|
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 COARCT INCLUDING LSCA
|
Facility
IP
|
$5,614.00
|
|
|
Service Code
|
CPT 33880
|
| Hospital Charge Code |
906820015
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,122.80 |
| Max. Negotiated Rate |
$5,052.60 |
| Rate for Payer: Cash Price |
$2,526.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,491.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,245.60
|
| Rate for Payer: Galaxy Health WC |
$4,771.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,368.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,052.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,744.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,122.80
|
| Rate for Payer: Multiplan Commercial |
$4,210.50
|
| Rate for Payer: Networks By Design Commercial |
$3,649.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,771.90
|
|
|
HC STENT COARCT INCLUDING LSCA
|
Facility
OP
|
$5,614.00
|
|
|
Service Code
|
CPT 33880
|
| Hospital Charge Code |
906811485
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,122.80 |
| Max. Negotiated Rate |
$13,979.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,822.09
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,771.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,087.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,087.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,368.40
|
| 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 |
$2,526.30
|
| Rate for Payer: Cash Price |
$2,526.30
|
| Rate for Payer: Cash Price |
$2,526.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,491.20
|
| Rate for Payer: Cigna of CA PPO |
$4,154.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,771.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,245.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,245.60
|
| Rate for Payer: Galaxy Health WC |
$4,771.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,368.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,052.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,210.50
|
| Rate for Payer: IEHP medi-cal |
$1,964.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,744.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,122.80
|
| Rate for Payer: Multiplan Commercial |
$4,210.50
|
| Rate for Payer: Networks By Design Commercial |
$3,649.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,771.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,368.40
|
| Rate for Payer: Riverside University Health MISP |
$2,245.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,368.40
|
| 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 |
$4,771.90
|
| Rate for Payer: Vantage Medical Group Senior |
$4,771.90
|
|
|
HC STENT COARCT INCLUDING LSCA
|
Facility
OP
|
$5,614.00
|
|
|
Service Code
|
CPT 33880
|
| Hospital Charge Code |
906820015
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,122.80 |
| Max. Negotiated Rate |
$13,979.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,822.09
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,771.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,087.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,087.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,368.40
|
| 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 |
$2,526.30
|
| Rate for Payer: Cash Price |
$2,526.30
|
| Rate for Payer: Cash Price |
$2,526.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,491.20
|
| Rate for Payer: Cigna of CA PPO |
$4,154.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,771.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,245.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,245.60
|
| Rate for Payer: Galaxy Health WC |
$4,771.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,368.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,052.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,210.50
|
| Rate for Payer: IEHP medi-cal |
$1,964.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,744.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,122.80
|
| Rate for Payer: Multiplan Commercial |
$4,210.50
|
| Rate for Payer: Networks By Design Commercial |
$3,649.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,771.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,368.40
|
| Rate for Payer: Riverside University Health MISP |
$2,245.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,368.40
|
| 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 |
$4,771.90
|
| Rate for Payer: Vantage Medical Group Senior |
$4,771.90
|
|
|
HC STENT COARCT INCLUDING LSCA
|
Facility
IP
|
$5,614.00
|
|
|
Service Code
|
CPT 33880
|
| Hospital Charge Code |
906811485
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,122.80 |
| Max. Negotiated Rate |
$5,052.60 |
| Rate for Payer: Cash Price |
$2,526.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,491.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,245.60
|
| Rate for Payer: Galaxy Health WC |
$4,771.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,368.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,052.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,744.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,122.80
|
| Rate for Payer: Multiplan Commercial |
$4,210.50
|
| Rate for Payer: Networks By Design Commercial |
$3,649.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,771.90
|
|
|
HC STENT COARCT NOT INCL LSCA
|
Facility
IP
|
$34,481.00
|
|
|
Service Code
|
CPT 33881
|
