|
HC STEM CELL HARVEST ALLOGENIC
|
Facility
IP
|
$4,924.00
|
|
|
Service Code
|
CPT 38205
|
| Hospital Charge Code |
947200100
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$984.80 |
| Max. Negotiated Rate |
$4,431.60 |
| Rate for Payer: Cash Price |
$2,215.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,939.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,969.60
|
| Rate for Payer: Galaxy Health WC |
$4,185.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,954.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,431.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,284.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$984.80
|
| Rate for Payer: Multiplan Commercial |
$3,693.00
|
| Rate for Payer: Networks By Design Commercial |
$3,200.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,185.40
|
|
|
HC STEM CELL HARVEST ALLOGENIC
|
Facility
OP
|
$4,924.00
|
|
|
Service Code
|
CPT 38205
|
| Hospital Charge Code |
947200100
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$434.90 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$434.90
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,185.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,708.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,708.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,954.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,097.20
|
| Rate for Payer: Blue Shield of California EPN |
$2,407.84
|
| Rate for Payer: Cash Price |
$2,215.80
|
| Rate for Payer: Cash Price |
$2,215.80
|
| Rate for Payer: Cash Price |
$2,215.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,939.20
|
| Rate for Payer: Cigna of CA HMO |
$3,151.36
|
| Rate for Payer: Cigna of CA PPO |
$3,643.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,185.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,969.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,969.60
|
| Rate for Payer: Galaxy Health WC |
$4,185.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,954.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,431.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,693.00
|
| Rate for Payer: IEHP medi-cal |
$1,723.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,284.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$984.80
|
| Rate for Payer: Multiplan Commercial |
$3,693.00
|
| Rate for Payer: Networks By Design Commercial |
$3,200.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,185.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,954.40
|
| Rate for Payer: Riverside University Health MISP |
$1,969.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,954.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,954.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,462.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,462.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,462.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,462.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,185.40
|
| Rate for Payer: Vantage Medical Group Senior |
$4,185.40
|
|
|
HC STEM CELL HARVEST ALLOGENIC
|
Facility
OP
|
$4,924.00
|
|
|
Service Code
|
CPT 38205
|
| Hospital Charge Code |
947300201
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$434.90 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$434.90
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,185.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,708.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,708.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,954.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,097.20
|
| Rate for Payer: Blue Shield of California EPN |
$2,407.84
|
| Rate for Payer: Cash Price |
$2,215.80
|
| Rate for Payer: Cash Price |
$2,215.80
|
| Rate for Payer: Cash Price |
$2,215.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,939.20
|
| Rate for Payer: Cigna of CA HMO |
$3,151.36
|
| Rate for Payer: Cigna of CA PPO |
$3,643.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,185.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,969.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,969.60
|
| Rate for Payer: Galaxy Health WC |
$4,185.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,954.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,431.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,693.00
|
| Rate for Payer: IEHP medi-cal |
$1,723.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,284.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$984.80
|
| Rate for Payer: Multiplan Commercial |
$3,693.00
|
| Rate for Payer: Networks By Design Commercial |
$3,200.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,185.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,954.40
|
| Rate for Payer: Riverside University Health MISP |
$1,969.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,954.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,954.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,462.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,462.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,462.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,462.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,185.40
|
| Rate for Payer: Vantage Medical Group Senior |
$4,185.40
|
|
|
HC STEM CELL HARVEST ALLOGENIC
|
Facility
OP
|
$4,924.00
|
|
|
Service Code
|
CPT 38205
|
| Hospital Charge Code |
947000100
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$434.90 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$434.90
