|
HC PERC PLCMNT FIDUCIAL MRKR
|
Facility
|
OP
|
$2,384.00
|
|
|
Service Code
|
CPT 32553
|
| Hospital Charge Code |
900832553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$476.80 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$476.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,607.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,912.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,738.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$570.02
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Cigna of CA HMO |
$1,525.76
|
| Rate for Payer: Cigna of CA PPO |
$1,764.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,607.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,912.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,738.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,346.99
|
| Rate for Payer: EPIC Health Plan Senior |
$1,738.51
|
| Rate for Payer: Galaxy Health WC |
$2,026.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,430.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,851.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$872.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,738.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,590.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$986.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,738.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$572.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,190.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,329.60
|
| Rate for Payer: Multiplan Commercial |
$1,907.20
|
| Rate for Payer: Multiplan WC |
$2,770.01
|
| Rate for Payer: Networks By Design Commercial |
$1,549.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,026.40
|
| Rate for Payer: Prime Health Services WC |
$2,741.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,430.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,738.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,607.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,912.36
|
| Rate for Payer: Vantage Medical Group Senior |
$1,738.51
|
|
|
HC PERC PLCMNT FIDUCIAL MRKR
|
Facility
|
IP
|
$2,384.00
|
|
|
Service Code
|
CPT 32553
|
| Hospital Charge Code |
900832553
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$476.80 |
| Max. Negotiated Rate |
$2,026.40 |
| Rate for Payer: Adventist Health Commercial |
$476.80
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$953.60
|
| Rate for Payer: EPIC Health Plan Senior |
$953.60
|
| Rate for Payer: Galaxy Health WC |
$2,026.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,430.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,590.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$908.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,475.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$572.16
|
| Rate for Payer: Multiplan Commercial |
$1,907.20
|
| Rate for Payer: Networks By Design Commercial |
$1,549.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,026.40
|
|
|
HC PERC PULM ART STENT ABN BI
|
Facility
|
IP
|
$25,085.00
|
|
|
Service Code
|
CPT 33903
|
| Hospital Charge Code |
906811903
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,017.00 |
| Max. Negotiated Rate |
$21,322.25 |
| Rate for Payer: Adventist Health Commercial |
$5,017.00
|
| Rate for Payer: Cash Price |
$11,288.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,034.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,034.00
|
| Rate for Payer: Galaxy Health WC |
$21,322.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15,051.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,731.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,557.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,527.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,020.40
|
| Rate for Payer: Multiplan Commercial |
$20,068.00
|
| Rate for Payer: Networks By Design Commercial |
$16,305.25
|
| Rate for Payer: Prime Health Services Commercial |
$21,322.25
|
|
|
HC PERC PULM ART STENT ABN BI
|
Facility
|
OP
|
$25,085.00
|
|
|
Service Code
|
CPT 33903
|
| Hospital Charge Code |
906811903
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,845.77 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,017.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$11,288.25
|
| Rate for Payer: Cash Price |
$11,288.25
|
| Rate for Payer: Cash Price |
$11,288.25
|
| Rate for Payer: Cigna of CA HMO |
$16,054.40
|
| Rate for Payer: Cigna of CA PPO |
$18,562.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$21,322.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15,051.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,731.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,020.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$20,068.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$16,305.25
|
| Rate for Payer: Prime Health Services Commercial |
$21,322.25
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,051.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC PERC PULM ART STENT ABN BI
|
Facility
|
IP
|
$29,512.00
|
|
|
Service Code
|
CPT 33903
|
| Hospital Charge Code |
906820326
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,902.40 |
| Max. Negotiated Rate |
$25,085.20 |
| Rate for Payer: Adventist Health Commercial |
$5,902.40
|
| Rate for Payer: Cash Price |
$13,280.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,804.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11,804.80
|
| Rate for Payer: Galaxy Health WC |
$25,085.20
|
| Rate for Payer: Global Benefits Group Commercial |
$17,707.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,684.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,244.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,267.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,082.88
|
| Rate for Payer: Multiplan Commercial |
$23,609.60
|
| Rate for Payer: Networks By Design Commercial |
$19,182.80
|
| Rate for Payer: Prime Health Services Commercial |
$25,085.20
|
|
|
HC PERC PULM ART STENT ABN BI
|
Facility
|
OP
|
$29,512.00
|
|
|
Service Code
|
CPT 33903
|
| Hospital Charge Code |
