40,000.00
|
| Rate for Payer: Networks By Design Commercial |
$32,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$42,500.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$18,765.00
|
| Rate for Payer: United Healthcare All Other HMO |
$18,265.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,870.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,375.00
|
|
|
HC MP CONTROL LE PROS
|
Facility
|
OP
|
$50,000.00
|
|
|
Service Code
|
CPT L5999
|
| Hospital Charge Code |
915380021
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$12,000.00 |
| Max. Negotiated Rate |
$42,500.00 |
| Rate for Payer: Adventist Health Commercial |
$20,500.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,500.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,500.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37,500.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30,265.00
|
| Rate for Payer: Blue Shield of California Commercial |
$25,350.00
|
| Rate for Payer: Blue Shield of California Commercial |
$38,450.00
|
| Rate for Payer: Cash Price |
$22,500.00
|
| Rate for Payer: Cigna of CA HMO |
$35,000.00
|
| Rate for Payer: Cigna of CA PPO |
$35,000.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,500.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$42,500.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42,500.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$20,000.00
|
| Rate for Payer: Galaxy Health WC |
$42,500.00
|
| Rate for Payer: Global Benefits Group Commercial |
$30,000.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31,750.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18,150.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29,500.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,000.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,000.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,000.00
|
| Rate for Payer: Multiplan Commercial |
$40,000.00
|
| Rate for Payer: Networks By Design Commercial |
$25,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$42,500.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30,000.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$18,765.00
|
| Rate for Payer: United Healthcare All Other HMO |
$18,265.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,870.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,375.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,500.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42,500.00
|
| Rate for Payer: Vantage Medical Group Senior |
$42,500.00
|
|
|
HC MP CONTROL LE PROS
|
Facility
|
OP
|
$50,000.00
|
|
|
Service Code
|
CPT L5999
|
| Hospital Charge Code |
905380021
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$12,000.00 |
| Max. Negotiated Rate |
$42,500.00 |
| Rate for Payer: Adventist Health Commercial |
$20,500.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42,500.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,500.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37,500.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30,265.00
|
| Rate for Payer: Blue Shield of California Commercial |
$25,350.00
|
| Rate for Payer: Blue Shield of California Commercial |
$38,450.00
|
| Rate for Payer: Cash Price |
$22,500.00
|
| Rate for Payer: Cigna of CA HMO |
$35,000.00
|
| Rate for Payer: Cigna of CA PPO |
$35,000.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42,500.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$42,500.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42,500.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,000.00
|
| Rate for Payer: EPIC Health Plan Senior |
$20,000.00
|
| Rate for Payer: Galaxy Health WC |
$42,500.00
|
| Rate for Payer: Global Benefits Group Commercial |
$30,000.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31,750.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18,150.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29,500.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,000.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35,000.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,000.00
|
| Rate for Payer: Multiplan Commercial |
$40,000.00
|
| Rate for Payer: Networks By Design Commercial |
$25,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$42,500.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30,000.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30,000.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$18,765.00
|
| Rate for Payer: United Healthcare All Other HMO |
$18,265.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,870.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,375.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42,500.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42,500.00
|
| Rate for Payer: Vantage Medical Group Senior |
$42,500.00
|
|
|
HC MR ANGIO ABDOMEN W CONTRAST
|
Facility
|
IP
|
$9,184.00
|
|
|
Service Code
|
CPT 74185
|
| Hospital Charge Code |
908801037
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,836.80 |
| Max. Negotiated Rate |
$7,806.40 |
| Rate for Payer: Adventist Health Commercial |
$1,836.80
|
| Rate for Payer: Cash Price |
$4,132.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,428.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,673.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,673.60
|
| Rate for Payer: Galaxy Health WC |
$7,806.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,510.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,831.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,418.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,204.16
|
| Rate for Payer: Multiplan Commercial |
$7,347.20
|
| Rate for Payer: Networks By Design Commercial |
$5,969.60
|
| Rate for Payer: Prime Health Services Commercial |
$7,806.40
|
|
|
HC MR ANGIO ABDOMEN W CONTRAST
|
Facility
|
OP
|
$7,283.00
|
|
|
Service Code
|
CPT 74185
|
| Hospital Charge Code |
908801037
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$557.81 |
| Max. Negotiated Rate |
$6,190.55 |
| Rate for Payer: Adventist Health Commercial |
$1,456.60
|
| Rate for Payer: Adventist Health Commercial |
$1,836.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,190.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,806.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,051.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,005.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,462.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,888.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,893.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,673.50
|
| Rate for Payer: Blue Shield of California Commercial |
$4,646.55
|
| Rate for Payer: Blue Shield of California Commercial |
$3,066.14
|
| Rate for Payer: Blue Shield of California Commercial |
$3,866.46
|
| Rate for Payer: Blue Shield of California Commercial |
$5,859.39
|
| Rate for Payer: Cash Price |
$4,132.80
|
| Rate for Payer: Cash Price |
$3,277.35
|
| Rate for Payer: Cash Price |
$4,132.80
|
| Rate for Payer: Cash Price |
$3,277.35
|
| Rate for Payer: Cash Price |
$3,277.35
|
| Rate for Payer: Cash Price |
$4,132.80
|
| Rate for Payer: Cigna of CA HMO |
$4,661.12
|
| Rate for Payer: Cigna of CA HMO |
$5,877.76
|
| Rate for Payer: Cigna of CA PPO |
$6,796.16
|
| Rate for Payer: Cigna of CA PPO |
$5,389.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,806.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,190.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,806.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,190.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,806.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,190.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,428.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,098.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,673.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,913.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,913.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,673.60
|
| Rate for Payer: Galaxy Health WC |
$7,806.40
|
| Rate for Payer: Galaxy Health WC |
