|
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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$476.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,670.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,958.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,780.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| 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 |
$2,670.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,958.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,780.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,668.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,937.36
|
| Rate for Payer: EPIC Health Plan Senior |
$1,958.24
|
| 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/Senior |
$2,919.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$872.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,780.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,513.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$986.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,492.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$572.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,243.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,385.49
|
| 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 |
$1,192.00
|
| 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 |
$1,780.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,670.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,958.24
|
| Rate for Payer: Vantage Medical Group Senior |
$1,780.22
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,668.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,513.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,406.56
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,559.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$15,928.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,800.15
|
| 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 |
$1,924.01 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,017.00
|
| 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 |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| 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 |
$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 |
$17,559.50
|
| 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 |
$21,322.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15,051.00
|
| 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 |
$15,928.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,020.40
|
| 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 |
$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 |
$12,542.50
|
| 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 |
$14,847.76
|
| 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 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$32,676.70
|
| 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 Foundation Hospitals Commercial/Self Funded |
$29,642.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27,541.79
|
| 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 ABN UNI
|
Facility
|
OP
|
$46,681.00
|
|
|
Service Code
|
CPT 33902
|
| Hospital Charge Code |
906811902
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,924.01 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$9,336.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| 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 |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| 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 |
$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 |
$32,676.70
|
| 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 |
$39,678.85
|
| Rate for Payer: Global Benefits Group Commercial |
$28,008.60
|
| 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 |
$29,642.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33,008.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,203.44
|
| 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 |
$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 |
$23,340.50
|
| 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 |
$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
|
|
|
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 |
$594.18 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,508.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| 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 |
$8,048.20
|
| Rate for Payer: Blue Shield of California Commercial |
$899.51
|
| Rate for Payer: Blue Shield of California Commercial |
$594.18
|
| Rate for Payer: Cash Price |
$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: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,779.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$7,964.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,399.78
|
| 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 |
$6,271.00
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,779.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$7,964.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,399.78
|
| 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 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,559.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$15,928.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,800.15
|
| 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
|
OP
|
$25,085.00
|
|
|
Service Code
|
CPT 33901
|
| Hospital Charge Code |
906811901
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,924.01 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,017.00
|
| 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 |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| 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 |
$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 |
$17,559.50
|
| 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 |
$21,322.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15,051.00
|
| 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 |
$15,928.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,020.40
|
| 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 |
$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 |
$12,542.50
|
| 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 |
$14,847.76
|
| 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 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,559.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$15,928.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,800.15
|
| 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
|
OP
|
$25,085.00
|
|
|
Service Code
|
CPT 33900
|
| Hospital Charge Code |
906811900
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,924.01 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,017.00
|
| 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 |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| 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 |
$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 |
$17,559.50
|
| 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 |
$21,322.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15,051.00
|
| 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 |
$15,928.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,020.40
|
| 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 |
$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 |
$12,542.50
|
| 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 |
$14,847.76
|
| 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 PERC RF ABLATION, LUNG
|
Facility
|
OP
|
$13,713.00
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
909081840
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,574.78 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,742.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,663.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,553.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,775.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,759.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$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 |
$11,663.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,553.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,775.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,599.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,829.67
|
