|
HC PLCMT CENTRLY INSERT TUN CVP GT 5YR
|
Facility
|
OP
|
$12,298.00
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
909080010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$227.67 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,459.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$5,534.10
|
| Rate for Payer: Cash Price |
$5,534.10
|
| Rate for Payer: Cash Price |
$5,534.10
|
| Rate for Payer: Cigna of CA HMO |
$7,870.72
|
| Rate for Payer: Cigna of CA PPO |
$9,100.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$10,453.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,378.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$227.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,202.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$257.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,951.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$9,838.40
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$7,993.70
|
| Rate for Payer: Prime Health Services Commercial |
$10,453.30
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,378.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC PLCMT CENTRLY INSERT TUN CVP GT 5YR
|
Facility
|
IP
|
$12,298.00
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
909080010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,459.60 |
| Max. Negotiated Rate |
$10,453.30 |
| Rate for Payer: Adventist Health Commercial |
$2,459.60
|
| Rate for Payer: Cash Price |
$5,534.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,919.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,919.20
|
| Rate for Payer: Galaxy Health WC |
$10,453.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7,378.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,202.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,685.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,612.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,951.52
|
| Rate for Payer: Multiplan Commercial |
$9,838.40
|
| Rate for Payer: Networks By Design Commercial |
$7,993.70
|
| Rate for Payer: Prime Health Services Commercial |
$10,453.30
|
|
|
HC PLCMT CENTRLY INSERT TUN CVP LT 5YR
|
Facility
|
IP
|
$11,279.00
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
909081359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,255.80 |
| Max. Negotiated Rate |
$9,587.15 |
| Rate for Payer: Adventist Health Commercial |
$2,255.80
|
| Rate for Payer: Cash Price |
$5,075.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,511.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,511.60
|
| Rate for Payer: Galaxy Health WC |
$9,587.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,767.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,523.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,297.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,981.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,706.96
|
| Rate for Payer: Multiplan Commercial |
$9,023.20
|
| Rate for Payer: Networks By Design Commercial |
$7,331.35
|
| Rate for Payer: Prime Health Services Commercial |
$9,587.15
|
|
|
HC PLCMT CENTRLY INSERT TUN CVP LT 5YR
|
Facility
|
OP
|
$11,279.00
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
909081359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$232.68 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: EPIC Health Plan Commercial |
$9,272.45
|
| Rate for Payer: EPIC Health Plan Senior |
$6,868.48
|
| Rate for Payer: Adventist Health Commercial |
$2,255.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$5,075.55
|
| Rate for Payer: Cash Price |
$5,075.55
|
| Rate for Payer: Cash Price |
$5,075.55
|
| Rate for Payer: Cigna of CA HMO |
$7,218.56
|
| Rate for Payer: Cigna of CA PPO |
$8,346.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,868.48
|
| Rate for Payer: Galaxy Health WC |
$9,587.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,767.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,264.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$232.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,523.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$263.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,706.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8,654.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,203.76
|
| Rate for Payer: Multiplan Commercial |
$9,023.20
|
| Rate for Payer: Multiplan WC |
$10,943.70
|
| Rate for Payer: Networks By Design Commercial |
$7,331.35
|
| Rate for Payer: Prime Health Services Commercial |
$9,587.15
|
| Rate for Payer: Prime Health Services WC |
$10,832.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,767.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,868.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC PLCMT PERIPH INSRT CV DEVC W/P
|
Facility
|
IP
|
$10,415.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
909080016
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,083.00 |
| Max. Negotiated Rate |
$8,852.75 |
| Rate for Payer: Adventist Health Commercial |
$2,083.00
|
| Rate for Payer: Cash Price |
$4,686.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,166.00
|
| Rate for Payer: Galaxy Health WC |
$8,852.75
|
| Rate for Payer: Global Benefits Group Commercial |
$6,249.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,946.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,968.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,446.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,499.60
|
| Rate for Payer: Multiplan Commercial |
$8,332.00
|
| Rate for Payer: Networks By Design Commercial |
$6,769.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,852.75
|
|
|
HC PLCMT PERIPH INSRT CV DEVC W/P
|
Facility
|
OP
|
$10,415.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
909080016
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$510.38 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,083.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$4,686.75
|
| Rate for Payer: Cash Price |
$4,686.75
|