906820326
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,845.77 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,902.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$13,280.40
|
| Rate for Payer: Cash Price |
$13,280.40
|
| Rate for Payer: Cash Price |
$13,280.40
|
| Rate for Payer: Cigna of CA HMO |
$18,887.68
|
| Rate for Payer: Cigna of CA PPO |
$21,838.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$25,085.20
|
| Rate for Payer: Global Benefits Group Commercial |
$17,707.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,684.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,082.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$23,609.60
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$19,182.80
|
| Rate for Payer: Prime Health Services Commercial |
$25,085.20
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,707.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC PERC PULM ART STENT ABN UNI
|
Facility
|
IP
|
$45,368.00
|
|
|
Service Code
|
CPT 33902
|
| Hospital Charge Code |
906820322
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,073.60 |
| Max. Negotiated Rate |
$38,562.80 |
| Rate for Payer: Adventist Health Commercial |
$9,073.60
|
| Rate for Payer: Cash Price |
$20,415.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,147.20
|
| Rate for Payer: EPIC Health Plan Senior |
$18,147.20
|
| Rate for Payer: Galaxy Health WC |
$38,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$27,220.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30,260.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,285.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,082.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,888.32
|
| Rate for Payer: Multiplan Commercial |
$36,294.40
|
| Rate for Payer: Networks By Design Commercial |
$29,489.20
|
| Rate for Payer: Prime Health Services Commercial |
$38,562.80
|
|
|
HC PERC PULM ART STENT ABN UNI
|
Facility
|
OP
|
$45,368.00
|
|
|
Service Code
|
CPT 33902
|
| Hospital Charge Code |
906820322
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,845.77 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$9,073.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$20,415.60
|
| Rate for Payer: Cash Price |
$20,415.60
|
| Rate for Payer: Cash Price |
$20,415.60
|
| Rate for Payer: Cigna of CA HMO |
$29,035.52
|
| Rate for Payer: Cigna of CA PPO |
$33,572.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$38,562.80
|
| Rate for Payer: Global Benefits Group Commercial |
$27,220.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30,260.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,888.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$36,294.40
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$29,489.20
|
| Rate for Payer: Prime Health Services Commercial |
$38,562.80
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27,220.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC PERC PULM ART STENT ABN UNI
|
Facility
|
OP
|
$46,681.00
|
|
|
Service Code
|
CPT 33902
|
| Hospital Charge Code |
906811902
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,845.77 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$9,336.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,192.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$21,006.45
|
| Rate for Payer: Cash Price |
$21,006.45
|
| Rate for Payer: Cash Price |
$21,006.45
|
| Rate for Payer: Cigna of CA HMO |
$29,875.84
|
| Rate for Payer: Cigna of CA PPO |
$34,543.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$39,678.85
|
| Rate for Payer: Global Benefits Group Commercial |
$28,008.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,136.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,203.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28,747.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$37,344.80
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$30,342.65
|
| Rate for Payer: Prime Health Services Commercial |
$39,678.85
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28,008.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC PERC PULM ART STENT ABN UNI
|
Facility
|
IP
|
$46,681.00
|
|
|
Service Code
|
CPT 33902
|
| Hospital Charge Code |
906811902
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,336.20 |
| Max. Negotiated Rate |
$39,678.85 |
| Rate for Payer: Adventist Health Commercial |
$9,336.20
|
| Rate for Payer: Cash Price |
$21,006.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,672.40
|
| Rate for Payer: EPIC Health Plan Senior |
$18,672.40
|
| Rate for Payer: Galaxy Health WC |
$39,678.85
|
| Rate for Payer: Global Benefits Group Commercial |
$28,008.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,136.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,785.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,895.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,203.44
|
| Rate for Payer: Multiplan Commercial |
$37,344.80
|
| Rate for Payer: Networks By Design Commercial |
$30,342.65
|
| Rate for Payer: Prime Health Services Commercial |
$39,678.85
|
|
|
HC PERC PULM ART STENT EA ADD ABN OR NRM
|
Facility
|
OP
|
$14,755.00
|
|
|
Service Code
|
CPT 33904
|
| Hospital Charge Code |
906820327
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$570.02 |
| Max. Negotiated Rate |
$12,541.75 |
| Rate for Payer: Adventist Health Commercial |
$2,951.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,541.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,115.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,066.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,061.05
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$570.02
|
| Rate for Payer: Cash Price |
$6,639.75
|
| Rate for Payer: Cash Price |
$6,639.75
|
| Rate for Payer: Cigna of CA HMO |
$9,443.20
|
| Rate for Payer: Cigna of CA PPO |
$10,918.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,541.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$12,541.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12,541.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,902.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,902.00