| Hospital Charge Code |
906820202
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,896.20 |
| Max. Negotiated Rate |
$31,032.90 |
| Rate for Payer: Cash Price |
$15,516.45
|
| Rate for Payer: Central Health Plan Commercial |
$27,584.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,792.40
|
| Rate for Payer: Galaxy Health WC |
$29,308.85
|
| Rate for Payer: Global Benefits Group Commercial |
$20,688.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$31,032.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,998.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,896.20
|
| Rate for Payer: Multiplan Commercial |
$25,860.75
|
| Rate for Payer: Networks By Design Commercial |
$22,412.65
|
| Rate for Payer: Prime Health Services Commercial |
$29,308.85
|
|
|
HC STENT COARCT NOT INCL LSCA
|
Facility
OP
|
$34,481.00
|
|
|
Service Code
|
CPT 33881
|
| Hospital Charge Code |
906820202
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,257.00 |
| Max. Negotiated Rate |
$31,032.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8,455.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$29,308.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18,964.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18,964.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$20,688.60
|
| 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 |
$15,516.45
|
| Rate for Payer: Cash Price |
$15,516.45
|
| Rate for Payer: Cash Price |
$15,516.45
|
| Rate for Payer: Central Health Plan Commercial |
$27,584.80
|
| Rate for Payer: Cigna of CA PPO |
$25,515.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29,308.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,792.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,792.40
|
| Rate for Payer: Galaxy Health WC |
$29,308.85
|
| Rate for Payer: Global Benefits Group Commercial |
$20,688.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$31,032.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$25,860.75
|
| Rate for Payer: IEHP medi-cal |
$12,068.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,998.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,896.20
|
| Rate for Payer: Multiplan Commercial |
$25,860.75
|
| Rate for Payer: Networks By Design Commercial |
$22,412.65
|
| Rate for Payer: Prime Health Services Commercial |
$29,308.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$20,688.60
|
| Rate for Payer: Riverside University Health MISP |
$13,792.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20,688.60
|
| 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 |
$29,308.85
|
| Rate for Payer: Vantage Medical Group Senior |
$29,308.85
|
|
|
HC STENT COARCT NOT INCL LSCA
|
Facility
OP
|
$34,481.00
|
|
|
Service Code
|
CPT 33881
|
| Hospital Charge Code |
906811493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,257.00 |
| Max. Negotiated Rate |
$31,032.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8,455.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$29,308.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18,964.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18,964.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$20,688.60
|
| 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 |
$15,516.45
|
| Rate for Payer: Cash Price |
$15,516.45
|
| Rate for Payer: Cash Price |
$15,516.45
|
| Rate for Payer: Central Health Plan Commercial |
$27,584.80
|
| Rate for Payer: Cigna of CA PPO |
$25,515.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29,308.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,792.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,792.40
|
| Rate for Payer: Galaxy Health WC |
$29,308.85
|
| Rate for Payer: Global Benefits Group Commercial |
$20,688.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$31,032.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$25,860.75
|
| Rate for Payer: IEHP medi-cal |
$12,068.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,998.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,896.20
|
| Rate for Payer: Multiplan Commercial |
$25,860.75
|
| Rate for Payer: Networks By Design Commercial |
$22,412.65
|
| Rate for Payer: Prime Health Services Commercial |
$29,308.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$20,688.60
|
| Rate for Payer: Riverside University Health MISP |
$13,792.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20,688.60
|
| 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 |
$29,308.85
|
| Rate for Payer: Vantage Medical Group Senior |
$29,308.85
|
|
|
HC STENT COARCT NOT INCL LSCA
|
Facility
IP
|
$34,481.00
|
|
|
Service Code
|
CPT 33881
|
| Hospital Charge Code |
906811493
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,896.20 |
| Max. Negotiated Rate |
$31,032.90 |
| Rate for Payer: Cash Price |
$15,516.45
|
| Rate for Payer: Central Health Plan Commercial |
$27,584.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,792.40
|
| Rate for Payer: Galaxy Health WC |
$29,308.85
|
| Rate for Payer: Global Benefits Group Commercial |
$20,688.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$31,032.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,998.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,896.20
|
| Rate for Payer: Multiplan Commercial |
$25,860.75
|
| Rate for Payer: Networks By Design Commercial |
$22,412.65
|
| Rate for Payer: Prime Health Services Commercial |
$29,308.85
|
|
|
HC STENT COVERED I CAST
|
Facility
IP
|
$6,437.50
|
|
|
Service Code
|
CPT C1874
|
