|
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 |
$5,728.25
|
| Rate for Payer: Cash Price |
$5,728.25
|
| Rate for Payer: Cash Price |
$5,728.25
|
| 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 |
$7,961.80
|
| 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 |
$7,961.80
|
| Rate for Payer: Cash Price |
$7,961.80
|
| Rate for Payer: Cash Price |
$7,961.80
|
| 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 |
$1,101.65
|
| Rate for Payer: Cash Price |
$1,101.65
|
| Rate for Payer: Cash Price |
$1,101.65
|
| 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 |
$1,101.65
|
| 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 |
$2,339.15
|
| Rate for Payer: Cash Price |
$2,339.15
|
| Rate for Payer: Cash Price |
$2,339.15
|
| 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 |
$2,339.15
|
| 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
|
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 |
$2,778.60
|
| Rate for Payer: Cash Price |
$2,778.60
|
| Rate for Payer: Cash Price |
$2,778.60
|
| 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 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 |
$2,778.60
|
| 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 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 |
$1,230.90
|
| Rate for Payer: Cash Price |
$1,230.90
|
| Rate for Payer: Cash Price |
$1,230.90
|
| 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 |
$1,230.90
|
| 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
|
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 |
$2,768.70
|
| Rate for Payer: Cash Price |
$2,768.70
|
| Rate for Payer: Cash Price |
$2,768.70
|
| 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 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 |
$2,768.70
|
| 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 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 |
$145.75
|
| 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 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 |
$145.75
|
| 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 PLEURODESIS
|
Facility
|
OP
|
$2,415.00
|
|
|
Service Code
|
CPT 32560
|
| Hospital Charge Code |
909000202
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$379.66 |
| Max. Negotiated Rate |
$11,230.65 |
| Rate for Payer: Adventist Health Commercial |
$483.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,385.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$785.56
|
| 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 |
$1,328.25
|
| Rate for Payer: Cash Price |
$1,328.25
|
| Rate for Payer: Cash Price |
$1,328.25
|
| Rate for Payer: Cigna of CA HMO |
$1,545.60
|
| Rate for Payer: Cigna of CA PPO |
$1,787.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$864.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$785.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,060.51
|
| Rate for Payer: EPIC Health Plan Senior |
$785.56
|
| Rate for Payer: Galaxy Health WC |
$2,052.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,449.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,288.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$379.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$785.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,610.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$429.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$785.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$579.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$989.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,052.65
|
| Rate for Payer: Multiplan Commercial |
$1,932.00
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$1,569.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,052.75
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,449.00
|
| 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 |
$785.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Vantage Medical Group Senior |
$785.56
|
|
|
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 |
$1,328.25
|
| 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
|
|
|
HC PLEURX CHEST DRAIN
|
Facility
|
OP
|
$1,205.20
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909020015
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.04 |
| Max. Negotiated Rate |
$1,024.42 |
| Rate for Payer: Adventist Health Commercial |
$241.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,024.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$662.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$903.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$698.05
|
| Rate for Payer: Blue Shield of California Commercial |
$889.44
|
| Rate for Payer: Blue Shield of California EPN |
$585.73
|
| Rate for Payer: Cash Price |
$662.86
|
| Rate for Payer: Cigna of CA HMO |
$843.64
|
| Rate for Payer: Cigna of CA PPO |
$843.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,024.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,024.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,024.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$482.08
|
| Rate for Payer: EPIC Health Plan Senior |
$482.08
|
| Rate for Payer: Galaxy Health WC |
$1,024.42
|
| Rate for Payer: Global Benefits Group Commercial |
$723.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$803.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$459.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$746.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$843.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$843.64
|
| Rate for Payer: Multiplan Commercial |
$964.16
|
| Rate for Payer: Networks By Design Commercial |
$602.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,024.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$723.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$723.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$452.31
|
| Rate for Payer: United Healthcare All Other HMO |
$440.26
|
| Rate for Payer: United Healthcare HMO Rider |
$430.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$394.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,024.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,024.42
|
| Rate for Payer: Vantage Medical Group Senior |
$1,024.42
|
|
|
HC PLEURX CHEST DRAIN
|
Facility
|
IP
|
$1,205.20
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909020015
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.04 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$241.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$662.86