|
| Rate for Payer: Galaxy Health WC |
$12,541.75
|
| Rate for Payer: Global Benefits Group Commercial |
$8,853.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,841.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,133.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,541.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10,328.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,328.50
|
| Rate for Payer: Multiplan Commercial |
$11,804.00
|
| Rate for Payer: Networks By Design Commercial |
$9,590.75
|
| Rate for Payer: Prime Health Services Commercial |
$12,541.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,853.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,541.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12,541.75
|
| Rate for Payer: Vantage Medical Group Senior |
$12,541.75
|
|
|
HC PERC PULM ART STENT EA ADD ABN OR NRM
|
Facility
|
OP
|
$12,542.00
|
|
|
Service Code
|
CPT 33904
|
| Hospital Charge Code |
906811904
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$570.02 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$2,508.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,660.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,898.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,406.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,702.04
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$570.02
|
| Rate for Payer: Cash Price |
$5,643.90
|
| Rate for Payer: Cash Price |
$5,643.90
|
| Rate for Payer: Cigna of CA HMO |
$8,026.88
|
| Rate for Payer: Cigna of CA PPO |
$9,281.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,660.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,660.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10,660.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,016.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,016.80
|
| Rate for Payer: Galaxy Health WC |
$10,660.70
|
| Rate for Payer: Global Benefits Group Commercial |
$7,525.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,365.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,763.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,010.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,779.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8,779.40
|
| Rate for Payer: Multiplan Commercial |
$10,033.60
|
| Rate for Payer: Networks By Design Commercial |
$8,152.30
|
| Rate for Payer: Prime Health Services Commercial |
$10,660.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,525.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,660.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,660.70
|
| Rate for Payer: Vantage Medical Group Senior |
$10,660.70
|
|
|
HC PERC PULM ART STENT EA ADD ABN OR NRM
|
Facility
|
IP
|
$12,542.00
|
|
|
Service Code
|
CPT 33904
|
| Hospital Charge Code |
906811904
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,508.40 |
| Max. Negotiated Rate |
$10,660.70 |
| Rate for Payer: Adventist Health Commercial |
$2,508.40
|
| Rate for Payer: Cash Price |
$5,643.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,016.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,016.80
|
| Rate for Payer: Galaxy Health WC |
$10,660.70
|
| Rate for Payer: Global Benefits Group Commercial |
$7,525.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,365.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,778.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,763.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,010.08
|
| Rate for Payer: Multiplan Commercial |
$10,033.60
|
| Rate for Payer: Networks By Design Commercial |
$8,152.30
|
| Rate for Payer: Prime Health Services Commercial |
$10,660.70
|
|
|
HC PERC PULM ART STENT EA ADD ABN OR NRM
|
Facility
|
IP
|
$14,755.00
|
|
|
Service Code
|
CPT 33904
|
| Hospital Charge Code |
906820327
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,951.00 |
| Max. Negotiated Rate |
$12,541.75 |
| Rate for Payer: Adventist Health Commercial |
$2,951.00
|
| Rate for Payer: Cash Price |
$6,639.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,902.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,902.00
|
| Rate for Payer: Galaxy Health WC |
$12,541.75
|
| Rate for Payer: Global Benefits Group Commercial |
$8,853.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,841.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,621.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,133.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,541.20
|
| Rate for Payer: Multiplan Commercial |
$11,804.00
|
| Rate for Payer: Networks By Design Commercial |
$9,590.75
|
| Rate for Payer: Prime Health Services Commercial |
$12,541.75
|
|
|
HC PERC PULM ART STENT NRM BI
|
Facility
|
OP
|
$25,085.00
|
|
|
Service Code
|
CPT 33901
|
| Hospital Charge Code |
906811901
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,845.77 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,017.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$11,288.25
|
| Rate for Payer: Cash Price |
$11,288.25
|
| Rate for Payer: Cash Price |
$11,288.25
|
| Rate for Payer: Cigna of CA HMO |
$16,054.40
|
| Rate for Payer: Cigna of CA PPO |
$18,562.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$21,322.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15,051.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,731.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,020.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$20,068.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$16,305.25
|
| Rate for Payer: Prime Health Services Commercial |
$21,322.25
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,051.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC PERC PULM ART STENT NRM BI
|
Facility
|
IP
|
$25,085.00
|
|
|
Service Code
|
CPT 33901
|
| Hospital Charge Code |
906811901
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,017.00 |
| Max. Negotiated Rate |
$21,322.25 |
| Rate for Payer: Adventist Health Commercial |
$5,017.00
|
| Rate for Payer: Cash Price |
