|
HC PASSY MUIR VALVE FOR VENTS
|
Facility
|
OP
|
$288.00
|
|
| Hospital Charge Code |
900800705
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$188.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$216.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$184.81
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$244.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$104.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.60
|
| Rate for Payer: Multiplan Commercial |
$230.40
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.00
|
| Rate for Payer: United Healthcare All Other HMO |
$144.00
|
| Rate for Payer: United Healthcare HMO Rider |
$144.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.80
|
| Rate for Payer: Vantage Medical Group Senior |
$244.80
|
|
|
HC PASSY MUIR VALVE SPEAKING
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
900800700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$244.80 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.12
|
| Rate for Payer: Multiplan Commercial |
$230.40
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
|
|
HC PASSY MUIR VALVE SPEAKING
|
Facility
|
OP
|
$288.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
900800700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$605.40 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$605.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$158.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$216.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$184.81
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Cigna of CA HMO |
$184.32
|
| Rate for Payer: Cigna of CA PPO |
$213.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$244.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$115.20
|
| Rate for Payer: Galaxy Health WC |
$244.80
|
| Rate for Payer: Global Benefits Group Commercial |
$172.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$104.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.60
|
| Rate for Payer: Multiplan Commercial |
$230.40
|
| Rate for Payer: Networks By Design Commercial |
$187.20
|
| Rate for Payer: Prime Health Services Commercial |
$244.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$144.00
|
| Rate for Payer: United Healthcare All Other HMO |
$144.00
|
| Rate for Payer: United Healthcare HMO Rider |
$144.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$244.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.80
|
| Rate for Payer: Vantage Medical Group Senior |
$244.80
|
|
|
HC PASTE MEDIHONEY TUBE .5FL OZ
|
Facility
|
OP
|
$39.69
|
|
|
Service Code
|
CPT A6240
|
| Hospital Charge Code |
901698328
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.94 |
| Max. Negotiated Rate |
$34.90 |
| Rate for Payer: Adventist Health Commercial |
$7.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.47
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Cigna of CA HMO |
$25.40
|
| Rate for Payer: Cigna of CA PPO |
$29.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.88
|
| Rate for Payer: EPIC Health Plan Senior |
$15.88
|
| Rate for Payer: Galaxy Health WC |
$33.74
|
| Rate for Payer: Global Benefits Group Commercial |
$23.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.78
|
| Rate for Payer: Multiplan Commercial |
$31.75
|
| Rate for Payer: Networks By Design Commercial |
$25.80
|
| Rate for Payer: Prime Health Services Commercial |
$33.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.84
|
| Rate for Payer: United Healthcare All Other HMO |
$19.84
|
| Rate for Payer: United Healthcare HMO Rider |
$19.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.74
|
| Rate for Payer: Vantage Medical Group Senior |
$33.74
|
|
|
HC PASTE MEDIHONEY TUBE .5FL OZ
|
Facility
|
IP
|
$39.69
|
|
|
Service Code
|
CPT A6240
|
| Hospital Charge Code |
901698328
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.94 |
| Max. Negotiated Rate |
$33.74 |
| Rate for Payer: Adventist Health Commercial |
$7.94
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.88
|
| Rate for Payer: EPIC Health Plan Senior |
$15.88
|
| Rate for Payer: Galaxy Health WC |
$33.74
|
| Rate for Payer: Global Benefits Group Commercial |
$23.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.53
|
| Rate for Payer: Multiplan Commercial |
$31.75
|
| Rate for Payer: Networks By Design Commercial |
$25.80
|
| Rate for Payer: Prime Health Services Commercial |
$33.74
|
|
|
HC PATH CONSULT SURG ADDL BLOCK P
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800220
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$21.25 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC PATH CONSULT SURG ADDL BLOCK P
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800220
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$86.10 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$79.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$86.10
|
| Rate for Payer: Blue Shield of California Commercial |
$17.43
|
| Rate for Payer: Blue Shield of California Commercial |
$11.53
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$32.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.50
|
| Rate for Payer: Multiplan Commercial |
$20.00
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.90
|
| Rate for Payer: United Healthcare All Other HMO |
$19.90
|
| Rate for Payer: United Healthcare HMO Rider |
$19.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.25
|
| Rate for Payer: Vantage Medical Group Senior |
$21.25
|
|
|
HC PATH CONSULT SURGERY FRZN PG
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
903800219
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$144.50 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$100.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Multiplan Commercial |
$136.00
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
|
|
HC PATH CONSULT SURGERY FRZN PG
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
903800219