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,185.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,708.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,708.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,954.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,097.20
|
| Rate for Payer: Blue Shield of California EPN |
$2,407.84
|
| Rate for Payer: Cash Price |
$2,215.80
|
| Rate for Payer: Cash Price |
$2,215.80
|
| Rate for Payer: Cash Price |
$2,215.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,939.20
|
| Rate for Payer: Cigna of CA HMO |
$3,151.36
|
| Rate for Payer: Cigna of CA PPO |
$3,643.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,185.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,969.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,969.60
|
| Rate for Payer: Galaxy Health WC |
$4,185.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,954.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,431.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,693.00
|
| Rate for Payer: IEHP medi-cal |
$1,723.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,284.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$984.80
|
| Rate for Payer: Multiplan Commercial |
$3,693.00
|
| Rate for Payer: Networks By Design Commercial |
$3,200.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,185.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,954.40
|
| Rate for Payer: Riverside University Health MISP |
$1,969.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,954.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,954.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,462.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,462.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,462.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,462.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,185.40
|
| Rate for Payer: Vantage Medical Group Senior |
$4,185.40
|
|
|
HC STEM CELL HARVEST ALLOGENIC
|
Facility
IP
|
$4,924.00
|
|
|
Service Code
|
CPT 38205
|
| Hospital Charge Code |
947000100
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$984.80 |
| Max. Negotiated Rate |
$4,431.60 |
| Rate for Payer: Cash Price |
$2,215.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,939.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,969.60
|
| Rate for Payer: Galaxy Health WC |
$4,185.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,954.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,431.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,284.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$984.80
|
| Rate for Payer: Multiplan Commercial |
$3,693.00
|
| Rate for Payer: Networks By Design Commercial |
$3,200.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,185.40
|
|
|
HC STEM CELL HARVEST ALLOGENIC
|
Facility
IP
|
$4,924.00
|
|
|
Service Code
|
CPT 38205
|
| Hospital Charge Code |
947300201
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$984.80 |
| Max. Negotiated Rate |
$4,431.60 |
| Rate for Payer: Cash Price |
$2,215.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,939.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,969.60
|
| Rate for Payer: Galaxy Health WC |
$4,185.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,954.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,431.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,284.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$984.80
|
| Rate for Payer: Multiplan Commercial |
$3,693.00
|
| Rate for Payer: Networks By Design Commercial |
$3,200.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,185.40
|
|
|
HC STEM CELL HARVEST AUTOLOGUS
|
Facility
OP
|
$6,691.00
|
|
|
Service Code
|
CPT 38206
|
| Hospital Charge Code |
947300202
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$437.84 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,917.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$437.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,917.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,014.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,208.64
|
| Rate for Payer: Blue Shield of California EPN |
$3,271.90
|
| Rate for Payer: Caremore Medicare Advantage |
$1,917.03
|
| Rate for Payer: Cash Price |
$3,010.95
|
| Rate for Payer: Cash Price |
$3,010.95
|
| Rate for Payer: Cash Price |
$3,010.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,352.80
|
| Rate for Payer: Cigna of CA HMO |
$4,282.24
|
| Rate for Payer: Cigna of CA PPO |
$4,951.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,875.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,587.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,917.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,917.03
|
| Rate for Payer: Galaxy Health WC |
$5,687.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,014.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,021.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,018.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,143.93
|
| Rate for Payer: IEHP medi-cal |
$3,163.10
|
| Rate for Payer: IEHP Medicare Advantage |
$1,917.03
|
| Rate for Payer: Innovage PACE Commercial |
$2,875.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,462.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,917.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,338.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,568.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,568.82
|
| Rate for Payer: Multiplan Commercial |
$5,018.25
|
| Rate for Payer: Networks By Design Commercial |
$4,349.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,687.35
|
| Rate for Payer: Prime Health Services Medicare |