| Hospital Charge Code |
909020087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,287.50 |
| Max. Negotiated Rate |
$5,793.75 |
| Rate for Payer: Blue Shield of California EPN |
$3,437.62
|
| Rate for Payer: Cash Price |
$2,896.88
|
| Rate for Payer: Central Health Plan Commercial |
$5,150.00
|
| Rate for Payer: Cigna of CA HMO |
$4,506.25
|
| Rate for Payer: Cigna of CA PPO |
$4,506.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,575.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,575.00
|
| Rate for Payer: Galaxy Health WC |
$5,471.88
|
| Rate for Payer: Global Benefits Group Commercial |
$3,862.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,793.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,293.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,287.50
|
| Rate for Payer: Multiplan Commercial |
$4,828.12
|
| Rate for Payer: Prime Health Services Commercial |
$5,471.88
|
|
|
HC STENT COVERED I CAST
|
Facility
OP
|
$6,437.50
|
|
|
Service Code
|
CPT C1874
|
| Hospital Charge Code |
909020087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,287.50 |
| Max. Negotiated Rate |
$17,854.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,854.40
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,471.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,540.62
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,540.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,939.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,585.69
|
| Rate for Payer: BCBS Transplant Transplant |
$3,862.50
|
| Rate for Payer: Blue Shield of California Commercial |
$4,828.12
|
| Rate for Payer: Blue Shield of California EPN |
$3,502.00
|
| Rate for Payer: Cash Price |
$2,896.88
|
| Rate for Payer: Cash Price |
$2,896.88
|
| Rate for Payer: Central Health Plan Commercial |
$5,150.00
|
| Rate for Payer: Cigna of CA HMO |
$4,506.25
|
| Rate for Payer: Cigna of CA PPO |
$4,506.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,471.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,575.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,575.00
|
| Rate for Payer: Galaxy Health WC |
$5,471.88
|
| Rate for Payer: Global Benefits Group Commercial |
$3,862.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,793.75
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,828.12
|
| Rate for Payer: IEHP medi-cal |
$2,253.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,293.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,287.50
|
| Rate for Payer: Multiplan Commercial |
$4,828.12
|
| Rate for Payer: Networks By Design Commercial |
$3,218.75
|
| Rate for Payer: Prime Health Services Commercial |
$5,471.88
|
| Rate for Payer: Riverside University Health MISP |
$2,575.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,862.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,862.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,218.75
|
| Rate for Payer: United Healthcare All Other HMO |
$3,218.75
|
| Rate for Payer: United Healthcare HMO Rider |
$3,218.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,218.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,471.88
|
| Rate for Payer: Vantage Medical Group Senior |
$5,471.88
|
|
|
HC STENT DUMONT TRACHEOBRONCHIAL
|
Facility
OP
|
$1,717.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
900803701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$343.40 |
| 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 |
$1,459.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$944.35
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$944.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$783.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$956.37
|
| Rate for Payer: BCBS Transplant Transplant |
$1,030.20
|
| Rate for Payer: Blue Shield of California Commercial |
$1,287.75
|
| Rate for Payer: Blue Shield of California EPN |
$934.05
|
| Rate for Payer: Cash Price |
$772.65
|
| Rate for Payer: Cash Price |
$772.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,373.60
|
| Rate for Payer: Cigna of CA HMO |
$1,201.90
|
| Rate for Payer: Cigna of CA PPO |
$1,201.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,459.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$686.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$686.80
|
| Rate for Payer: Galaxy Health WC |
$1,459.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,030.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,545.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,287.75
|
| Rate for Payer: IEHP medi-cal |
$600.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,145.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$343.40
|
| Rate for Payer: Multiplan Commercial |
$1,287.75
|
| Rate for Payer: Networks By Design Commercial |
$858.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,459.45
|
| Rate for Payer: Riverside University Health MISP |
$686.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,030.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,030.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$858.50
|
| Rate for Payer: United Healthcare All Other HMO |
$858.50
|
| Rate for Payer: United Healthcare HMO Rider |
$858.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$858.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,459.45
|
| Rate for Payer: Vantage Medical Group Senior |
$1,459.45
|
|
|
HC STENT DUMONT TRACHEOBRONCHIAL
|
Facility
IP
|
$1,717.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