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$361.55 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$229.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$164.34
|
| Rate for Payer: Blue Shield of California Commercial |
$118.49
|
| Rate for Payer: Blue Shield of California Commercial |
$78.37
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cigna of CA HMO |
$108.80
|
| Rate for Payer: Cigna of CA PPO |
$125.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$119.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.55
|
| Rate for Payer: EPIC Health Plan Senior |
$241.03
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$359.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$74.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$107.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$84.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$306.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$276.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$136.00
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$219.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
|
HC PATTEN BOTTOM ADDITION LE
|
Facility
|
OP
|
$754.00
|
|
|
Service Code
|
CPT L2370
|
| Hospital Charge Code |
915352370
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$180.96 |
| Max. Negotiated Rate |
$640.90 |
| Rate for Payer: Adventist Health Commercial |
$309.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$640.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$414.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$565.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$456.40
|
| Rate for Payer: Blue Shield of California Commercial |
$579.83
|
| Rate for Payer: Blue Shield of California Commercial |
$382.28
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cigna of CA HMO |
$527.80
|
| Rate for Payer: Cigna of CA PPO |
$527.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$640.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$640.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$640.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$527.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Senior |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$346.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$478.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$391.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$444.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$527.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$527.80
|
| Rate for Payer: Multiplan Commercial |
$603.20
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$452.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$452.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$282.98
|
| Rate for Payer: United Healthcare All Other HMO |
$275.44
|
| Rate for Payer: United Healthcare HMO Rider |
$269.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$640.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$640.90
|
| Rate for Payer: Vantage Medical Group Senior |
$640.90
|
|
|
HC PATTEN BOTTOM ADDITION LE
|
Facility
|
OP
|
$754.00
|
|
|
Service Code
|
CPT L2370
|
| Hospital Charge Code |
905352370
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$180.96 |
| Max. Negotiated Rate |
$640.90 |
| Rate for Payer: Adventist Health Commercial |
$309.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$640.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$414.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$565.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$456.40
|
| Rate for Payer: Blue Shield of California Commercial |
$579.83
|
| Rate for Payer: Blue Shield of California Commercial |
$382.28
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cigna of CA HMO |
$527.80
|
| Rate for Payer: Cigna of CA PPO |
$527.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$640.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$640.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$640.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$527.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Senior |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$346.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$478.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$391.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$444.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$527.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$527.80
|
| Rate for Payer: Multiplan Commercial |
$603.20
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$452.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$452.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$282.98
|
| Rate for Payer: United Healthcare All Other HMO |
$275.44
|
| Rate for Payer: United Healthcare HMO Rider |
$269.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$640.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$640.90
|
| Rate for Payer: Vantage Medical Group Senior |
$640.90
|
|
|
HC PATTEN BOTTOM ADDITION LE
|
Facility
|
IP
|
$754.00
|
|
|
Service Code
|
CPT L2370
|
| Hospital Charge Code |
915352370
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$150.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cigna of CA HMO |
$527.80
|
| Rate for Payer: Cigna of CA PPO |
$527.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$527.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Senior |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$478.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$444.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.96
|
| Rate for Payer: Multiplan Commercial |
$603.20
|
| Rate for Payer: Networks By Design Commercial |
$490.10
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$282.98
|
| Rate for Payer: United Healthcare All Other HMO |
$275.44
|
| Rate for Payer: United Healthcare HMO Rider |
$269.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.94
|
|
|