$2,032.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,014.60
|
| Rate for Payer: Riverside University Health MISP |
$2,108.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,014.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,014.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,345.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,345.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,345.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,345.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,917.03
|
| Rate for Payer: Vantage Medical Group Senior |
$1,917.03
|
|
|
HC STEM CELL HARVEST AUTOLOGUS
|
Facility
IP
|
$6,691.00
|
|
|
Service Code
|
CPT 38206
|
| Hospital Charge Code |
947300202
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$1,338.20 |
| Max. Negotiated Rate |
$6,021.90 |
| Rate for Payer: Cash Price |
$3,010.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,352.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,676.40
|
| Rate for Payer: Galaxy Health WC |
$5,687.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,014.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,021.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,462.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,338.20
|
| Rate for Payer: Multiplan Commercial |
$5,018.25
|
| Rate for Payer: Networks By Design Commercial |
$4,349.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,687.35
|
|
|
HC STEM CELL HARVEST AUTOLOGUS
|
Facility
IP
|
$6,691.00
|
|
|
Service Code
|
CPT 38206
|
| Hospital Charge Code |
947000101
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$1,338.20 |
| Max. Negotiated Rate |
$6,021.90 |
| Rate for Payer: Cash Price |
$3,010.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,352.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,676.40
|
| Rate for Payer: Galaxy Health WC |
$5,687.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,014.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,021.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,462.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,338.20
|
| Rate for Payer: Multiplan Commercial |
$5,018.25
|
| Rate for Payer: Networks By Design Commercial |
$4,349.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,687.35
|
|
|
HC STEM CELL HARVEST AUTOLOGUS
|
Facility
OP
|
$6,691.00
|
|
|
Service Code
|
CPT 38206
|
| Hospital Charge Code |
947000101
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$437.84 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,917.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$437.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,917.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,014.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,208.64
|
| Rate for Payer: Blue Shield of California EPN |
$3,271.90
|
| Rate for Payer: Caremore Medicare Advantage |
$1,917.03
|
| Rate for Payer: Cash Price |
$3,010.95
|
| Rate for Payer: Cash Price |
$3,010.95
|
| Rate for Payer: Cash Price |
$3,010.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,352.80
|
| Rate for Payer: Cigna of CA HMO |
$4,282.24
|
| Rate for Payer: Cigna of CA PPO |
$4,951.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,875.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,587.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,917.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,917.03
|
| Rate for Payer: Galaxy Health WC |
$5,687.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,014.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,021.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,018.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,143.93
|
| Rate for Payer: IEHP medi-cal |
$3,163.10
|
| Rate for Payer: IEHP Medicare Advantage |
$1,917.03
|
| Rate for Payer: Innovage PACE Commercial |
$2,875.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,462.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,917.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,338.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,568.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,568.82
|
| Rate for Payer: Multiplan Commercial |
$5,018.25
|
| Rate for Payer: Networks By Design Commercial |
$4,349.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,687.35
|
| Rate for Payer: Prime Health Services Medicare |
$2,032.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,014.60
|
| Rate for Payer: Riverside University Health MISP |
$2,108.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,014.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,014.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,345.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,345.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,345.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,345.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,917.03
|
| Rate for Payer: Vantage Medical Group Senior |
$1,917.03
|
|
|
HC STEM CELL HARVEST AUTOLOGUS
|
Facility
IP
|
$6,691.00
|
|
|
Service Code
|
CPT 38206
|
| Hospital Charge Code |
947200101
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$1,338.20 |
| Max. Negotiated Rate |
$6,021.90 |
| Rate for Payer: Cash Price |
$3,010.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,352.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,676.40
|
| Rate for Payer: Galaxy Health WC |
$5,687.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,014.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,021.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,462.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,338.20
