|
HC PLCMNT NEPHU CATH PERCU
|
Facility
|
IP
|
$5,139.00
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
909050433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,027.80 |
| Max. Negotiated Rate |
$4,368.15 |
| Rate for Payer: Adventist Health Commercial |
$1,027.80
|
| Rate for Payer: Cash Price |
$2,312.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,597.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,055.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,055.60
|
| Rate for Payer: Galaxy Health WC |
$4,368.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3,083.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,263.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,032.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,233.36
|
| Rate for Payer: Multiplan Commercial |
$4,111.20
|
| Rate for Payer: Networks By Design Commercial |
$3,340.35
|
| Rate for Payer: Prime Health Services Commercial |
$4,368.15
|
|
|
HC PLCMNT TRANSESOPHEAGEAL PROBE
|
Facility
|
OP
|
$2,073.00
|
|
|
Service Code
|
CPT 93316
|
| Hospital Charge Code |
900501593
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$414.60 |
| Max. Negotiated Rate |
$3,171.00 |
| Rate for Payer: Adventist Health Commercial |
$414.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$773.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$702.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,601.00
|
| Rate for Payer: Cash Price |
$932.85
|
| Rate for Payer: Cash Price |
$932.85
|
| Rate for Payer: Cash Price |
$932.85
|
| Rate for Payer: Cigna of CA HMO |
$1,326.72
|
| Rate for Payer: Cigna of CA PPO |
$1,534.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$773.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$702.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,451.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,159.59
|
| Rate for Payer: EPIC Health Plan Senior |
$773.06
|
| Rate for Payer: Galaxy Health WC |
$1,762.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,243.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,152.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$702.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,316.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$752.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$755.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$497.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$885.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$941.73
|
| Rate for Payer: Multiplan Commercial |
$1,658.40
|
| Rate for Payer: Multiplan WC |
$1,110.02
|
| Rate for Payer: Networks By Design Commercial |
$1,347.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,762.05
|
| Rate for Payer: Prime Health Services WC |
$1,098.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,243.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,036.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,036.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,036.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$702.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,054.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$773.06
|
| Rate for Payer: Vantage Medical Group Senior |
$702.78
|
|
|
HC PLCMNT TRANSESOPHEAGEAL PROBE
|
Facility
|
IP
|
$2,073.00
|
|
|
Service Code
|
CPT 93316
|
| Hospital Charge Code |
900501593
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$414.60 |
| Max. Negotiated Rate |
$1,762.05 |
| Rate for Payer: EPIC Health Plan Commercial |
$829.20
|
| Rate for Payer: EPIC Health Plan Senior |
$829.20
|
| Rate for Payer: Galaxy Health WC |
$1,762.05
|
| Rate for Payer: Adventist Health Commercial |
$414.60
|
| Rate for Payer: Cash Price |
$932.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,451.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,243.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,316.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,223.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$497.52
|
| Rate for Payer: Multiplan Commercial |
$1,658.40
|
| Rate for Payer: Networks By Design Commercial |
$1,347.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,762.05
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,608.60
|
| 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 Foundation Hospitals Commercial/Self Funded |
$7,809.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,255.82
|
| 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 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,459.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$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 |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,608.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| 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/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$227.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,809.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$257.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,951.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| 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 |
$6,149.00
|
| 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 |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,895.30
|
| 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 Foundation Hospitals Commercial/Self Funded |
$7,162.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,654.61
|
| 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,255.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,156.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$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 |
$10,735.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,872.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,156.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,895.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,808.82
|
| Rate for Payer: EPIC Health Plan Senior |
$7,872.55
|
| 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/Senior |
$11,737.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$232.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,162.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$263.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,019.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,706.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,017.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,590.19
|
| 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 |
$5,639.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,156.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,156.86
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,290.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$6,613.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,144.85
|
| 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,083.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$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 |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,290.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| 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/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$510.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,613.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$577.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,499.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| 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 |
$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 |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,290.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$6,613.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,144.85
|
| 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,083.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$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 |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,290.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| 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/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$568.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,613.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$643.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,499.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| 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 |
$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 |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
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 |
$8,852.75 |
| Rate for Payer: Cigna of CA PPO |
$7,707.10
|
| Rate for Payer: Adventist Health Commercial |
$2,083.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| 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: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,290.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| 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/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,613.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$643.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,365.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,499.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| 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 |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,290.50
|
| 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 Foundation Hospitals Commercial/Self Funded |
$6,613.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,144.85
|
| 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 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,133.20
|
| 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 Foundation Hospitals Commercial/Self Funded |
$9,192.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,540.84
|
| 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$2,895.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,136.63
|
| Rate for Payer: Blue Shield of California Commercial |
$6,262.29
|
| Rate for Payer: Cash Price |
$6,514.20
|
| 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 |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,133.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| 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/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$440.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,192.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$498.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,474.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| 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 |
$7,238.00
|
| 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 |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,402.10
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,271.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,181.77
|
| 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 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$400.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$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 |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,402.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| 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/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$225.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,271.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$254.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$480.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,676.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,846.47
|
| 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 |
$1,001.50
|
| 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 |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$850.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,024.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$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 |
$3,036.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,227.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,024.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,977.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,340.64
|
| Rate for Payer: EPIC Health Plan Senior |
$2,227.09
|
| 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/Senior |
$3,320.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$170.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,700.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,834.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,020.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,551.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,713.00
|
| 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 |
$2,126.50
|
| 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 |
$2,024.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,024.63
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,977.10
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,700.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,509.27
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,536.40
|
| 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 Foundation Hospitals Commercial/Self Funded |
$3,208.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,980.68
|
| 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,010.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$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 |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,536.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$4,294.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,031.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$155.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,208.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$175.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,212.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$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 |
$2,526.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$447.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,468.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$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 |
$3,702.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,714.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,468.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,566.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,072.27
|
| Rate for Payer: EPIC Health Plan Senior |
$2,714.84
|
| Rate for Payer: Galaxy Health WC |
$1,902.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,342.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,047.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$155.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,468.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,421.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$175.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,455.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$537.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,109.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.17
|
| Rate for Payer: Multiplan Commercial |
$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 |
$1,119.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,468.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,702.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,714.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,468.04
|
|
|
HC 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,566.60
|
| 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 Foundation Hospitals Commercial/Self Funded |
$1,421.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,320.42
|
| 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 |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,006.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,024.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$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 |
$3,036.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,227.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,024.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,523.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,340.64
|
| Rate for Payer: EPIC Health Plan Senior |
$2,227.09
|
| 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/Senior |
$3,320.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$170.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,024.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,196.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,834.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,208.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,551.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,713.00
|
| 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 |
$2,517.00
|
| 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 |
$2,024.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,036.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,227.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2,024.63
|
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,523.80
|
| 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 Foundation Hospitals Commercial/Self Funded |
$3,196.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,970.06
|
| 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
|
|