HC PATTEN BOTTOM ADDITION LE
|
Facility
|
IP
|
$754.00
|
|
|
Service Code
|
CPT L2370
|
| Hospital Charge Code |
905352370
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Adventist Health Commercial |
$150.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$339.30
|
| Rate for Payer: Cigna of CA HMO |
$527.80
|
| Rate for Payer: Cigna of CA PPO |
$527.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$527.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Senior |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$478.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$444.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$180.96
|
| Rate for Payer: Multiplan Commercial |
$603.20
|
| Rate for Payer: Networks By Design Commercial |
$490.10
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$282.98
|
| Rate for Payer: United Healthcare All Other HMO |
$275.44
|
| Rate for Payer: United Healthcare HMO Rider |
$269.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.94
|
|
|
HC PCI BYPASS GRAFT
|
Facility
|
OP
|
$15,309.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
906811440
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$810.53 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$3,061.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,136.63
|
| Rate for Payer: Blue Shield of California Commercial |
$6,262.29
|
| Rate for Payer: Cash Price |
$6,889.05
|
| Rate for Payer: Cash Price |
$6,889.05
|
| Rate for Payer: Cash Price |
$6,889.05
|
| Rate for Payer: Cigna of CA HMO |
$9,950.85
|
| Rate for Payer: Cigna of CA PPO |
$11,328.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,716.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$13,012.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9,185.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$810.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,721.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$916.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,674.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,708.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$12,247.20
|
| Rate for Payer: Networks By Design Commercial |
$9,950.85
|
| Rate for Payer: Prime Health Services Commercial |
$13,012.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,185.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,185.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,654.50
|
| 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 |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC PCI BYPASS GRAFT
|
Facility
|
IP
|
$15,309.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
906811440
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,061.80 |
| Max. Negotiated Rate |
$13,012.65 |
| Rate for Payer: Adventist Health Commercial |
$3,061.80
|
| Rate for Payer: Cash Price |
$6,889.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,716.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,123.60
|
| Rate for Payer: EPIC Health Plan Senior |
$6,123.60
|
| Rate for Payer: Galaxy Health WC |
$13,012.65
|
| Rate for Payer: Global Benefits Group Commercial |
$9,185.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,721.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,032.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,674.16
|
| Rate for Payer: Multiplan Commercial |
$12,247.20
|
| Rate for Payer: Networks By Design Commercial |
$9,950.85
|
| Rate for Payer: Prime Health Services Commercial |
$13,012.65
|
|
|
HC PCI BYPASS GRAFT ADD
|
Facility
|
OP
|
$27,471.00
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
906811464
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$23,350.35 |
| Rate for Payer: Adventist Health Commercial |
$5,494.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18,018.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23,350.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,109.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,603.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,136.63
|
| Rate for Payer: Blue Shield of California Commercial |
$6,262.29
|
| Rate for Payer: Cash Price |
$12,361.95
|
| Rate for Payer: Cash Price |
$12,361.95
|
| Rate for Payer: Cash Price |
$12,361.95
|
| Rate for Payer: Cigna of CA HMO |
$17,581.44
|
| Rate for Payer: Cigna of CA PPO |
$20,328.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,350.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,350.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,350.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,229.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,988.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,988.40
|
| Rate for Payer: Galaxy Health WC |
$23,350.35
|
| Rate for Payer: Global Benefits Group Commercial |
$16,482.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,444.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,971.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16,207.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,593.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,229.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,229.70
|
| Rate for Payer: Multiplan Commercial |
$21,976.80
|
| Rate for Payer: Networks By Design Commercial |
$17,856.15
|
| Rate for Payer: Prime Health Services Commercial |
$23,350.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,482.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,482.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23,350.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,350.35
|
| Rate for Payer: Vantage Medical Group Senior |
$23,350.35
|
|
|
HC PCI BYPASS GRAFT ADD
|
Facility
|
IP
|
$27,471.00
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
906811464
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5,494.20 |
| Max. Negotiated Rate |
$23,350.35 |
| Rate for Payer: Adventist Health Commercial |
$5,494.20
|
| Rate for Payer: Cash Price |