$6,190.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,510.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,369.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$557.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$557.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,624.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,831.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$630.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$630.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,418.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,296.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,204.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,747.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,098.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,428.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,098.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,428.80
|
| Rate for Payer: Multiplan Commercial |
$5,826.40
|
| Rate for Payer: Multiplan Commercial |
$7,347.20
|
| Rate for Payer: Networks By Design Commercial |
$4,733.95
|
| Rate for Payer: Networks By Design Commercial |
$5,969.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,190.55
|
| Rate for Payer: Prime Health Services Commercial |
$7,806.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,510.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,369.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,510.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,369.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,111.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,111.86
|
| Rate for Payer: United Healthcare All Other HMO |
$1,111.86
|
| Rate for Payer: United Healthcare All Other HMO |
$1,111.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1,111.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1,111.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,111.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,111.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,806.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,190.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,806.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,190.55
|
| Rate for Payer: Vantage Medical Group Senior |
$6,190.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,806.40
|
|
|
HC MR ANGIO ABD W/O CONTRAST
|
Facility
|
OP
|
$6,824.00
|
|
|
Service Code
|
CPT 74185
|
| Hospital Charge Code |
908801089
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$557.81 |
| Max. Negotiated Rate |
$5,800.40 |
| Rate for Payer: Dignity Health Medi-Cal |
$7,434.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,800.40
|
| Rate for Payer: Adventist Health Commercial |
$1,364.80
|
| Rate for Payer: Adventist Health Commercial |
$1,749.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,800.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,434.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,810.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,753.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,118.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,559.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,612.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,378.96
|
| Rate for Payer: Blue Shield of California Commercial |
$4,353.71
|
| Rate for Payer: Blue Shield of California Commercial |
$2,872.90
|
| Rate for Payer: Blue Shield of California Commercial |
$3,682.07
|
| Rate for Payer: Blue Shield of California Commercial |
$5,579.95
|
| Rate for Payer: Cash Price |
$3,935.70
|
| Rate for Payer: Cash Price |
$3,070.80
|
| Rate for Payer: Cash Price |
$3,935.70
|
| Rate for Payer: Cash Price |
$3,070.80
|
| Rate for Payer: Cash Price |
$3,070.80
|
| Rate for Payer: Cash Price |
$3,935.70
|
| Rate for Payer: Cigna of CA HMO |
$4,367.36
|
| Rate for Payer: Cigna of CA HMO |
$5,597.44
|
| Rate for Payer: Cigna of CA PPO |
$6,472.04
|
| Rate for Payer: Cigna of CA PPO |
$5,049.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,434.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,800.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,434.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,800.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,122.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,776.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,498.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,729.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,729.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,498.40
|
| Rate for Payer: Galaxy Health WC |
$7,434.10
|
| Rate for Payer: Galaxy Health WC |
$5,800.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,247.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,094.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$557.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$557.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,333.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,553.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$630.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$630.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,160.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,026.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,099.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,637.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,776.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,122.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,776.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,122.20
|
| Rate for Payer: Multiplan Commercial |
$5,459.20
|
| Rate for Payer: Multiplan Commercial |
$6,996.80
|
| Rate for Payer: Networks By Design Commercial |
$4,435.60
|
| Rate for Payer: Networks By Design Commercial |
$5,684.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,800.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,434.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,247.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,094.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,247.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,094.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,111.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,111.86
|
| Rate for Payer: United Healthcare All Other HMO |
$1,111.86
|
| Rate for Payer: United Healthcare All Other HMO |
$1,111.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1,111.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1,111.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,111.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,111.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,434.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,800.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,434.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,800.40
|
| Rate for Payer: Vantage Medical Group Senior |
$5,800.40
|
| Rate for Payer: Vantage Medical Group Senior |
$7,434.10
|
|
|
HC MR ANGIO ABD W/O CONTRAST
|
Facility
|
IP
|
$8,746.00
|
|
|
Service Code
|
CPT 74185
|
| Hospital Charge Code |
908801089
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,749.20 |
| Max. Negotiated Rate |
$7,434.10 |
| Rate for Payer: Adventist Health Commercial |
$1,749.20
|
| Rate for Payer: Cash Price |
$3,935.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,122.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,498.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,498.40
|
| Rate for Payer: Galaxy Health WC |
$7,434.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,247.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,553.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,160.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,099.04
|
| Rate for Payer: Multiplan Commercial |
$6,996.80
|
| Rate for Payer: Networks By Design Commercial |
$5,684.90
|
| Rate for Payer: Prime Health Services Commercial |
$7,434.10
|
|
|
HC MR ANGIO CHEST W CONTRAST
|
Facility
|
OP
|
$6,406.00
|
|
|
Service Code
|
CPT 71555
|
| Hospital Charge Code |
908801090
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$553.96 |
| Max. Negotiated Rate |
$5,445.10 |
| Rate for Payer: Adventist Health Commercial |
$1,281.20
|
| Rate for Payer: Adventist Health Commercial |
$1,573.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,445.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,685.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,325.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,523.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,804.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,898.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,046.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,110.73