| Rate for Payer: Cash Price |
$4,686.75
|
| Rate for Payer: Cigna of CA HMO |
$6,665.60
|
| Rate for Payer: Cigna of CA PPO |
$7,707.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$8,852.75
|
| Rate for Payer: Global Benefits Group Commercial |
$6,249.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$510.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,946.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$577.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,499.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$8,332.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$6,769.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,852.75
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,249.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC PLCMT PERIPH INSRT CV DVC W/PO
|
Facility
|
IP
|
$10,415.00
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
909080015
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,083.00 |
| Max. Negotiated Rate |
$8,852.75 |
| Rate for Payer: Adventist Health Commercial |
$2,083.00
|
| Rate for Payer: Cash Price |
$4,686.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,166.00
|
| Rate for Payer: Galaxy Health WC |
$8,852.75
|
| Rate for Payer: Global Benefits Group Commercial |
$6,249.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,946.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,968.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,446.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,499.60
|
| Rate for Payer: Multiplan Commercial |
$8,332.00
|
| Rate for Payer: Networks By Design Commercial |
$6,769.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,852.75
|
|
|
HC PLCMT PERIPH INSRT CV DVC W/PO
|
Facility
|
IP
|
$10,415.00
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
909080015
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,083.00 |
| Max. Negotiated Rate |
$8,852.75 |
| Rate for Payer: Adventist Health Commercial |
$2,083.00
|
| Rate for Payer: Cash Price |
$4,686.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,166.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,166.00
|
| Rate for Payer: Galaxy Health WC |
$8,852.75
|
| Rate for Payer: Global Benefits Group Commercial |
$6,249.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,946.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,968.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,446.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,499.60
|
| Rate for Payer: Multiplan Commercial |
$8,332.00
|
| Rate for Payer: Networks By Design Commercial |
$6,769.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,852.75
|
|
|
HC PLCMT PERIPH INSRT CV DVC W/PO
|
Facility
|
OP
|
$10,415.00
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
909080015
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$568.55 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,083.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$4,686.75
|
| Rate for Payer: Cash Price |
$4,686.75
|
| Rate for Payer: Cash Price |
$4,686.75
|
| Rate for Payer: Cigna of CA HMO |
$6,665.60
|
| Rate for Payer: Cigna of CA PPO |
$7,707.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$8,852.75
|
| Rate for Payer: Global Benefits Group Commercial |
$6,249.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$568.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,946.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$643.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,499.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$8,332.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$6,769.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,852.75
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,249.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC PLCMT PERIPH INSRT CV DVC W/PO
|
Facility
|
OP
|
$10,415.00
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
909080015
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$9,590.00 |
| Rate for Payer: Adventist Health Commercial |
$2,083.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,885.00
|
| Rate for Payer: Cash Price |
$4,686.75
|
| Rate for Payer: Cash Price |
$4,686.75
|
| Rate for Payer: Cash Price |
$4,686.75
|
| Rate for Payer: Cigna of CA HMO |
$6,665.60
|
| Rate for Payer: Cigna of CA PPO |
$7,707.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$8,852.75
|
| Rate for Payer: Global Benefits Group Commercial |
$6,249.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,946.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$643.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,499.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$8,332.00
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$6,769.75
|
| Rate for Payer: Prime Health Services Commercial |
$8,852.75
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,249.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,207.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,207.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,207.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,207.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC PLC TUN CNTRL VAD W/SUB PRT LT 5YR
|
Facility
|
IP
|
$14,476.00
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
909080011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,895.20 |
| Max. Negotiated Rate |
$12,304.60 |
| Rate for Payer: Adventist Health Commercial |
$2,895.20
|
| Rate for Payer: Cash Price |
$6,514.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,790.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,790.40
|
| Rate for Payer: Galaxy Health WC |
$12,304.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8,685.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,655.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,515.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,960.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,474.24
|
| Rate for Payer: Multiplan Commercial |
$11,580.80
|
| Rate for Payer: Networks By Design Commercial |