| Rate for Payer: EPIC Health Plan Senior |
$8,553.12
|
| 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/Senior |
$12,751.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4,350.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,775.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,707.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,920.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,885.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,291.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,797.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,419.25
|
| 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 |
$6,856.50
|
| 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 |
$7,775.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,663.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,553.12
|
| Rate for Payer: Vantage Medical Group Senior |
$7,775.56
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,599.10
|
| 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 Foundation Hospitals Commercial/Self Funded |
$8,707.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,090.67
|
| 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 |
$4,136.63 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$4,337.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,663.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,553.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,775.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,759.00
|
| 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 |
$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 |
$11,663.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,553.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,775.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,182.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,829.67
|
| Rate for Payer: EPIC Health Plan Senior |
$8,553.12
|
| 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/Senior |
$12,751.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,775.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,772.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,885.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,205.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,797.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10,419.25
|
| 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 |
$10,844.50
|
| 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 |
$7,775.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,663.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,553.12
|
| Rate for Payer: Vantage Medical Group Senior |
$7,775.56
|
|
|
HC PERC RF ABLATION, RENAL TUMOR
|
Facility
|
IP
|
$21,689.00
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
909081854
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,337.80 |
| Max. Negotiated Rate |
$18,435.65 |
| Rate for Payer: Adventist Health Commercial |
$4,337.80
|
| Rate for Payer: Cash Price |
$9,760.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,182.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,675.60
|
| Rate for Payer: EPIC Health Plan Senior |
$8,675.60
|
| Rate for Payer: Galaxy Health WC |
$18,435.65
|
| Rate for Payer: Global Benefits Group Commercial |
$13,013.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,772.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,796.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,205.36
|
| Rate for Payer: Multiplan Commercial |
$17,351.20
|
| Rate for Payer: Networks By Design Commercial |
$14,097.85
|
| Rate for Payer: Prime Health Services Commercial |
$18,435.65
|
|
|
HC PERC SKEL FIX OF FEM FRAC
|
Facility
|
OP
|
$7,001.00
|
|
|
Service Code
|
CPT 27509
|
| Hospital Charge Code |
900501086
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$111.06 |
| Max. Negotiated Rate |
$15,398.95 |
| Rate for Payer: Adventist Health Commercial |
$1,400.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,332.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Cash Price |
$3,150.45
|
| Rate for Payer: Cash Price |
$3,150.45
|
| Rate for Payer: Cash Price |
$3,150.45
|
| Rate for Payer: Cigna of CA HMO |
$4,480.64
|
| Rate for Payer: Cigna of CA PPO |
$5,180.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,265.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,332.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,900.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,398.95
|
| Rate for Payer: EPIC Health Plan Senior |
$10,265.97
|
| Rate for Payer: Galaxy Health WC |
$5,950.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,200.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,305.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,332.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,445.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$111.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,032.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,680.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,759.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,505.82
|
| Rate for Payer: Multiplan Commercial |
$5,600.80
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: Networks By Design Commercial |
$4,550.65
|
| Rate for Payer: Prime Health Services Commercial |
$5,950.85
|
| Rate for Payer: Prime Health Services WC |
$14,314.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,200.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,500.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,500.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,500.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,500.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$9,332.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9,332.70
|
|
|
HC PERC SKEL FIX OF FEM FRAC
|
Facility
|
IP
|
$7,001.00
|
|
|
Service Code
|
CPT 27509
|
| Hospital Charge Code |
900501086
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,400.20 |
| Max. Negotiated Rate |
$5,950.85 |
| Rate for Payer: Adventist Health Commercial |
$1,400.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,549.51
|
| Rate for Payer: Blue Shield of California Commercial |
$5,383.77
|
| Rate for Payer: Cash Price |
$3,150.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,900.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,800.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,800.40
|
| Rate for Payer: Galaxy Health WC |
$5,950.85
|
| Rate for Payer: Global Benefits Group Commercial |
$4,200.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,445.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,130.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,680.24
|
| Rate for Payer: Multiplan Commercial |
$5,600.80
|
| Rate for Payer: Networks By Design Commercial |
$4,550.65
|
| Rate for Payer: Prime Health Services Commercial |
$5,950.85
|
|
|
HC PERC SKEL FIX OF FEM FRAC PROX
|
Facility
|
OP
|
$4,806.00
|
|
|
Service Code
|
CPT 27235
|
| Hospital Charge Code |
900501082
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$961.20 |
| Max. Negotiated Rate |
$15,398.95 |
| Rate for Payer: Vantage Medical Group Senior |
$9,332.70
|
| Rate for Payer: Adventist Health Commercial |
$961.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,265.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,332.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,323.00
|
| Rate for Payer: Cash Price |
$2,162.70
|
| Rate for Payer: Cash Price |
$2,162.70
|
| Rate for Payer: Cash Price |
$2,162.70
|
| Rate for Payer: Cigna of CA HMO |
$3,075.84
|
| Rate for Payer: Cigna of CA PPO |
$3,556.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,265.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,332.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,364.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,398.95
|
| Rate for Payer: EPIC Health Plan Senior |
$10,265.97
|
| Rate for Payer: Galaxy Health WC |
$4,085.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,883.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,305.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,332.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,051.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,556.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,032.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,153.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,759.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,505.82