|
| Rate for Payer: Blue Shield of California Commercial |
$4,087.03
|
| Rate for Payer: Blue Shield of California Commercial |
$2,696.93
|
| Rate for Payer: Blue Shield of California Commercial |
$3,311.16
|
| Rate for Payer: Blue Shield of California Commercial |
$5,017.87
|
| Rate for Payer: Cash Price |
$3,539.25
|
| Rate for Payer: Cash Price |
$2,882.70
|
| Rate for Payer: Cash Price |
$3,539.25
|
| Rate for Payer: Cash Price |
$2,882.70
|
| Rate for Payer: Cash Price |
$2,882.70
|
| Rate for Payer: Cash Price |
$3,539.25
|
| Rate for Payer: Cigna of CA HMO |
$4,099.84
|
| Rate for Payer: Cigna of CA HMO |
$5,033.60
|
| Rate for Payer: Cigna of CA PPO |
$5,820.10
|
| Rate for Payer: Cigna of CA PPO |
$4,740.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,685.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,445.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,685.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,445.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,685.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,445.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,505.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,484.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,146.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,562.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,562.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,146.00
|
| Rate for Payer: Galaxy Health WC |
$6,685.25
|
| Rate for Payer: Galaxy Health WC |
$5,445.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,719.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,843.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$553.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$553.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,067.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,994.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$626.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$626.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,640.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,779.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,887.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,537.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,484.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,505.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,484.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,505.50
|
| Rate for Payer: Multiplan Commercial |
$5,124.80
|
| Rate for Payer: Multiplan Commercial |
$6,292.00
|
| Rate for Payer: Networks By Design Commercial |
$4,163.90
|
| Rate for Payer: Networks By Design Commercial |
$5,112.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,445.10
|
| Rate for Payer: Prime Health Services Commercial |
$6,685.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,719.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,843.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,719.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,843.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,110.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,110.11
|
| Rate for Payer: United Healthcare All Other HMO |
$1,110.11
|
| Rate for Payer: United Healthcare All Other HMO |
$1,110.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1,110.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1,110.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,110.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,110.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,685.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,445.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,685.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,445.10
|
| Rate for Payer: Vantage Medical Group Senior |
$5,445.10
|
| Rate for Payer: Vantage Medical Group Senior |
$6,685.25
|
|
|
HC MR ANGIO CHEST W CONTRAST
|
Facility
|
IP
|
$7,865.00
|
|
|
Service Code
|
CPT 71555
|
| Hospital Charge Code |
908801090
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,573.00 |
| Max. Negotiated Rate |
$6,685.25 |
| Rate for Payer: Adventist Health Commercial |
$1,573.00
|
| Rate for Payer: Cash Price |
$3,539.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,505.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,146.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,146.00
|
| Rate for Payer: Galaxy Health WC |
$6,685.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,719.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,994.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,640.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,887.60
|
| Rate for Payer: Multiplan Commercial |
$6,292.00
|
| Rate for Payer: Networks By Design Commercial |
$5,112.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,685.25
|
|
|
HC MR ANGIO CHEST W/O CONTRAST
|
Facility
|
IP
|
$7,149.00
|
|
|
Service Code
|
CPT 71555
|
| Hospital Charge Code |
908801091
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,429.80 |
| Max. Negotiated Rate |
$6,076.65 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,004.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,859.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,859.60
|
| Rate for Payer: Galaxy Health WC |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,217.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,715.76
|
| Rate for Payer: Multiplan Commercial |
$5,719.20
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
|
|
HC MR ANGIO CHEST W/O CONTRAST
|
Facility
|
OP
|
$5,952.00
|
|
|
Service Code
|
CPT 71555
|
| Hospital Charge Code |
908801091
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$553.96 |
| Max. Negotiated Rate |
$5,059.20 |
| Rate for Payer: Adventist Health Commercial |
$1,190.40
|
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,059.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,076.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,931.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,273.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,464.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,361.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,587.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,819.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,797.38
|
| Rate for Payer: Blue Shield of California Commercial |
$2,505.79
|
| Rate for Payer: Blue Shield of California Commercial |
$3,009.73
|
| Rate for Payer: Blue Shield of California Commercial |
$4,561.06
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cash Price |
$2,678.40
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cash Price |
$2,678.40
|
| Rate for Payer: Cash Price |
$2,678.40
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cigna of CA HMO |
$3,809.28
|
| Rate for Payer: Cigna of CA HMO |
$4,575.36
|
| Rate for Payer: Cigna of CA PPO |
$5,290.26
|
| Rate for Payer: Cigna of CA PPO |
$4,404.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,076.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,059.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,076.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,059.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,076.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,059.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,004.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,166.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,859.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,380.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,380.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,859.60
|
| Rate for Payer: Galaxy Health WC |
$6,076.65
|
| Rate for Payer: Galaxy Health WC |
$5,059.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,571.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$553.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$553.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,779.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$626.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$626.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,217.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,511.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,715.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,428.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,166.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,004.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,166.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,004.30