$11,288.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,034.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,034.00
|
| Rate for Payer: Galaxy Health WC |
$21,322.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15,051.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,731.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,557.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,527.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,020.40
|
| Rate for Payer: Multiplan Commercial |
$20,068.00
|
| Rate for Payer: Networks By Design Commercial |
$16,305.25
|
| Rate for Payer: Prime Health Services Commercial |
$21,322.25
|
|
|
HC PERC PULM ART STENT NRM BI
|
Facility
|
IP
|
$29,512.00
|
|
|
Service Code
|
CPT 33901
|
| Hospital Charge Code |
906820325
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,902.40 |
| Max. Negotiated Rate |
$25,085.20 |
| Rate for Payer: Adventist Health Commercial |
$5,902.40
|
| Rate for Payer: Cash Price |
$13,280.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,804.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11,804.80
|
| Rate for Payer: Galaxy Health WC |
$25,085.20
|
| Rate for Payer: Global Benefits Group Commercial |
$17,707.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,684.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,244.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,267.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,082.88
|
| Rate for Payer: Multiplan Commercial |
$23,609.60
|
| Rate for Payer: Networks By Design Commercial |
$19,182.80
|
| Rate for Payer: Prime Health Services Commercial |
$25,085.20
|
|
|
HC PERC PULM ART STENT NRM BI
|
Facility
|
OP
|
$29,512.00
|
|
|
Service Code
|
CPT 33901
|
| Hospital Charge Code |
906820325
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,845.77 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,902.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$13,280.40
|
| Rate for Payer: Cash Price |
$13,280.40
|
| Rate for Payer: Cash Price |
$13,280.40
|
| Rate for Payer: Cigna of CA HMO |
$18,887.68
|
| Rate for Payer: Cigna of CA PPO |
$21,838.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$25,085.20
|
| Rate for Payer: Global Benefits Group Commercial |
$17,707.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,684.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,082.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$23,609.60
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$19,182.80
|
| Rate for Payer: Prime Health Services Commercial |
$25,085.20
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,707.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC PERC PULM ART STENT NRM UNI
|
Facility
|
OP
|
$25,085.00
|
|
|
Service Code
|
CPT 33900
|
| Hospital Charge Code |
906811900
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,845.77 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,017.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$11,288.25
|
| Rate for Payer: Cash Price |
$11,288.25
|
| Rate for Payer: Cash Price |
$11,288.25
|
| Rate for Payer: Cigna of CA HMO |
$16,054.40
|
| Rate for Payer: Cigna of CA PPO |
$18,562.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$21,322.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15,051.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,731.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,020.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$20,068.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$16,305.25
|
| Rate for Payer: Prime Health Services Commercial |
$21,322.25
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,051.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC PERC PULM ART STENT NRM UNI
|
Facility
|
OP
|
$29,512.00
|
|
|
Service Code
|
CPT 33900
|
| Hospital Charge Code |
906820324
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,845.77 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,902.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11,370.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,561.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$13,280.40
|
| Rate for Payer: Cash Price |
$13,280.40
|
| Rate for Payer: Cash Price |
$13,280.40
|
| Rate for Payer: Cigna of CA HMO |
$18,887.68
|
| Rate for Payer: Cigna of CA PPO |
$21,838.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$25,085.20
|
| Rate for Payer: Global Benefits Group Commercial |
$17,707.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,684.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,082.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,155.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$23,609.60
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$19,182.80
|
| Rate for Payer: Prime Health Services Commercial |
$25,085.20
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,707.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC PERC PULM ART STENT NRM UNI
|
Facility
|
IP
|
$25,085.00
|
|
|
Service Code
|
CPT 33900
|
| Hospital Charge Code |
906811900
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,017.00 |
| Max. Negotiated Rate |
$21,322.25 |
| Rate for Payer: Adventist Health Commercial |
$5,017.00
|
| Rate for Payer: Cash Price |
$11,288.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,034.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10,034.00
|
| Rate for Payer: Galaxy Health WC |
$21,322.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15,051.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,731.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,557.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,527.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,020.40
|
| Rate for Payer: Multiplan Commercial |
$20,068.00
|
| Rate for Payer: Networks By Design Commercial |
$16,305.25
|
| Rate for Payer: Prime Health Services Commercial |
$21,322.25
|
|
|
HC PERC PULM ART STENT NRM UNI
|
Facility
|
IP
|
$29,512.00
|
|
|
Service Code
|
CPT 33900
|
| Hospital Charge Code |
906820324
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,902.40 |
| Max. Negotiated Rate |
$25,085.20 |
| Rate for Payer: Adventist Health Commercial |