900803701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$343.40 |
| Max. Negotiated Rate |
$1,545.30 |
| Rate for Payer: Blue Shield of California EPN |
$916.88
|
| Rate for Payer: Cash Price |
$772.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,373.60
|
| Rate for Payer: Cigna of CA HMO |
$1,201.90
|
| Rate for Payer: Cigna of CA PPO |
$1,201.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$686.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$686.80
|
| Rate for Payer: Galaxy Health WC |
$1,459.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,030.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,545.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,145.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$343.40
|
| Rate for Payer: Multiplan Commercial |
$1,287.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,459.45
|
|
|
HC STENT ENTERPRISE
|
Facility
OP
|
$13,000.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909020034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,600.00 |
| Max. Negotiated Rate |
$11,700.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8,941.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11,050.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,150.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,150.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,935.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,241.00
|
| Rate for Payer: BCBS Transplant Transplant |
$7,800.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,750.00
|
| Rate for Payer: Blue Shield of California EPN |
$7,072.00
|
| Rate for Payer: Cash Price |
$5,850.00
|
| Rate for Payer: Cash Price |
$5,850.00
|
| Rate for Payer: Central Health Plan Commercial |
$10,400.00
|
| Rate for Payer: Cigna of CA HMO |
$9,100.00
|
| Rate for Payer: Cigna of CA PPO |
$9,100.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,050.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,200.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,200.00
|
| Rate for Payer: Galaxy Health WC |
$11,050.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,800.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,700.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,750.00
|
| Rate for Payer: IEHP medi-cal |
$4,550.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,671.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,600.00
|
| Rate for Payer: Multiplan Commercial |
$9,750.00
|
| Rate for Payer: Networks By Design Commercial |
$6,500.00
|
| Rate for Payer: Prime Health Services Commercial |
$11,050.00
|
| Rate for Payer: Riverside University Health MISP |
$5,200.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,800.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,500.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,500.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,500.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,500.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,050.00
|
| Rate for Payer: Vantage Medical Group Senior |
$11,050.00
|
|
|
HC STENT ENTERPRISE
|
Facility
IP
|
$13,000.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909020034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,600.00 |
| Max. Negotiated Rate |
$11,700.00 |
| Rate for Payer: Blue Shield of California EPN |
$6,942.00
|
| Rate for Payer: Cash Price |
$5,850.00
|
| Rate for Payer: Central Health Plan Commercial |
$10,400.00
|
| Rate for Payer: Cigna of CA HMO |
$9,100.00
|
| Rate for Payer: Cigna of CA PPO |
$9,100.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,200.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,200.00
|
| Rate for Payer: Galaxy Health WC |
$11,050.00
|
| Rate for Payer: Global Benefits Group Commercial |
$7,800.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,700.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,671.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,600.00
|
| Rate for Payer: Multiplan Commercial |
$9,750.00
|
| Rate for Payer: Prime Health Services Commercial |
$11,050.00
|
|
|
HC STENT EV3 VISI PRO
|
Facility
OP
|
$3,705.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909020092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$741.00 |
| 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 |
$3,149.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,037.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,037.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,691.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,063.68
|
| Rate for Payer: BCBS Transplant Transplant |
$2,223.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,778.75
|
| Rate for Payer: Blue Shield of California EPN |
$2,015.52
|
| Rate for Payer: Cash Price |
$1,667.25
|
| Rate for Payer: Cash Price |
$1,667.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,964.00
|
| Rate for Payer: Cigna of CA HMO |
$2,593.50
|
| Rate for Payer: Cigna of CA PPO |
$2,593.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,149.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,482.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,482.00
|
| Rate for Payer: Galaxy Health WC |
$3,149.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,223.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,334.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,778.75
|
| Rate for Payer: IEHP medi-cal |
$1,296.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,471.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$741.00