|
| Rate for Payer: Multiplan Commercial |
$4,761.60
|
| Rate for Payer: Multiplan Commercial |
$5,719.20
|
| Rate for Payer: Networks By Design Commercial |
$3,868.80
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,059.20
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,289.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,571.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,289.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,571.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,110.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,110.11
|
| Rate for Payer: United Healthcare All Other HMO |
$1,110.11
|
| Rate for Payer: United Healthcare All Other HMO |
$1,110.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1,110.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1,110.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,110.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,110.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,076.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,059.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,076.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,059.20
|
| Rate for Payer: Vantage Medical Group Senior |
$5,059.20
|
| Rate for Payer: Vantage Medical Group Senior |
$6,076.65
|
|
|
HC MR ANGIO CHEST W WO CONTRAST
|
Facility
|
IP
|
$8,516.00
|
|
|
Service Code
|
CPT 71555
|
| Hospital Charge Code |
908801032
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$1,703.20 |
| Max. Negotiated Rate |
$7,238.60 |
| Rate for Payer: Adventist Health Commercial |
$1,703.20
|
| Rate for Payer: Cash Price |
$3,832.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,961.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,406.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,406.40
|
| Rate for Payer: Galaxy Health WC |
$7,238.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5,109.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,407.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,024.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,043.84
|
| Rate for Payer: Multiplan Commercial |
$6,812.80
|
| Rate for Payer: Networks By Design Commercial |
$5,535.40
|
| Rate for Payer: Prime Health Services Commercial |
$7,238.60
|
|
|
HC MR ANGIO CHEST W WO CONTRAST
|
Facility
|
OP
|
$6,752.00
|
|
|
Service Code
|
CPT 71555
|
| Hospital Charge Code |
908801032
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$553.96 |
| Max. Negotiated Rate |
$5,739.20 |
| Rate for Payer: Adventist Health Commercial |
$1,350.40
|
| Rate for Payer: Adventist Health Commercial |
$1,703.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,739.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,238.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,683.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,713.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,064.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,387.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,464.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,332.76
|
| Rate for Payer: Blue Shield of California Commercial |
$4,307.78
|
| Rate for Payer: Blue Shield of California Commercial |
$2,842.59
|
| Rate for Payer: Blue Shield of California Commercial |
$3,585.24
|
| Rate for Payer: Blue Shield of California Commercial |
$5,433.21
|
| Rate for Payer: Cash Price |
$3,832.20
|
| Rate for Payer: Cash Price |
$3,038.40
|
| Rate for Payer: Cash Price |
$3,832.20
|
| Rate for Payer: Cash Price |
$3,038.40
|
| Rate for Payer: Cash Price |
$3,038.40
|
| Rate for Payer: Cash Price |
$3,832.20
|
| Rate for Payer: Cigna of CA HMO |
$4,321.28
|
| Rate for Payer: Cigna of CA HMO |
$5,450.24
|
| Rate for Payer: Cigna of CA PPO |
$6,301.84
|
| Rate for Payer: Cigna of CA PPO |
$4,996.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,238.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,739.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,238.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,739.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,238.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,739.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,961.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,726.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,406.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,700.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,700.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,406.40
|
| Rate for Payer: Galaxy Health WC |
$7,238.60
|
| Rate for Payer: Galaxy Health WC |
$5,739.20
|
| Rate for Payer: Global Benefits Group Commercial |
$5,109.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,051.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$553.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$553.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,287.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,407.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$626.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$626.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,024.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,983.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,043.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,620.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,726.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,961.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,726.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,961.20
|
| Rate for Payer: Multiplan Commercial |
$5,401.60
|
| Rate for Payer: Multiplan Commercial |
$6,812.80
|
| Rate for Payer: Networks By Design Commercial |
$4,388.80
|
| Rate for Payer: Networks By Design Commercial |
$5,535.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,739.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,238.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,109.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,051.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,109.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,051.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,110.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,110.11
|
| Rate for Payer: United Healthcare All Other HMO |
$1,110.11
|
| Rate for Payer: United Healthcare All Other HMO |
$1,110.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1,110.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1,110.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,110.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,110.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,238.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,739.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,238.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,739.20
|
| Rate for Payer: Vantage Medical Group Senior |
$5,739.20
|
| Rate for Payer: Vantage Medical Group Senior |
$7,238.60
|
|
|
HC MR ANGIO LOW EXT W CONTRAST
|
Facility
|
OP
|
$6,474.00
|
|
|
Service Code
|
CPT 73725
|
| Hospital Charge Code |
908801092
|
|
Hospital Revenue Code
|
616
|
| Min. Negotiated Rate |
$554.48 |
| Max. Negotiated Rate |
$5,502.90 |
| Rate for Payer: Networks By Design Commercial |
$4,208.10
|
| Rate for Payer: Adventist Health Commercial |
$1,294.80
|
| Rate for Payer: Adventist Health Commercial |
$1,071.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,328.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,328.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,502.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,552.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,945.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,560.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,017.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,855.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,436.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,154.37
|
| Rate for Payer: Blue Shield of California Commercial |
$4,130.41
|
| Rate for Payer: Blue Shield of California Commercial |
$3,417.13
|
| Rate for Payer: Blue Shield of California Commercial |
$2,254.88
|
| Rate for Payer: Blue Shield of California Commercial |
$2,725.55
|
| Rate for Payer: Cash Price |
$2,410.20
|
| Rate for Payer: Cash Price |
$2,913.30
|
| Rate for Payer: Cash Price |