|
| Rate for Payer: Cash Price |
$662.86
|
| Rate for Payer: Cigna of CA HMO |
$843.64
|
| Rate for Payer: Cigna of CA PPO |
$843.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$482.08
|
| Rate for Payer: EPIC Health Plan Senior |
$482.08
|
| Rate for Payer: Galaxy Health WC |
$1,024.42
|
| Rate for Payer: Global Benefits Group Commercial |
$723.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$803.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$459.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$746.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$289.25
|
| Rate for Payer: Multiplan Commercial |
$964.16
|
| Rate for Payer: Networks By Design Commercial |
$602.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,024.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$452.31
|
| Rate for Payer: United Healthcare All Other HMO |
$440.26
|
| Rate for Payer: United Healthcare HMO Rider |
$430.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$394.70
|
|
|
HC PLEURX PERITONEAL DRAIN
|
Facility
|
IP
|
$1,973.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909020016
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$394.60 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$394.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,085.15
|
| Rate for Payer: Cash Price |
$1,085.15
|
| Rate for Payer: Cigna of CA HMO |
$1,381.10
|
| Rate for Payer: Cigna of CA PPO |
$1,381.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$789.20
|
| Rate for Payer: EPIC Health Plan Senior |
$789.20
|
| Rate for Payer: Galaxy Health WC |
$1,677.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,183.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,315.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$751.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,221.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$473.52
|
| Rate for Payer: Multiplan Commercial |
$1,578.40
|
| Rate for Payer: Networks By Design Commercial |
$986.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,677.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$740.47
|
| Rate for Payer: United Healthcare All Other HMO |
$720.74
|
| Rate for Payer: United Healthcare HMO Rider |
$705.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$646.16
|
|
|
HC PLEURX PERITONEAL DRAIN
|
Facility
|
OP
|
$1,973.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909020016
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$394.60 |
| Max. Negotiated Rate |
$1,677.05 |
| Rate for Payer: Adventist Health Commercial |
$394.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,677.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,085.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,479.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,142.76
|
| Rate for Payer: Blue Shield of California Commercial |
$1,456.07
|
| Rate for Payer: Blue Shield of California EPN |
$958.88
|
| Rate for Payer: Cash Price |
$1,085.15
|
| Rate for Payer: Cigna of CA HMO |
$1,381.10
|
| Rate for Payer: Cigna of CA PPO |
$1,381.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,677.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,677.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,677.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$789.20
|
| Rate for Payer: EPIC Health Plan Senior |
$789.20
|
| Rate for Payer: Galaxy Health WC |
$1,677.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,183.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,315.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$751.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,221.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$473.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,381.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,381.10
|
| Rate for Payer: Multiplan Commercial |
$1,578.40
|
| Rate for Payer: Networks By Design Commercial |
$986.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,677.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,183.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,183.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$740.47
|
| Rate for Payer: United Healthcare All Other HMO |
$720.74
|
| Rate for Payer: United Healthcare HMO Rider |
$705.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$646.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,677.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,677.05
|
| Rate for Payer: Vantage Medical Group Senior |
$1,677.05
|
|
|
HC PLUG DECANNULATION 10.0
|
Facility
|
IP
|
$38.62
|
|
| Hospital Charge Code |
900800861
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Cash Price |
$21.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.27
|
| Rate for Payer: Multiplan Commercial |
$30.90
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
|
|
HC PLUG DECANNULATION 10.0
|
Facility
|
OP
|
$38.62
|
|
| Hospital Charge Code |
900800861
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.72
|
| Rate for Payer: Cash Price |
$21.24
|
| Rate for Payer: Cigna of CA HMO |
$24.72
|
| Rate for Payer: Cigna of CA PPO |
$28.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.03
|
| Rate for Payer: Multiplan Commercial |
$30.90
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.31
|
| Rate for Payer: United Healthcare All Other HMO |
$19.31
|
| Rate for Payer: United Healthcare HMO Rider |
$19.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.83
|
| Rate for Payer: Vantage Medical Group Senior |
$32.83
|
|
|
HC PLUG DECANNULATION 4.0
|
Facility
|
OP
|
$38.62
|
|
| Hospital Charge Code |
900800858
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.72
|
| Rate for Payer: Cash Price |
$21.24
|
| Rate for Payer: Cigna of CA HMO |
$24.72
|
| Rate for Payer: Cigna of CA PPO |
$28.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.03
|
| Rate for Payer: Multiplan Commercial |
$30.90
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.31
|
| Rate for Payer: United Healthcare All Other HMO |
$19.31
|
| Rate for Payer: United Healthcare HMO Rider |
$19.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.83
|
| Rate for Payer: Vantage Medical Group Senior |
$32.83
|
|
|
HC PLUG DECANNULATION 4.0
|
Facility
|
IP
|
$38.62
|
|
| Hospital Charge Code |
900800858
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Cash Price |
$21.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.27
|
| Rate for Payer: Multiplan Commercial |
$30.90
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
|