|
| Rate for Payer: Multiplan Commercial |
$2,778.75
|
| Rate for Payer: Networks By Design Commercial |
$1,852.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,149.25
|
| Rate for Payer: Riverside University Health MISP |
$1,482.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,223.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,223.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,852.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,852.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,852.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,852.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,149.25
|
| Rate for Payer: Vantage Medical Group Senior |
$3,149.25
|
|
|
HC STENT EV3 VISI PRO
|
Facility
IP
|
$3,705.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909020092
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$741.00 |
| Max. Negotiated Rate |
$3,334.50 |
| Rate for Payer: Blue Shield of California EPN |
$1,978.47
|
| Rate for Payer: Cash Price |
$1,667.25
|
| Rate for Payer: Central Health Plan Commercial |
$2,964.00
|
| Rate for Payer: Cigna of CA HMO |
$2,593.50
|
| Rate for Payer: Cigna of CA PPO |
$2,593.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,482.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,482.00
|
| Rate for Payer: Galaxy Health WC |
$3,149.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,223.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,334.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,471.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$741.00
|
| Rate for Payer: Multiplan Commercial |
$2,778.75
|
| Rate for Payer: Prime Health Services Commercial |
$3,149.25
|
|
|
HC STENT FEM/POP
|
Facility
OP
|
$21,002.00
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
909020067
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,183.44 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: BCBS Transplant Transplant |
$12,601.20
|
| Rate for Payer: Blue Shield of California Commercial |
$5,824.53
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.44
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$9,450.90
|
| Rate for Payer: Cash Price |
$9,450.90
|
| Rate for Payer: Central Health Plan Commercial |
$16,801.60
|
| Rate for Payer: Cigna of CA PPO |
$15,541.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$17,851.70
|
| Rate for Payer: Global Benefits Group Commercial |
$12,601.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,901.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15,751.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: IEHP medi-cal |
$22,679.61
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Innovage PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,008.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,200.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$15,751.50
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$13,651.30
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$17,851.70
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12,601.20
|
| Rate for Payer: Riverside University Health MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,601.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC STENT FEM/POP
|
Facility
IP
|
$21,002.00
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
909020067
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,200.40 |
| Max. Negotiated Rate |
$18,901.80 |
| Rate for Payer: Cash Price |
$9,450.90
|
| Rate for Payer: Central Health Plan Commercial |
$16,801.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,400.80
|
| Rate for Payer: Galaxy Health WC |
$17,851.70
|
| Rate for Payer: Global Benefits Group Commercial |
$12,601.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,901.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,008.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,200.40
|
| Rate for Payer: Multiplan Commercial |
$15,751.50
|
| Rate for Payer: Networks By Design Commercial |
$13,651.30
|
| Rate for Payer: Prime Health Services Commercial |
$17,851.70
|
|
|
HC STENT FEM/POP
|
Facility
IP
|
$21,002.00
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
906820150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,200.40 |
| Max. Negotiated Rate |
$18,901.80 |
| Rate for Payer: Cash Price |
$9,450.90
|
| Rate for Payer: Central Health Plan Commercial |
$16,801.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,400.80
|
| Rate for Payer: Galaxy Health WC |
$17,851.70
|
| Rate for Payer: Global Benefits Group Commercial |
$12,601.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,901.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,008.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,200.40
|
| Rate for Payer: Multiplan Commercial |
$15,751.50
|
| Rate for Payer: Networks By Design Commercial |
$13,651.30
|
| Rate for Payer: Prime Health Services Commercial |
$17,851.70
|
|
|
HC STENT FEM/POP
|
Facility
OP
|
$21,002.00
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
906820150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,183.44 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: BCBS Transplant Transplant |
$12,601.20
|
| Rate for Payer: Blue Shield of California Commercial |
$5,824.53
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.44
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$9,450.90
|
| Rate for Payer: Cash Price |
$9,450.90
|