$2,913.30
|
| Rate for Payer: Cash Price |
$2,410.20
|
| Rate for Payer: Cigna of CA HMO |
$4,143.36
|
| Rate for Payer: Cigna of CA HMO |
$3,427.84
|
| Rate for Payer: Cigna of CA PPO |
$3,963.44
|
| Rate for Payer: Cigna of CA PPO |
$4,790.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,552.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,502.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,552.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,502.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,552.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,502.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,531.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,749.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,589.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,142.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,589.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,142.40
|
| Rate for Payer: Galaxy Health WC |
$5,502.90
|
| Rate for Payer: Galaxy Health WC |
$4,552.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,213.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,884.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$554.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$554.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,110.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,401.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$627.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$627.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,160.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,819.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,285.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,553.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,531.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,749.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,531.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,749.20
|
| Rate for Payer: Multiplan Commercial |
$5,179.20
|
| Rate for Payer: Multiplan Commercial |
$4,284.80
|
| Rate for Payer: Networks By Design Commercial |
$3,481.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,502.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,552.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,213.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,884.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,884.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,213.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,114.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,114.46
|
| Rate for Payer: United Healthcare All Other HMO |
$1,114.46
|
| Rate for Payer: United Healthcare All Other HMO |
$1,114.46
|
| Rate for Payer: United Healthcare HMO Rider |
$1,114.46
|
| Rate for Payer: United Healthcare HMO Rider |
$1,114.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,114.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,114.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,502.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,552.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,552.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,502.90
|
| Rate for Payer: Vantage Medical Group Senior |
$5,502.90
|
| Rate for Payer: Vantage Medical Group Senior |
$4,552.60
|
|
|
HC MR ANGIO LOW EXT W CONTRAST
|
Facility
|
IP
|
$6,474.00
|
|
|
Service Code
|
CPT 73725
|
| Hospital Charge Code |
908801092
|
|
Hospital Revenue Code
|
616
|
| Min. Negotiated Rate |
$1,294.80 |
| Max. Negotiated Rate |
$5,502.90 |
| Rate for Payer: Adventist Health Commercial |
$1,294.80
|
| Rate for Payer: Cash Price |
$2,913.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,531.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,589.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,589.60
|
| Rate for Payer: Galaxy Health WC |
$5,502.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,884.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,110.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,819.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,553.76
|
| Rate for Payer: Multiplan Commercial |
$5,179.20
|
| Rate for Payer: Networks By Design Commercial |
$4,208.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,502.90
|
|
|
HC MR ANGIO LOW EXT WO CONT
|
Facility
|
IP
|
$5,885.00
|
|
|
Service Code
|
CPT 73725
|
| Hospital Charge Code |
908801094
|
|
Hospital Revenue Code
|
616
|
| Min. Negotiated Rate |
$1,177.00 |
| Max. Negotiated Rate |
$5,002.25 |
| Rate for Payer: Adventist Health Commercial |
$1,177.00
|
| Rate for Payer: Cash Price |
$2,648.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,119.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,354.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,354.00
|
| Rate for Payer: Galaxy Health WC |
$5,002.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,531.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,736.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,472.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,412.40
|
| Rate for Payer: Multiplan Commercial |
$4,708.00
|
| Rate for Payer: Networks By Design Commercial |
$3,825.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,002.25
|
|
|
HC MR ANGIO LOW EXT WO CONT
|
Facility
|
OP
|
$5,885.00
|
|
|
Service Code
|
CPT 73725
|
| Hospital Charge Code |
908801094
|
|
Hospital Revenue Code
|
616
|
| Min. Negotiated Rate |
$554.48 |
| Max. Negotiated Rate |
$5,002.25 |
| Rate for Payer: Adventist Health Commercial |
$1,177.00
|
| Rate for Payer: Adventist Health Commercial |
$979.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,328.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,328.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,002.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,163.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,693.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,236.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,673.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,413.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,143.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,776.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,754.63
|
| Rate for Payer: Blue Shield of California Commercial |
$3,124.92
|
| Rate for Payer: Blue Shield of California Commercial |
$2,062.06
|
| Rate for Payer: Blue Shield of California Commercial |
$2,477.59
|
| Rate for Payer: Cash Price |
$2,204.10
|
| Rate for Payer: Cash Price |
$2,648.25
|
| Rate for Payer: Cash Price |
$2,648.25
|
| Rate for Payer: Cash Price |
$2,204.10
|
| Rate for Payer: Cigna of CA HMO |
$3,766.40
|
| Rate for Payer: Cigna of CA HMO |
$3,134.72
|
| Rate for Payer: Cigna of CA PPO |
$3,624.52
|
| Rate for Payer: Cigna of CA PPO |
$4,354.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,163.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,002.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,163.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,002.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,163.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,002.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,119.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,428.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,354.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,959.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,354.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,959.20
|
| Rate for Payer: Galaxy Health WC |
$5,002.25
|
| Rate for Payer: Galaxy Health WC |
$4,163.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,938.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,531.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$554.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$554.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,736.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,110.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$627.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$627.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,889.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,472.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,175.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,412.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,119.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,428.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,119.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,428.60