|
| Rate for Payer: Multiplan Commercial |
$5,018.25
|
| Rate for Payer: Networks By Design Commercial |
$4,349.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,687.35
|
|
|
HC STEM CELL HARVEST AUTOLOGUS
|
Facility
OP
|
$6,691.00
|
|
|
Service Code
|
CPT 38206
|
| Hospital Charge Code |
947200101
|
|
Hospital Revenue Code
|
362
|
| Min. Negotiated Rate |
$437.84 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,917.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$437.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,108.73
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,917.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,014.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,208.64
|
| Rate for Payer: Blue Shield of California EPN |
$3,271.90
|
| Rate for Payer: Caremore Medicare Advantage |
$1,917.03
|
| Rate for Payer: Cash Price |
$3,010.95
|
| Rate for Payer: Cash Price |
$3,010.95
|
| Rate for Payer: Cash Price |
$3,010.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,352.80
|
| Rate for Payer: Cigna of CA HMO |
$4,282.24
|
| Rate for Payer: Cigna of CA PPO |
$4,951.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,875.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,587.99
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,917.03
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,917.03
|
| Rate for Payer: Galaxy Health WC |
$5,687.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,014.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,021.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,018.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,143.93
|
| Rate for Payer: IEHP medi-cal |
$3,163.10
|
| Rate for Payer: IEHP Medicare Advantage |
$1,917.03
|
| Rate for Payer: Innovage PACE Commercial |
$2,875.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,462.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,917.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,338.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,568.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,568.82
|
| Rate for Payer: Multiplan Commercial |
$5,018.25
|
| Rate for Payer: Networks By Design Commercial |
$4,349.15
|
| Rate for Payer: Prime Health Services Commercial |
$5,687.35
|
| Rate for Payer: Prime Health Services Medicare |
$2,032.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,014.60
|
| Rate for Payer: Riverside University Health MISP |
$2,108.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,014.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,014.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,345.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,345.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,345.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,345.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,875.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,917.03
|
| Rate for Payer: Vantage Medical Group Senior |
$1,917.03
|
|
|
HC STEMM CELL TOTAL COUNT CD34
|
Facility
OP
|
$96.00
|
|
|
Service Code
|
CPT 86367
|
| Hospital Charge Code |
903901970
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$327.43 |
| Rate for Payer: Adventist Health Medi-Cal |
$77.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$276.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$116.67
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$85.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$77.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$268.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$327.43
|
| Rate for Payer: BCBS Transplant Transplant |
$57.60
|
| Rate for Payer: Blue Shield of California Commercial |
$59.33
|
| Rate for Payer: Blue Shield of California EPN |
$46.66
|
| Rate for Payer: Caremore Medicare Advantage |
$77.78
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Central Health Plan Commercial |
$76.80
|
| Rate for Payer: Cigna of CA HMO |
$61.44
|
| Rate for Payer: Cigna of CA PPO |
$71.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$116.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$77.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$77.78
|
| Rate for Payer: Galaxy Health WC |
$81.60
|
| Rate for Payer: Global Benefits Group Commercial |
$57.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$86.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$72.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$127.56
|
| Rate for Payer: IEHP medi-cal |
$128.34
|
| Rate for Payer: IEHP Medicare Advantage |
$77.78
|
| Rate for Payer: Innovage PACE Commercial |
$116.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$104.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$104.23
|
| Rate for Payer: Multiplan Commercial |
$72.00
|
| Rate for Payer: Networks By Design Commercial |
$62.40
|
| Rate for Payer: Prime Health Services Commercial |
$81.60
|
| Rate for Payer: Prime Health Services Medicare |
$82.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$57.60
|
| Rate for Payer: Riverside University Health MISP |
$85.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.00
|
| Rate for Payer: United Healthcare All Other HMO |
$63.00
|
| Rate for Payer: United Healthcare HMO Rider |
$63.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$63.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$116.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$85.56
|
| Rate for Payer: Vantage Medical Group Senior |
$77.78
|
|
|
HC STEMM CELL TOTAL COUNT CD34
|
Facility
IP
|
$920.00
|
|
|
Service Code
|
CPT 86367