|
| Rate for Payer: Multiplan Commercial |
$3,844.80
|
| Rate for Payer: Multiplan WC |
$14,462.30
|
| Rate for Payer: Networks By Design Commercial |
$3,123.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,085.10
|
| Rate for Payer: Prime Health Services WC |
$14,314.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,883.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,403.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,403.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,403.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,403.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$9,332.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,999.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,265.97
|
|
|
HC PERC SKEL FIX OF FEM FRAC PROX
|
Facility
|
IP
|
$4,806.00
|
|
|
Service Code
|
CPT 27235
|
| Hospital Charge Code |
900501082
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$961.20 |
| Max. Negotiated Rate |
$4,085.10 |
| Rate for Payer: Adventist Health Commercial |
$961.20
|
| Rate for Payer: Cash Price |
$2,162.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,364.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,922.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,922.40
|
| Rate for Payer: Galaxy Health WC |
$4,085.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,883.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,051.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,835.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,153.44
|
| Rate for Payer: Multiplan Commercial |
$3,844.80
|
| Rate for Payer: Networks By Design Commercial |
$3,123.90
|
| Rate for Payer: Prime Health Services Commercial |
$4,085.10
|
|
|
HC PERC THROMB DIALYSIS CRCT
|
Facility
|
OP
|
$16,668.00
|
|
|
Service Code
|
CPT 36904
|
| Hospital Charge Code |
909036904
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,719.52 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$3,333.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,320.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,702.17
|
| Rate for Payer: Blue Shield of California Commercial |
$7,730.00
|
| Rate for Payer: Cash Price |
$7,500.60
|
| Rate for Payer: Cash Price |
$7,500.60
|
| Rate for Payer: Cash Price |
$7,500.60
|
| Rate for Payer: Cigna of CA HMO |
$10,667.52
|
| Rate for Payer: Cigna of CA PPO |
$12,334.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,052.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,320.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,667.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,078.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8,052.33
|
| Rate for Payer: Galaxy Health WC |
$14,167.80
|
| Rate for Payer: Global Benefits Group Commercial |
$10,000.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,005.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,719.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,584.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,075.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,248.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,000.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,223.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,809.20
|
| Rate for Payer: Multiplan Commercial |
$13,334.40
|
| Rate for Payer: Multiplan WC |
$11,542.58
|
| Rate for Payer: Networks By Design Commercial |
$10,834.20
|
| Rate for Payer: Prime Health Services Commercial |
$14,167.80
|
| Rate for Payer: Prime Health Services WC |
$11,424.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,000.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,334.00
|
| 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 |
$7,320.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Vantage Medical Group Senior |
$7,320.30
|
|
|
HC PERC THROMB DIALYSIS CRCT
|
Facility
|
IP
|
$16,668.00
|
|
|
Service Code
|
CPT 36904
|
| Hospital Charge Code |
909036904
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,333.60 |
| Max. Negotiated Rate |
$14,167.80 |
| Rate for Payer: Adventist Health Commercial |
$3,333.60
|
| Rate for Payer: Cash Price |
$7,500.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,667.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,667.20
|
| Rate for Payer: EPIC Health Plan Senior |
$6,667.20
|
| Rate for Payer: Galaxy Health WC |
$14,167.80
|
| Rate for Payer: Global Benefits Group Commercial |
$10,000.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,584.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,834.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,000.32
|
| Rate for Payer: Multiplan Commercial |
$13,334.40
|
| Rate for Payer: Networks By Design Commercial |
$10,834.20
|
| Rate for Payer: Prime Health Services Commercial |
$14,167.80
|
|
|
HC PERCT PLCMNT DUODENAL/JEJUNOST
|
Facility
|
IP
|
$6,826.00
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
909020003
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,365.20 |
| Max. Negotiated Rate |
$5,802.10 |
| Rate for Payer: Adventist Health Commercial |
$1,365.20
|
| Rate for Payer: Cash Price |
$3,071.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,778.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,730.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,730.40
|
| Rate for Payer: Galaxy Health WC |
$5,802.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,095.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,334.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,027.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,638.24
|
| Rate for Payer: Multiplan Commercial |
$5,460.80
|
| Rate for Payer: Networks By Design Commercial |
$4,436.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,802.10
|
|
|
HC PERCT PLCMNT DUODENAL/JEJUNOST
|
Facility
|
OP
|
$6,826.00
|
|
|
Service Code
|
CPT 49441
|
| Hospital Charge Code |
909020003
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,365.20 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,365.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,574.78
|
| Rate for Payer: Blue Shield of California Commercial |
$3,897.87
|
| Rate for Payer: Cash Price |
$3,071.70
|
| Rate for Payer: Cash Price |
$3,071.70
|
| Rate for Payer: Cash Price |
$3,071.70
|
| Rate for Payer: Cigna of CA HMO |
$4,368.64
|
| Rate for Payer: Cigna of CA PPO |
$5,051.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,778.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$5,802.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,095.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1,837.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,334.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,078.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,638.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$5,460.80
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: Networks By Design Commercial |
$4,436.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,802.10
|
| Rate for Payer: Prime Health Services WC |
$3,801.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,095.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,413.00
|
| 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 |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC PERC TRANSPORTAL W HEMO
|
Facility
|
IP
|
$6,570.00
|
|
|
Service Code
|
CPT 75885
|
| Hospital Charge Code |
909081690
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,314.00 |
| Max. Negotiated Rate |
$5,584.50 |
| Rate for Payer: Adventist Health Commercial |
$1,314.00
|
| Rate for Payer: Cash Price |
$2,956.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,599.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,628.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,628.00
|
| Rate for Payer: Galaxy Health WC |
$5,584.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,942.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,171.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,876.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,576.80
|
| Rate for Payer: Multiplan Commercial |
$5,256.00
|
| Rate for Payer: Networks By Design Commercial |
$4,270.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,584.50
|
|