|
| Rate for Payer: Multiplan Commercial |
$4,708.00
|
| Rate for Payer: Multiplan Commercial |
$3,918.40
|
| Rate for Payer: Networks By Design Commercial |
$3,183.70
|
| Rate for Payer: Networks By Design Commercial |
$3,825.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,002.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,163.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,938.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,531.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,531.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,938.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,114.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,114.46
|
| Rate for Payer: United Healthcare All Other HMO |
$1,114.46
|
| Rate for Payer: United Healthcare All Other HMO |
$1,114.46
|
| Rate for Payer: United Healthcare HMO Rider |
$1,114.46
|
| Rate for Payer: United Healthcare HMO Rider |
$1,114.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,114.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,114.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,002.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,163.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,163.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,002.25
|
| Rate for Payer: Vantage Medical Group Senior |
$5,002.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4,163.30
|
|
|
HC MR ANGIO LOW EXT W&WO CON
|
Facility
|
IP
|
$7,680.00
|
|
|
Service Code
|
CPT 73725
|
| Hospital Charge Code |
908801036
|
|
Hospital Revenue Code
|
616
|
| Min. Negotiated Rate |
$1,536.00 |
| Max. Negotiated Rate |
$6,528.00 |
| Rate for Payer: Adventist Health Commercial |
$1,536.00
|
| Rate for Payer: Cash Price |
$3,456.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,376.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,072.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,072.00
|
| Rate for Payer: Galaxy Health WC |
$6,528.00
|
| Rate for Payer: Global Benefits Group Commercial |
$4,608.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,876.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,531.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,843.20
|
| Rate for Payer: Multiplan Commercial |
$6,144.00
|
| Rate for Payer: Networks By Design Commercial |
$4,992.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,528.00
|
|
|
HC MR ANGIO LOW EXT W&WO CON
|
Facility
|
OP
|
$7,680.00
|
|
|
Service Code
|
CPT 73725
|
| Hospital Charge Code |
908801036
|
|
Hospital Revenue Code
|
616
|
| Min. Negotiated Rate |
$554.48 |
| Max. Negotiated Rate |
$6,528.00 |
| Rate for Payer: Adventist Health Commercial |
$1,536.00
|
| Rate for Payer: Adventist Health Commercial |
$1,162.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,328.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,328.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,528.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,939.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,196.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,224.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,358.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,760.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,728.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,928.26
|
| Rate for Payer: Blue Shield of California Commercial |
$4,899.84
|
| Rate for Payer: Blue Shield of California Commercial |
$3,707.42
|
| Rate for Payer: Blue Shield of California Commercial |
$2,446.43
|
| Rate for Payer: Blue Shield of California Commercial |
$3,233.28
|
| Rate for Payer: Cash Price |
$2,614.95
|
| Rate for Payer: Cash Price |
$3,456.00
|
| Rate for Payer: Cash Price |
$3,456.00
|
| Rate for Payer: Cash Price |
$2,614.95
|
| Rate for Payer: Cigna of CA HMO |
$4,915.20
|
| Rate for Payer: Cigna of CA HMO |
$3,719.04
|
| Rate for Payer: Cigna of CA PPO |
$4,300.14
|
| Rate for Payer: Cigna of CA PPO |
$5,683.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,939.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,528.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,939.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,528.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,939.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,528.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,376.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,067.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,072.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,324.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,072.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,324.40
|
| Rate for Payer: Galaxy Health WC |
$6,528.00
|
| Rate for Payer: Galaxy Health WC |
$4,939.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3,486.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,608.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$554.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$554.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,876.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,689.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$627.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$627.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,428.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,531.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,394.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,843.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,376.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,067.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,376.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,067.70
|
| Rate for Payer: Multiplan Commercial |
$6,144.00
|
| Rate for Payer: Multiplan Commercial |
$4,648.80
|
| Rate for Payer: Networks By Design Commercial |
$3,777.15
|
| Rate for Payer: Networks By Design Commercial |
$4,992.00
|
| Rate for Payer: Prime Health Services Commercial |
$6,528.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,939.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,486.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,608.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,608.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,486.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,114.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,114.46
|
| Rate for Payer: United Healthcare All Other HMO |
$1,114.46
|
| Rate for Payer: United Healthcare All Other HMO |
$1,114.46
|
| Rate for Payer: United Healthcare HMO Rider |
$1,114.46
|
| Rate for Payer: United Healthcare HMO Rider |
$1,114.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,114.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,114.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,528.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,939.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,939.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,528.00
|
| Rate for Payer: Vantage Medical Group Senior |
$6,528.00
|
| Rate for Payer: Vantage Medical Group Senior |
$4,939.35
|
|
|
HC MR ANGIO PELVIS W/CONT
|
Facility
|
IP
|
$4,734.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801097
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$946.80 |
| Max. Negotiated Rate |
$4,023.90 |
| Rate for Payer: Adventist Health Commercial |
$946.80
|
| Rate for Payer: Cash Price |
$2,130.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,313.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,893.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,893.60
|
| Rate for Payer: Galaxy Health WC |
$4,023.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,840.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,006.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,793.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.16
|
| Rate for Payer: Multiplan Commercial |
$3,787.20
|
| Rate for Payer: Networks By Design Commercial |
$3,077.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,023.90
|
|
|
HC MR ANGIO PELVIS W/CONT
|
Facility
|
OP
|
$3,752.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801097
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$556.74 |
| Max. Negotiated Rate |
$3,443.00 |
| Rate for Payer: Adventist Health Commercial |
$750.40
|
| Rate for Payer: Adventist Health Commercial |