|
| Hospital Charge Code |
903901970
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$184.00 |
| Max. Negotiated Rate |
$828.00 |
| Rate for Payer: Cash Price |
$414.00
|
| Rate for Payer: Central Health Plan Commercial |
$736.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$368.00
|
| Rate for Payer: Galaxy Health WC |
$782.00
|
| Rate for Payer: Global Benefits Group Commercial |
$552.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$828.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$613.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$184.00
|
| Rate for Payer: Multiplan Commercial |
$690.00
|
| Rate for Payer: Networks By Design Commercial |
$598.00
|
| Rate for Payer: Prime Health Services Commercial |
$782.00
|
|
|
HC STENT BILIARY SMART CORIDS 2-6
|
Facility
IP
|
$2,880.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909081208
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$576.00 |
| Max. Negotiated Rate |
$2,592.00 |
| Rate for Payer: Blue Shield of California EPN |
$1,537.92
|
| Rate for Payer: Cash Price |
$1,296.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,304.00
|
| Rate for Payer: Cigna of CA HMO |
$2,016.00
|
| Rate for Payer: Cigna of CA PPO |
$2,016.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,152.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,152.00
|
| Rate for Payer: Galaxy Health WC |
$2,448.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,728.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,592.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,920.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$576.00
|
| Rate for Payer: Multiplan Commercial |
$2,160.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,448.00
|
|
|
HC STENT BILIARY SMART CORIDS 2-6
|
Facility
OP
|
$2,880.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909081208
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$576.00 |
| Max. Negotiated Rate |
$8,941.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8,941.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,448.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,584.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,584.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,315.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,604.16
|
| Rate for Payer: BCBS Transplant Transplant |
$1,728.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,160.00
|
| Rate for Payer: Blue Shield of California EPN |
$1,566.72
|
| Rate for Payer: Cash Price |
$1,296.00
|
| Rate for Payer: Cash Price |
$1,296.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,304.00
|
| Rate for Payer: Cigna of CA HMO |
$2,016.00
|
| Rate for Payer: Cigna of CA PPO |
$2,016.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,448.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,152.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,152.00
|
| Rate for Payer: Galaxy Health WC |
$2,448.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,728.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,592.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,160.00
|
| Rate for Payer: IEHP medi-cal |
$1,008.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,920.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$576.00
|
| Rate for Payer: Multiplan Commercial |
$2,160.00
|
| Rate for Payer: Networks By Design Commercial |
$1,440.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,448.00
|
| Rate for Payer: Riverside University Health MISP |
$1,152.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,728.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,728.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,440.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,440.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,440.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,440.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,448.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,448.00
|
|
|
HC STENT CAROTID UNCVRD
|
Facility
IP
|
$6,825.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909020141
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,365.00 |
| Max. Negotiated Rate |
$6,142.50 |
| Rate for Payer: Blue Shield of California EPN |
$3,644.55
|
| Rate for Payer: Cash Price |
$3,071.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,460.00
|
| Rate for Payer: Cigna of CA HMO |
$4,777.50
|
| Rate for Payer: Cigna of CA PPO |
$4,777.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,730.00
|
| Rate for Payer: Galaxy Health WC |
$5,801.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,095.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,142.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,552.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,365.00
|
| Rate for Payer: Multiplan Commercial |
$5,118.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,801.25
|
|
|
HC STENT CAROTID UNCVRD
|
Facility
OP
|
$6,825.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909020141
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,365.00 |
| Max. Negotiated Rate |
$8,941.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8,941.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,801.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,753.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,753.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,116.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,801.52
|
| Rate for Payer: BCBS Transplant Transplant |
$4,095.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,118.75
|