$12,361.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,229.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,988.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,988.40
|
| Rate for Payer: Galaxy Health WC |
$23,350.35
|
| Rate for Payer: Global Benefits Group Commercial |
$16,482.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,444.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16,207.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,593.04
|
| Rate for Payer: Multiplan Commercial |
$21,976.80
|
| Rate for Payer: Networks By Design Commercial |
$17,856.15
|
| Rate for Payer: Prime Health Services Commercial |
$23,350.35
|
|
|
HC PCI BYPASS GRAFT, ADDN'L
|
Facility
|
OP
|
$7,654.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
906811441
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,530.80 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,530.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,505.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,209.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,740.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,136.63
|
| Rate for Payer: Blue Shield of California Commercial |
$6,262.29
|
| Rate for Payer: Cash Price |
$3,444.30
|
| Rate for Payer: Cash Price |
$3,444.30
|
| Rate for Payer: Cigna of CA HMO |
$4,975.10
|
| Rate for Payer: Cigna of CA PPO |
$5,663.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,505.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,505.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,505.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,357.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,061.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,061.60
|
| Rate for Payer: Galaxy Health WC |
$6,505.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,592.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,860.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,778.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,515.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,836.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,357.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,357.80
|
| Rate for Payer: Multiplan Commercial |
$6,123.20
|
| Rate for Payer: Networks By Design Commercial |
$4,975.10
|
| Rate for Payer: Prime Health Services Commercial |
$6,505.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,592.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,592.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,827.00
|
| 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: Vantage Medical Group Commercial/Exchange |
$6,505.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,505.90
|
| Rate for Payer: Vantage Medical Group Senior |
$6,505.90
|
|
|
HC PCI BYPASS GRAFT, ADDN'L
|
Facility
|
IP
|
$7,654.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
906811441
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,530.80 |
| Max. Negotiated Rate |
$6,505.90 |
| Rate for Payer: Adventist Health Commercial |
$1,530.80
|
| Rate for Payer: Cash Price |
$3,444.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,357.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,061.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,061.60
|
| Rate for Payer: Galaxy Health WC |
$6,505.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,592.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,860.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,515.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,836.96
|
| Rate for Payer: Multiplan Commercial |
$6,123.20
|
| Rate for Payer: Networks By Design Commercial |
$4,975.10
|
| Rate for Payer: Prime Health Services Commercial |
$6,505.90
|
|
|
HC PCI CORO/BYPASS CHRNC CMBND AG AND RG
|
Facility
|
IP
|
$36,182.00
|
|
|
Service Code
|
CPT 92945
|
| Hospital Charge Code |
906811867
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,236.40 |
| Max. Negotiated Rate |
$30,754.70 |
| Rate for Payer: Adventist Health Commercial |
$7,236.40
|
| Rate for Payer: Cash Price |
$16,281.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25,327.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,472.80
|
| Rate for Payer: EPIC Health Plan Senior |
$14,472.80
|
| Rate for Payer: Galaxy Health WC |
$30,754.70
|
| Rate for Payer: Global Benefits Group Commercial |
$21,709.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22,975.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21,347.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,683.68
|
| Rate for Payer: Multiplan Commercial |
$28,945.60
|
| Rate for Payer: Networks By Design Commercial |
$23,518.30
|
| Rate for Payer: Prime Health Services Commercial |
$30,754.70
|
|
|
HC PCI CORO/BYPASS CHRNC CMBND AG AND RG
|
Facility
|
OP
|
$36,182.00
|
|
|
Service Code
|
CPT 92945
|
| Hospital Charge Code |
906811867
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,753.44 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$7,236.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23,217.99
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Cash Price |
$16,281.90
|
| Rate for Payer: Cash Price |
$16,281.90
|
| Rate for Payer: Cash Price |
$16,281.90
|
| Rate for Payer: Cigna of CA HMO |
$23,518.30
|
| Rate for Payer: Cigna of CA PPO |
$26,774.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25,327.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$30,754.70
|
| Rate for Payer: Global Benefits Group Commercial |
$21,709.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22,975.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,683.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,708.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$28,945.60
|
| Rate for Payer: Networks By Design Commercial |
$23,518.30
|
| Rate for Payer: Prime Health Services Commercial |