$946.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,189.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,023.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,603.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,063.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,814.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,037.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,407.66
|
| Rate for Payer: Blue Shield of California Commercial |
$2,393.78
|
| Rate for Payer: Blue Shield of California Commercial |
$1,579.59
|
| Rate for Payer: Blue Shield of California Commercial |
$1,993.01
|
| Rate for Payer: Blue Shield of California Commercial |
$3,020.29
|
| Rate for Payer: Cash Price |
$2,130.30
|
| Rate for Payer: Cash Price |
$1,688.40
|
| Rate for Payer: Cash Price |
$2,130.30
|
| Rate for Payer: Cash Price |
$1,688.40
|
| Rate for Payer: Cash Price |
$1,688.40
|
| Rate for Payer: Cash Price |
$2,130.30
|
| Rate for Payer: Cigna of CA HMO |
$2,401.28
|
| Rate for Payer: Cigna of CA HMO |
$3,029.76
|
| Rate for Payer: Cigna of CA PPO |
$3,503.16
|
| Rate for Payer: Cigna of CA PPO |
$2,776.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,023.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,189.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,023.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,189.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,023.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,189.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,313.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,626.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,893.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,500.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,500.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,893.60
|
| Rate for Payer: Galaxy Health WC |
$4,023.90
|
| Rate for Payer: Galaxy Health WC |
$3,189.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,840.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,251.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$556.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$556.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,382.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,006.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,793.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,213.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$900.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,626.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,313.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,626.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,313.80
|
| Rate for Payer: Multiplan Commercial |
$3,001.60
|
| Rate for Payer: Multiplan Commercial |
$3,787.20
|
| Rate for Payer: Networks By Design Commercial |
$2,438.80
|
| Rate for Payer: Networks By Design Commercial |
$3,077.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,189.20
|
| Rate for Payer: Prime Health Services Commercial |
$4,023.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,840.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,251.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,840.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,251.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,023.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,189.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,023.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,189.20
|
| Rate for Payer: Vantage Medical Group Senior |
$3,189.20
|
| Rate for Payer: Vantage Medical Group Senior |
$4,023.90
|
|
|
HC MR ANGIO PELVIS WO CONT
|
Facility
|
IP
|
$4,509.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801098
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$901.80 |
| Max. Negotiated Rate |
$3,832.65 |
| Rate for Payer: Networks By Design Commercial |
$2,930.85
|
| Rate for Payer: Adventist Health Commercial |
$901.80
|
| Rate for Payer: Cash Price |
$2,029.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,156.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,803.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,803.60
|
| Rate for Payer: Galaxy Health WC |
$3,832.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,705.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,863.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,660.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,082.16
|
| Rate for Payer: Multiplan Commercial |
$3,607.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,832.65
|
|
|
HC MR ANGIO PELVIS WO CONT
|
Facility
|
OP
|
$3,298.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801098
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$556.74 |
| Max. Negotiated Rate |
$3,443.00 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,832.65
|
| Rate for Payer: Adventist Health Commercial |
$659.60
|
| Rate for Payer: Adventist Health Commercial |
$901.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,803.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,832.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,479.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,813.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,473.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,381.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,893.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,116.33
|
| Rate for Payer: Blue Shield of California Commercial |
$2,104.12
|
| Rate for Payer: Blue Shield of California Commercial |
$1,388.46
|
| Rate for Payer: Blue Shield of California Commercial |
$1,898.29
|
| Rate for Payer: Blue Shield of California Commercial |
$2,876.74
|
| Rate for Payer: Cash Price |
$2,029.05
|
| Rate for Payer: Cash Price |
$1,484.10
|
| Rate for Payer: Cash Price |
$2,029.05
|
| Rate for Payer: Cash Price |
$1,484.10
|
| Rate for Payer: Cash Price |
$1,484.10
|
| Rate for Payer: Cash Price |
$2,029.05
|
| Rate for Payer: Cigna of CA HMO |
$2,110.72
|
| Rate for Payer: Cigna of CA HMO |
$2,885.76
|
| Rate for Payer: Cigna of CA PPO |
$3,336.66
|
| Rate for Payer: Cigna of CA PPO |
$2,440.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,832.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,803.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,832.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,803.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,832.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,803.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,156.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,308.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,803.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,319.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,319.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,803.60
|
| Rate for Payer: Galaxy Health WC |
$3,832.65
|
| Rate for Payer: Galaxy Health WC |
$2,803.30
|
| Rate for Payer: Global Benefits Group Commercial |
$2,705.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,978.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$556.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$556.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,094.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,863.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,660.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,945.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,082.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$791.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,308.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,156.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,308.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,156.30
|
| Rate for Payer: Multiplan Commercial |
$2,638.40
|
| Rate for Payer: Multiplan Commercial |
$3,607.20
|
| Rate for Payer: Networks By Design Commercial |
$2,143.70
|
| Rate for Payer: Networks By Design Commercial |
$2,930.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,803.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,832.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,705.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,978.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,705.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,978.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,832.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,803.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,803.30