| Rate for Payer: Blue Shield of California EPN |
$3,712.80
|
| Rate for Payer: Cash Price |
$3,071.25
|
| Rate for Payer: Cash Price |
$3,071.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,460.00
|
| Rate for Payer: Cigna of CA HMO |
$4,777.50
|
| Rate for Payer: Cigna of CA PPO |
$4,777.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,801.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,730.00
|
| Rate for Payer: Galaxy Health WC |
$5,801.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,095.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,142.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,118.75
|
| Rate for Payer: IEHP medi-cal |
$2,388.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,552.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,365.00
|
| Rate for Payer: Multiplan Commercial |
$5,118.75
|
| Rate for Payer: Networks By Design Commercial |
$3,412.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,801.25
|
| Rate for Payer: Riverside University Health MISP |
$2,730.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,095.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,095.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,412.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,412.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,412.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,412.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,801.25
|
| Rate for Payer: Vantage Medical Group Senior |
$5,801.25
|
|
|
HC STENT, CCA W EPD
|
Facility
OP
|
$17,826.00
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
909080026
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,257.00 |
| Max. Negotiated Rate |
$16,043.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15,152.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,804.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,804.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: BCBS Transplant Transplant |
$10,695.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$8,021.70
|
| Rate for Payer: Cash Price |
$8,021.70
|
| Rate for Payer: Cash Price |
$8,021.70
|
| Rate for Payer: Central Health Plan Commercial |
$14,260.80
|
| Rate for Payer: Cigna of CA PPO |
$13,191.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,152.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,130.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,130.40
|
| Rate for Payer: Galaxy Health WC |
$15,152.10
|
| Rate for Payer: Global Benefits Group Commercial |
$10,695.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,043.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13,369.50
|
| Rate for Payer: IEHP medi-cal |
$6,239.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,889.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,565.20
|
| Rate for Payer: Multiplan Commercial |
$13,369.50
|
| Rate for Payer: Networks By Design Commercial |
$11,586.90
|
| Rate for Payer: Prime Health Services Commercial |
$15,152.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10,695.60
|
| Rate for Payer: Riverside University Health MISP |
$7,130.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,695.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,152.10
|
| Rate for Payer: Vantage Medical Group Senior |
$15,152.10
|
|
|
HC STENT, CCA W EPD
|
Facility
IP
|
$17,826.00
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
909080026
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,565.20 |
| Max. Negotiated Rate |
$16,043.40 |
| Rate for Payer: Cash Price |
$8,021.70
|
| Rate for Payer: Central Health Plan Commercial |
$14,260.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,130.40
|
| Rate for Payer: Galaxy Health WC |
$15,152.10
|
| Rate for Payer: Global Benefits Group Commercial |
$10,695.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,043.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,889.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,565.20
|
| Rate for Payer: Multiplan Commercial |
$13,369.50
|
| Rate for Payer: Networks By Design Commercial |
$11,586.90
|
| Rate for Payer: Prime Health Services Commercial |
$15,152.10
|
|
|
HC STENT, CCA W EPD
|
Facility
IP
|
$17,826.00
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
906820166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,565.20 |
| Max. Negotiated Rate |
$16,043.40 |
| Rate for Payer: Cash Price |
$8,021.70
|
| Rate for Payer: Central Health Plan Commercial |
$14,260.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,130.40
|
| Rate for Payer: Galaxy Health WC |
$15,152.10
|
| Rate for Payer: Global Benefits Group Commercial |
$10,695.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,043.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,889.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,565.20
|
| Rate for Payer: Multiplan Commercial |
$13,369.50
|
| Rate for Payer: Networks By Design Commercial |
$11,586.90
|
| Rate for Payer: Prime Health Services Commercial |
$15,152.10
|
|
|
HC STENT, CCA W EPD
|
Facility
OP
|
$17,826.00
|
|
|
Service Code
|
CPT 37215
|
| Hospital Charge Code |
906820166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,257.00 |
| Max. Negotiated Rate |
$16,043.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15,152.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9,804.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9,804.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: BCBS Transplant Transplant |
$10,695.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$8,021.70
|
| Rate for Payer: Cash Price |
$8,021.70
|