$9,409.40
|
| Rate for Payer: Prime Health Services Commercial |
$12,304.60
|
|
|
HC PLC TUN CNTRL VAD W/SUB PRT LT 5YR
|
Facility
|
OP
|
$14,476.00
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
909080011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$440.95 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,895.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,590.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,427.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$3,968.41
|
| Rate for Payer: Cash Price |
$6,514.20
|
| Rate for Payer: Cash Price |
$6,514.20
|
| Rate for Payer: Cash Price |
$6,514.20
|
| Rate for Payer: Cigna of CA HMO |
$9,264.64
|
| Rate for Payer: Cigna of CA PPO |
$10,712.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$12,304.60
|
| Rate for Payer: Global Benefits Group Commercial |
$8,685.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$440.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,655.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$498.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,474.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,039.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$11,580.80
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$9,409.40
|
| Rate for Payer: Prime Health Services Commercial |
$12,304.60
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,685.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC PLEURA BIOPSY, PERCUTANEOUS
|
Facility
|
OP
|
$2,003.00
|
|
|
Service Code
|
CPT 32400
|
| Hospital Charge Code |
909000123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$225.17 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$400.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,058.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$901.35
|
| Rate for Payer: Cash Price |
$901.35
|
| Rate for Payer: Cash Price |
$901.35
|
| Rate for Payer: Cigna of CA HMO |
$1,281.92
|
| Rate for Payer: Cigna of CA PPO |
$1,482.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,264.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,058.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,779.22
|
| Rate for Payer: EPIC Health Plan Senior |
$2,058.68
|
| Rate for Payer: Galaxy Health WC |
$1,702.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,201.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,376.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$225.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,058.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,336.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$254.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,058.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$480.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,593.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,758.63
|
| Rate for Payer: Multiplan Commercial |
$1,602.40
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$1,301.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,702.55
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,201.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,058.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,088.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,264.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2,058.68
|
|
|
HC PLEURA BIOPSY, PERCUTANEOUS
|
Facility
|
IP
|
$2,003.00
|
|
|
Service Code
|
CPT 32400
|
| Hospital Charge Code |
909000123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$400.60 |
| Max. Negotiated Rate |
$1,702.55 |
| Rate for Payer: Adventist Health Commercial |
$400.60
|
| Rate for Payer: Cash Price |
$901.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$801.20
|
| Rate for Payer: EPIC Health Plan Senior |
$801.20
|
| Rate for Payer: Galaxy Health WC |
$1,702.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,201.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,336.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$763.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,239.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$480.72
|
| Rate for Payer: Multiplan Commercial |
$1,602.40
|
| Rate for Payer: Networks By Design Commercial |
$1,301.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,702.55
|
|
|
HC PLEURAL DRAINAGE, PERC W INS OF IND CATH W IG
|
Facility
|
OP
|
$4,253.00
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
900200009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$170.13 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$850.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,913.85
|
| Rate for Payer: Cash Price |
$1,913.85
|
| Rate for Payer: Cash Price |
$1,913.85
|
| Rate for Payer: Cigna of CA HMO |
$2,721.92
|
| Rate for Payer: Cigna of CA PPO |
$3,147.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,664.63
|
| Rate for Payer: EPIC Health Plan Senior |
$1,973.80
|
| Rate for Payer: Galaxy Health WC |
$3,615.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,551.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,237.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$170.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,836.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,973.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,020.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,486.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,644.89
|
| Rate for Payer: Multiplan Commercial |
$3,402.40
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: Networks By Design Commercial |
$2,764.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,615.05
|
| Rate for Payer: Prime Health Services WC |
$3,112.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,551.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,973.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
|
HC PLEURAL DRAINAGE, PERC W INS OF IND CATH W IG
|
Facility
|
IP
|
$4,253.00
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
900200009
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$850.60 |