$30,754.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21,709.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21,709.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$18,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$18,091.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,091.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18,091.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC PCI CORO/BYPASS CHRONIC 1 VESL
|
Facility
|
OP
|
$18,372.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
906811443
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$909.18 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$3,674.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,136.63
|
| Rate for Payer: Blue Shield of California Commercial |
$6,262.29
|
| Rate for Payer: Cash Price |
$8,267.40
|
| Rate for Payer: Cash Price |
$8,267.40
|
| Rate for Payer: Cash Price |
$8,267.40
|
| Rate for Payer: Cigna of CA HMO |
$11,941.80
|
| Rate for Payer: Cigna of CA PPO |
$13,595.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,860.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$15,616.20
|
| Rate for Payer: Global Benefits Group Commercial |
$11,023.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$909.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,666.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,028.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,409.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,708.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$14,697.60
|
| Rate for Payer: Networks By Design Commercial |
$11,941.80
|
| Rate for Payer: Prime Health Services Commercial |
$15,616.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,023.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,023.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,186.00
|
| 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 |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC PCI CORO/BYPASS CHRONIC 1 VESL
|
Facility
|
IP
|
$18,372.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
906811443
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,674.40 |
| Max. Negotiated Rate |
$15,616.20 |
| Rate for Payer: Adventist Health Commercial |
$3,674.40
|
| Rate for Payer: Cash Price |
$8,267.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,860.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,348.80
|
| Rate for Payer: EPIC Health Plan Senior |
$7,348.80
|
| Rate for Payer: Galaxy Health WC |
$15,616.20
|
| Rate for Payer: Global Benefits Group Commercial |
$11,023.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,666.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,839.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,409.28
|
| Rate for Payer: Multiplan Commercial |
$14,697.60
|
| Rate for Payer: Networks By Design Commercial |
$11,941.80
|
| Rate for Payer: Prime Health Services Commercial |
$15,616.20
|
|
|
HC PCI CORO BYPASS CHRONIC 1 VSL
|
Facility
|
IP
|
$37,952.00
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
906811466
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7,590.40 |
| Max. Negotiated Rate |
$32,259.20 |
| Rate for Payer: Adventist Health Commercial |
$7,590.40
|
| Rate for Payer: Cash Price |
$17,078.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26,566.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,180.80
|
| Rate for Payer: EPIC Health Plan Senior |
$15,180.80
|
| Rate for Payer: Galaxy Health WC |
$32,259.20
|
| Rate for Payer: Global Benefits Group Commercial |
$22,771.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24,099.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22,391.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,108.48
|
| Rate for Payer: Multiplan Commercial |
$30,361.60
|
| Rate for Payer: Networks By Design Commercial |
$24,668.80
|
| Rate for Payer: Prime Health Services Commercial |
$32,259.20
|
|
|
HC PCI CORO BYPASS CHRONIC 1 VSL
|
Facility
|
OP
|
$37,952.00
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
906811466
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$38,902.96 |
| Rate for Payer: Adventist Health Commercial |
$7,590.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,971.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,577.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,261.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,262.29
|
| Rate for Payer: Blue Shield of California Commercial |
$4,136.63
|
| Rate for Payer: Cash Price |
$17,078.40
|
| Rate for Payer: Cash Price |
$17,078.40
|
| Rate for Payer: Cash Price |
$17,078.40
|
| Rate for Payer: Cash Price |
$17,078.40
|
| Rate for Payer: Cigna of CA HMO |
$24,289.28
|
| Rate for Payer: Cigna of CA PPO |
$28,084.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,935.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,577.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26,566.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,902.96
|
| Rate for Payer: EPIC Health Plan Senior |
$25,935.31
|
| Rate for Payer: Galaxy Health WC |
$32,259.20
|
| Rate for Payer: Global Benefits Group Commercial |
$22,771.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$38,667.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24,099.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13,776.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33,008.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,108.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,707.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$31,593.92
|
| Rate for Payer: Multiplan Commercial |
$30,361.60
|
| Rate for Payer: Networks By Design Commercial |
$24,668.80
|
| Rate for Payer: Prime Health Services Commercial |
$32,259.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22,771.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22,771.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$23,577.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Vantage Medical Group Senior |
$23,577.55
|
|