|
| Rate for Payer: Vantage Medical Group Senior |
$2,803.30
|
| Rate for Payer: Vantage Medical Group Senior |
$3,832.65
|
|
|
HC MR ANGIO PELVIS WO FOL W CONT
|
Facility
|
OP
|
$4,211.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801099
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$556.74 |
| Max. Negotiated Rate |
$3,579.35 |
| Rate for Payer: Adventist Health Commercial |
$842.20
|
| Rate for Payer: Adventist Health Commercial |
$994.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,579.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,226.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,734.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,316.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,158.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,729.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,190.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,702.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,686.62
|
| Rate for Payer: Blue Shield of California Commercial |
$1,772.83
|
| Rate for Payer: Blue Shield of California Commercial |
$2,093.21
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.14
|
| Rate for Payer: Cash Price |
$2,237.40
|
| Rate for Payer: Cash Price |
$1,894.95
|
| Rate for Payer: Cash Price |
$2,237.40
|
| Rate for Payer: Cash Price |
$1,894.95
|
| Rate for Payer: Cash Price |
$1,894.95
|
| Rate for Payer: Cash Price |
$2,237.40
|
| Rate for Payer: Cigna of CA HMO |
$2,695.04
|
| Rate for Payer: Cigna of CA HMO |
$3,182.08
|
| Rate for Payer: Cigna of CA PPO |
$3,679.28
|
| Rate for Payer: Cigna of CA PPO |
$3,116.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,226.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,579.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,226.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,579.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,226.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,579.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,480.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,947.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,988.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,684.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,684.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,988.80
|
| Rate for Payer: Galaxy Health WC |
$4,226.20
|
| Rate for Payer: Galaxy Health WC |
$3,579.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,983.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,526.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$556.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$556.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,673.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,157.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,933.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,484.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,193.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,010.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,947.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,480.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,947.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,480.40
|
| Rate for Payer: Multiplan Commercial |
$3,368.80
|
| Rate for Payer: Multiplan Commercial |
$3,977.60
|
| Rate for Payer: Networks By Design Commercial |
$2,737.15
|
| Rate for Payer: Networks By Design Commercial |
$3,231.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,579.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,226.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,983.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,526.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,983.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,526.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,226.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,579.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,226.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,579.35
|
| Rate for Payer: Vantage Medical Group Senior |
$3,579.35
|
| Rate for Payer: Vantage Medical Group Senior |
$4,226.20
|
|
|
HC MR ANGIO PELVIS WO FOL W CONT
|
Facility
|
OP
|
$4,211.00
|
|
|
Service Code
|
CPT 72198
|
| Hospital Charge Code |
908801034
|
|
Hospital Revenue Code
|
618
|
| Min. Negotiated Rate |
$556.74 |
| Max. Negotiated Rate |
$3,579.35 |
| Rate for Payer: Adventist Health Commercial |
$842.20
|
| Rate for Payer: Adventist Health Commercial |
$994.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,443.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,579.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,226.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,734.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,316.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,158.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,729.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,190.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,702.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,686.62
|
| Rate for Payer: Blue Shield of California Commercial |
$1,772.83
|
| Rate for Payer: Blue Shield of California Commercial |
$2,093.21
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.14
|
| Rate for Payer: Cash Price |
$2,237.40
|
| Rate for Payer: Cash Price |
$1,894.95
|
| Rate for Payer: Cash Price |
$2,237.40
|
| Rate for Payer: Cash Price |
$1,894.95
|
| Rate for Payer: Cash Price |
$1,894.95
|
| Rate for Payer: Cash Price |
$2,237.40
|
| Rate for Payer: Cigna of CA HMO |
$2,695.04
|
| Rate for Payer: Cigna of CA HMO |
$3,182.08
|
| Rate for Payer: Cigna of CA PPO |
$3,679.28
|
| Rate for Payer: Cigna of CA PPO |
$3,116.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,226.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,579.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,226.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,579.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,226.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,579.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,480.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,947.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,988.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,684.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,684.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,988.80
|
| Rate for Payer: Galaxy Health WC |
$4,226.20
|
| Rate for Payer: Galaxy Health WC |
$3,579.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,983.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,526.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$556.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$556.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,673.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,157.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$629.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,933.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,484.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,193.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,010.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,947.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,480.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,947.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,480.40
|
| Rate for Payer: Multiplan Commercial |
$3,368.80
|
| Rate for Payer: Multiplan Commercial |
$3,977.60
|
| Rate for Payer: Networks By Design Commercial |
$2,737.15
|
| Rate for Payer: Networks By Design Commercial |
$3,231.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,579.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,226.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,983.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,526.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,983.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,526.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,113.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,226.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,579.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,226.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,579.35
|
| Rate for Payer: Vantage Medical Group Senior |
$3,579.35
|
| Rate for Payer: Vantage Medical Group Senior |
$4,226.20
|
|