| Rate for Payer: Cash Price |
$8,021.70
|
| Rate for Payer: Central Health Plan Commercial |
$14,260.80
|
| Rate for Payer: Cigna of CA PPO |
$13,191.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,152.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,130.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,130.40
|
| Rate for Payer: Galaxy Health WC |
$15,152.10
|
| Rate for Payer: Global Benefits Group Commercial |
$10,695.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,043.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13,369.50
|
| Rate for Payer: IEHP medi-cal |
$6,239.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,889.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,565.20
|
| Rate for Payer: Multiplan Commercial |
$13,369.50
|
| Rate for Payer: Networks By Design Commercial |
$11,586.90
|
| Rate for Payer: Prime Health Services Commercial |
$15,152.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10,695.60
|
| Rate for Payer: Riverside University Health MISP |
$7,130.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,695.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,152.10
|
| Rate for Payer: Vantage Medical Group Senior |
$15,152.10
|
|
|
HC STENT CCA W/O EPD
|
Facility
OP
|
$20,831.00
|
|
|
Service Code
|
CPT 37216
|
| Hospital Charge Code |
906820167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,257.00 |
| Max. Negotiated Rate |
$18,747.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17,706.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11,457.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11,457.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$12,498.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$9,373.95
|
| Rate for Payer: Cash Price |
$9,373.95
|
| Rate for Payer: Cash Price |
$9,373.95
|
| Rate for Payer: Central Health Plan Commercial |
$16,664.80
|
| Rate for Payer: Cigna of CA PPO |
$15,414.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,706.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,332.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,332.40
|
| Rate for Payer: Galaxy Health WC |
$17,706.35
|
| Rate for Payer: Global Benefits Group Commercial |
$12,498.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,747.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15,623.25
|
| Rate for Payer: IEHP medi-cal |
$7,290.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,894.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,166.20
|
| Rate for Payer: Multiplan Commercial |
$15,623.25
|
| Rate for Payer: Networks By Design Commercial |
$13,540.15
|
| Rate for Payer: Prime Health Services Commercial |
$17,706.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12,498.60
|
| Rate for Payer: Riverside University Health MISP |
$8,332.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,498.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,706.35
|
| Rate for Payer: Vantage Medical Group Senior |
$17,706.35
|
|
|
HC STENT CCA W/O EPD
|
Facility
IP
|
$20,831.00
|
|
|
Service Code
|
CPT 37216
|
| Hospital Charge Code |
906820167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,166.20 |
| Max. Negotiated Rate |
$18,747.90 |
| Rate for Payer: Cash Price |
$9,373.95
|
| Rate for Payer: Central Health Plan Commercial |
$16,664.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,332.40
|
| Rate for Payer: Galaxy Health WC |
$17,706.35
|
| Rate for Payer: Global Benefits Group Commercial |
$12,498.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,747.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,894.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,166.20
|
| Rate for Payer: Multiplan Commercial |
$15,623.25
|
| Rate for Payer: Networks By Design Commercial |
$13,540.15
|
| Rate for Payer: Prime Health Services Commercial |
$17,706.35
|
|
|
HC STENT CCA W/O EPD
|
Facility
OP
|
$20,831.00
|
|
|
Service Code
|
CPT 37216
|
| Hospital Charge Code |
909080027
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,257.00 |
| Max. Negotiated Rate |
$18,747.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17,706.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11,457.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11,457.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$12,498.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$9,373.95
|
| Rate for Payer: Cash Price |
$9,373.95
|
| Rate for Payer: Cash Price |
$9,373.95
|
| Rate for Payer: Central Health Plan Commercial |
$16,664.80
|
| Rate for Payer: Cigna of CA PPO |
$15,414.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,706.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,332.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,332.40
|
| Rate for Payer: Galaxy Health WC |
$17,706.35
|
| Rate for Payer: Global Benefits Group Commercial |
$12,498.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,747.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15,623.25
|
| Rate for Payer: IEHP medi-cal |
$7,290.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,894.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,166.20
|
| Rate for Payer: Multiplan Commercial |
$15,623.25
|
| Rate for Payer: Networks By Design Commercial |
$13,540.15
|
| Rate for Payer: Prime Health Services Commercial |
$17,706.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12,498.60
|
| Rate for Payer: Riverside University Health MISP |
$8,332.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,498.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,706.35
|
| Rate for Payer: Vantage Medical Group Senior |
$17,706.35
|
|