| Max. Negotiated Rate |
$3,615.05 |
| Rate for Payer: Adventist Health Commercial |
$850.60
|
| Rate for Payer: Cash Price |
$1,913.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,701.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,701.20
|
| Rate for Payer: Galaxy Health WC |
$3,615.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,551.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,836.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,620.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,632.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,020.72
|
| Rate for Payer: Multiplan Commercial |
$3,402.40
|
| Rate for Payer: Networks By Design Commercial |
$2,764.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,615.05
|
|
|
HC PLEURAL DRAINAGE, PERC W INS OF IND CATH WO IG
|
Facility
|
IP
|
$5,052.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
900200008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,010.40 |
| Max. Negotiated Rate |
$4,294.20 |
| Rate for Payer: Adventist Health Commercial |
$1,010.40
|
| Rate for Payer: Cash Price |
$2,273.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,020.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,020.80
|
| Rate for Payer: Galaxy Health WC |
$4,294.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,031.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,369.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,924.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,127.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,212.48
|
| Rate for Payer: Multiplan Commercial |
$4,041.60
|
| Rate for Payer: Networks By Design Commercial |
$3,283.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,294.20
|
|
|
HC PLEURAL DRAINAGE, PERC W INS OF IND CATH WO IG
|
Facility
|
OP
|
$5,052.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
900200008
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.11 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$1,010.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$2,273.40
|
| Rate for Payer: Cash Price |
$2,273.40
|
| Rate for Payer: Cash Price |
$2,273.40
|
| Rate for Payer: Cigna of CA HMO |
$3,233.28
|
| Rate for Payer: Cigna of CA PPO |
$3,738.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.93
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.32
|
| Rate for Payer: Galaxy Health WC |
$4,294.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,031.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$155.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,369.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,212.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,037.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,229.83
|
| Rate for Payer: Multiplan Commercial |
$4,041.60
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: Networks By Design Commercial |
$3,283.80
|
| Rate for Payer: Prime Health Services Commercial |
$4,294.20
|
| Rate for Payer: Prime Health Services WC |
$3,801.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,031.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,410.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC PLEURAL DRAIN PERC CATH WO IMAGE
|
Facility
|
OP
|
$2,238.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
909032556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$155.11 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$447.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,410.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$1,007.10
|
| Rate for Payer: Cash Price |
$1,007.10
|
| Rate for Payer: Cash Price |
$1,007.10
|
| Rate for Payer: Cigna of CA HMO |
$1,432.32
|
| Rate for Payer: Cigna of CA PPO |
$1,656.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,651.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,410.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,253.93
|
| Rate for Payer: EPIC Health Plan Senior |
$2,410.32
|
| Rate for Payer: Galaxy Health WC |
$1,902.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,342.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,952.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$155.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,410.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,492.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,410.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$537.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,037.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,229.83
|
| Rate for Payer: Multiplan Commercial |
$1,790.40
|
| Rate for Payer: Multiplan WC |
$3,840.40
|
| Rate for Payer: Networks By Design Commercial |
$1,454.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,902.30
|
| Rate for Payer: Prime Health Services WC |
$3,801.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,342.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,410.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,615.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,651.35
|
| Rate for Payer: Vantage Medical Group Senior |
$2,410.32
|
|
|
HC PLEURAL DRAIN PERC CATH WO IMAGE
|
Facility
|
IP
|
$2,238.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
909032556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$447.60 |
| Max. Negotiated Rate |
$1,902.30 |
| Rate for Payer: Adventist Health Commercial |
$447.60
|
| Rate for Payer: Cash Price |
$1,007.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$895.20
|
| Rate for Payer: EPIC Health Plan Senior |
$895.20
|
| Rate for Payer: Galaxy Health WC |
$1,902.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,342.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,492.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$852.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,385.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$537.12
|
| Rate for Payer: Multiplan Commercial |
$1,790.40
|
| Rate for Payer: Networks By Design Commercial |