$5,902.40
|
| Rate for Payer: Cash Price |
$13,280.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,804.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11,804.80
|
| Rate for Payer: Galaxy Health WC |
$25,085.20
|
| Rate for Payer: Global Benefits Group Commercial |
$17,707.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,684.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,244.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,267.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,082.88
|
| Rate for Payer: Multiplan Commercial |
$23,609.60
|
| Rate for Payer: Networks By Design Commercial |
$19,182.80
|
| Rate for Payer: Prime Health Services Commercial |
$25,085.20
|
|
|
HC PERC RF ABLATION, LUNG
|
Facility
|
OP
|
$13,713.00
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
909081840
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,470.08 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,742.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,119.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,154.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,413.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,339.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$2,470.08
|
| Rate for Payer: Cash Price |
$6,170.85
|
| Rate for Payer: Cash Price |
$6,170.85
|
| Rate for Payer: Cash Price |
$6,170.85
|
| Rate for Payer: Cigna of CA HMO |
$8,776.32
|
| Rate for Payer: Cigna of CA PPO |
$10,147.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,119.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,154.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,413.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,007.74
|
| Rate for Payer: EPIC Health Plan Senior |
$7,413.14
|
| Rate for Payer: Galaxy Health WC |
$11,656.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,227.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$12,157.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4,350.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,413.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,146.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,920.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,413.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,291.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,340.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,933.61
|
| Rate for Payer: Multiplan Commercial |
$10,970.40
|
| Rate for Payer: Multiplan WC |
$11,811.52
|
| Rate for Payer: Networks By Design Commercial |
$8,913.45
|
| Rate for Payer: Prime Health Services Commercial |
$11,656.05
|
| Rate for Payer: Prime Health Services WC |
$11,690.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,227.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,413.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,119.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,154.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,413.14
|
|
|
HC PERC RF ABLATION, LUNG
|
Facility
|
IP
|
$13,713.00
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
909081840
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,742.60 |
| Max. Negotiated Rate |
$11,656.05 |
| Rate for Payer: Adventist Health Commercial |
$2,742.60
|
| Rate for Payer: Cash Price |
$6,170.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,485.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,485.20
|
| Rate for Payer: Galaxy Health WC |
$11,656.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,227.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,146.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,224.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,488.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,291.12
|
| Rate for Payer: Multiplan Commercial |
$10,970.40
|
| Rate for Payer: Networks By Design Commercial |
$8,913.45
|
| Rate for Payer: Prime Health Services Commercial |
$11,656.05
|
|
|
HC PERC RF ABLATION, RENAL TUMOR
|
Facility
|
OP
|
$21,689.00
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
909081854
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,968.41 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$4,337.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,491.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,119.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,154.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,413.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,339.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$9,760.05
|
| Rate for Payer: Cash Price |
$9,760.05
|
| Rate for Payer: Cash Price |
$9,760.05
|
| Rate for Payer: Cigna of CA HMO |
$13,880.96
|
| Rate for Payer: Cigna of CA PPO |
$16,049.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,119.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,154.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,413.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,007.74
|
| Rate for Payer: EPIC Health Plan Senior |
$7,413.14
|
| Rate for Payer: Galaxy Health WC |
$18,435.65
|
| Rate for Payer: Global Benefits Group Commercial |
$13,013.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$12,157.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,413.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,466.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,413.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,205.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,340.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,933.61
|
| Rate for Payer: Multiplan Commercial |
$17,351.20
|
| Rate for Payer: Multiplan WC |
$11,811.52
|
| Rate for Payer: Networks By Design Commercial |
$14,097.85
|
| Rate for Payer: Prime Health Services Commercial |
$18,435.65
|
| Rate for Payer: Prime Health Services WC |
$11,690.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,013.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,413.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,119.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,154.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,413.14
|
|