| Rate for Payer: Central Health Plan Commercial |
$16,801.60
|
| Rate for Payer: Cigna of CA PPO |
$15,541.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$17,851.70
|
| Rate for Payer: Global Benefits Group Commercial |
$12,601.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,901.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15,751.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: IEHP medi-cal |
$22,679.61
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Innovage PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,008.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,200.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$15,751.50
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$13,651.30
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$17,851.70
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12,601.20
|
| Rate for Payer: Riverside University Health MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,601.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC STENT FLAIR
|
Facility
OP
|
$6,250.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909020120
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,250.00 |
| 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 |
$5,312.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,437.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,437.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,853.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,481.25
|
| Rate for Payer: BCBS Transplant Transplant |
$3,750.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,687.50
|
| Rate for Payer: Blue Shield of California EPN |
$3,400.00
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Central Health Plan Commercial |
$5,000.00
|
| Rate for Payer: Cigna of CA HMO |
$4,375.00
|
| Rate for Payer: Cigna of CA PPO |
$4,375.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,312.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,500.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,500.00
|
| Rate for Payer: Galaxy Health WC |
$5,312.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,750.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,625.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,687.50
|
| Rate for Payer: IEHP medi-cal |
$2,187.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,168.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,250.00
|
| Rate for Payer: Multiplan Commercial |
$4,687.50
|
| Rate for Payer: Networks By Design Commercial |
$3,125.00
|
| Rate for Payer: Prime Health Services Commercial |
$5,312.50
|
| Rate for Payer: Riverside University Health MISP |
$2,500.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,750.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,750.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,125.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,125.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,125.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,125.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,312.50
|
| Rate for Payer: Vantage Medical Group Senior |
$5,312.50
|
|
|
HC STENT FLAIR
|
Facility
IP
|
$6,250.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909020120
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,250.00 |
| Max. Negotiated Rate |
$5,625.00 |
| Rate for Payer: Blue Shield of California EPN |
$3,337.50
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Central Health Plan Commercial |
$5,000.00
|
| Rate for Payer: Cigna of CA HMO |
$4,375.00
|
| Rate for Payer: Cigna of CA PPO |
$4,375.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,500.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,500.00
|
| Rate for Payer: Galaxy Health WC |
$5,312.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,750.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,625.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,168.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,250.00
|
| Rate for Payer: Multiplan Commercial |
$4,687.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,312.50
|
|
|
HC STENT GENESIS MOUNTED
|
Facility
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909020089
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| 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 |
$3,315.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,145.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,780.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,172.30
|
| Rate for Payer: BCBS Transplant Transplant |
$2,340.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,925.00
|
| Rate for Payer: Blue Shield of California EPN |
$2,121.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,925.00
|
| Rate for Payer: IEHP medi-cal |
$1,365.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Riverside University Health MISP |
$1,560.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC STENT GENESIS MOUNTED
|
Facility
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1876
|
| Hospital Charge Code |
909020089
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,510.00 |
| Rate for Payer: Blue Shield of California EPN |
$2,082.60
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Central Health Plan Commercial |
$3,120.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,510.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$780.00
|
| Rate for Payer: Multiplan Commercial |
$2,925.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