$1,454.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,902.30
|
|
|
HC PLEURAL DRAIN PLCMNT NO TUNN
|
Facility
|
IP
|
$5,034.00
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
909020159
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,006.80 |
| Max. Negotiated Rate |
$4,278.90 |
| Rate for Payer: Adventist Health Commercial |
$1,006.80
|
| Rate for Payer: Cash Price |
$2,265.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,013.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,013.60
|
| Rate for Payer: Galaxy Health WC |
$4,278.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,020.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,357.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,917.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,116.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.16
|
| Rate for Payer: Multiplan Commercial |
$4,027.20
|
| Rate for Payer: Networks By Design Commercial |
$3,272.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,278.90
|
|
|
HC PLEURAL DRAIN PLCMNT NO TUNN
|
Facility
|
OP
|
$5,034.00
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
909020159
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$170.13 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$1,006.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$2,265.30
|
| Rate for Payer: Cash Price |
$2,265.30
|
| Rate for Payer: Cash Price |
$2,265.30
|
| Rate for Payer: Cigna of CA HMO |
$3,221.76
|
| Rate for Payer: Cigna of CA PPO |
$3,725.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,664.63
|
| Rate for Payer: EPIC Health Plan Senior |
$1,973.80
|
| Rate for Payer: Galaxy Health WC |
$4,278.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,020.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,237.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$170.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,357.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,973.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,486.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,644.89
|
| Rate for Payer: Multiplan Commercial |
$4,027.20
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: Networks By Design Commercial |
$3,272.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,278.90
|
| Rate for Payer: Prime Health Services WC |
$3,112.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,020.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,973.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
|
HC PLEURA VAC
|
Facility
|
OP
|
$265.00
|
|
| Hospital Charge Code |
909081710
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.00 |
| Max. Negotiated Rate |
$225.25 |
| Rate for Payer: Adventist Health Commercial |
$53.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$173.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$225.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$145.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.74
|
| Rate for Payer: Cash Price |
$119.25
|
| Rate for Payer: Cigna of CA HMO |
$169.60
|
| Rate for Payer: Cigna of CA PPO |
$196.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$225.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.00
|
| Rate for Payer: EPIC Health Plan Senior |
$106.00
|
| Rate for Payer: Galaxy Health WC |
$225.25
|
| Rate for Payer: Global Benefits Group Commercial |
$159.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$176.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$164.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$185.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$185.50
|
| Rate for Payer: Multiplan Commercial |
$212.00
|
| Rate for Payer: Networks By Design Commercial |
$172.25
|
| Rate for Payer: Prime Health Services Commercial |
$225.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$159.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$159.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.50
|
| Rate for Payer: United Healthcare All Other HMO |
$132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$132.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$132.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$225.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$225.25
|
| Rate for Payer: Vantage Medical Group Senior |
$225.25
|
|
|
HC PLEURA VAC
|
Facility
|
IP
|
$265.00
|
|
| Hospital Charge Code |
909081710
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.00 |
| Max. Negotiated Rate |
$225.25 |
| Rate for Payer: Adventist Health Commercial |
$53.00
|
| Rate for Payer: Cash Price |
$119.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.00
|
| Rate for Payer: EPIC Health Plan Senior |
$106.00
|
| Rate for Payer: Galaxy Health WC |
$225.25
|
| Rate for Payer: Global Benefits Group Commercial |
$159.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$176.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$164.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.60
|
| Rate for Payer: Multiplan Commercial |
$212.00
|
| Rate for Payer: Networks By Design Commercial |
$172.25
|
| Rate for Payer: Prime Health Services Commercial |
$225.25
|
|
|
HC PLEURODESIS
|
Facility
|
IP
|
$2,415.00
|
|
|
Service Code
|
CPT 32560
|
| Hospital Charge Code |
909000202
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$2,052.75 |
| Rate for Payer: Adventist Health Commercial |
$483.00
|
| Rate for Payer: Cash Price |
$1,086.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$966.00
|
| Rate for Payer: EPIC Health Plan Senior |
$966.00
|
| Rate for Payer: Galaxy Health WC |
$2,052.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,449.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,610.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$920.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,494.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$579.60
|
| Rate for Payer: Multiplan Commercial |
$1,932.00
|
| Rate for Payer: Networks By Design Commercial |
$1,569.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,052.75
|
|
