|
HC TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$13,096.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
909081356
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,619.20 |
| Max. Negotiated Rate |
$11,786.40 |
| Rate for Payer: Adventist Health Commercial |
$2,619.20
|
| Rate for Payer: Cash Price |
$5,893.20
|
| Rate for Payer: Central Health Plan Commercial |
$10,476.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,167.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,238.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,238.40
|
| Rate for Payer: Galaxy Health WC |
$11,131.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,857.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,786.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,315.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,726.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,619.20
|
| Rate for Payer: Multiplan Commercial |
$9,822.00
|
| Rate for Payer: Networks By Design Commercial |
$8,512.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,131.60
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$6,289.00
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
909081664
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,257.80 |
| Max. Negotiated Rate |
$5,660.10 |
| Rate for Payer: Adventist Health Commercial |
$1,257.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,676.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,345.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,458.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,716.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,389.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,321.91
|
| Rate for Payer: Blue Shield of California Commercial |
$3,962.07
|
| Rate for Payer: Blue Shield of California EPN |
$2,496.73
|
| Rate for Payer: Cash Price |
$2,830.05
|
| Rate for Payer: Cash Price |
$2,830.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,031.20
|
| Rate for Payer: Cigna of CA HMO |
$4,024.96
|
| Rate for Payer: Cigna of CA PPO |
$4,653.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,345.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,345.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,345.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,402.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,515.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,515.60
|
| Rate for Payer: Galaxy Health WC |
$5,345.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,773.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,660.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,993.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,710.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,257.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,402.30
|
| Rate for Payer: Multiplan Commercial |
$4,716.75
|
| Rate for Payer: Networks By Design Commercial |
$4,087.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,345.65
|
| Rate for Payer: Riverside University Health System MISP |
$2,515.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,773.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,773.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,144.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,144.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,144.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,144.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,345.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,345.65
|
| Rate for Payer: Vantage Medical Group Senior |
$5,345.65
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
|
OP
|
$28,097.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906811451
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$436.09 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$5,619.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,061.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$12,643.65
|
| Rate for Payer: Cash Price |
$12,643.65
|
| Rate for Payer: Cash Price |
$12,643.65
|
| Rate for Payer: Central Health Plan Commercial |
$22,477.60
|
| Rate for Payer: Cigna of CA HMO |
$18,263.05
|
| Rate for Payer: Cigna of CA PPO |
$20,791.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,667.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$23,882.45
|
| Rate for Payer: Global Benefits Group Commercial |
$16,858.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,287.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$436.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,841.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$481.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,619.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$21,072.75
|
| Rate for Payer: Networks By Design Commercial |
$18,263.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Prime Health Services Commercial |
$23,882.45
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,858.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,858.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,048.50
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
|
IP
|
$28,097.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906811451
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,619.40 |
| Max. Negotiated Rate |
$25,287.30 |
| Rate for Payer: Adventist Health Commercial |
$5,619.40
|
| Rate for Payer: Cash Price |
$12,643.65
|
| Rate for Payer: Central Health Plan Commercial |
$22,477.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,667.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,238.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11,238.80
|
| Rate for Payer: Galaxy Health WC |
$23,882.45
|
| Rate for Payer: Global Benefits Group Commercial |
$16,858.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,287.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,841.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16,577.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,619.40
|
| Rate for Payer: Multiplan Commercial |
$21,072.75
|
| Rate for Payer: Networks By Design Commercial |
$18,263.05
|
| Rate for Payer: Prime Health Services Commercial |
$23,882.45
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0796T
|
| Hospital Charge Code |
906819778
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$40,876.69 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$24,773.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,773.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21,161.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,422.62
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,609.08
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,963.20
|
| Rate for Payer: Cigna of CA HMO |
$27,970.56
|
| Rate for Payer: Cigna of CA PPO |
$32,340.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,251.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,773.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,876.69
|
| Rate for Payer: EPIC Health Plan Senior |
$27,251.12
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$39,333.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$40,628.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,752.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15,864.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34,683.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,740.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$33,196.82
|
| Rate for Payer: Multiplan Commercial |
$32,778.00
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Preferred Health Network WC |
$39,397.02
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
| Rate for Payer: Prime Health Services Medicare |
$26,260.17
|
| Rate for Payer: Prime Health Services WC |
$38,215.11
|
| Rate for Payer: Riverside University Health System MISP |
$27,251.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26,222.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,852.00
|
| Rate for Payer: United Healthcare All Other HMO |
$21,852.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,852.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,852.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$24,773.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Vantage Medical Group Senior |
$24,773.75
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0796T
|
| Hospital Charge Code |
906819778
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,740.80 |
| Max. Negotiated Rate |
$39,333.60 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,963.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,481.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,481.60
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$39,333.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,752.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25,785.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,740.80
|
| Rate for Payer: Multiplan Commercial |
$32,778.00
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA RV COMP SYS
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0795T
|
| Hospital Charge Code |
906819777
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,740.80 |
| Max. Negotiated Rate |
$39,333.60 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,963.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,481.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,481.60
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$39,333.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,752.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25,785.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,740.80
|
| Rate for Payer: Multiplan Commercial |
$32,778.00
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA RV COMP SYS
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0795T
|
| Hospital Charge Code |
906819777
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$40,876.69 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$24,773.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,773.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21,161.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,422.62
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,609.08
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,963.20
|
| Rate for Payer: Cigna of CA HMO |
$27,970.56
|
| Rate for Payer: Cigna of CA PPO |
$32,340.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,251.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,773.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,876.69
|
| Rate for Payer: EPIC Health Plan Senior |
$27,251.12
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$39,333.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$40,628.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,752.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15,864.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34,683.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,740.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$33,196.82
|
| Rate for Payer: Multiplan Commercial |
$32,778.00
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Preferred Health Network WC |
$39,397.02
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
| Rate for Payer: Prime Health Services Medicare |
$26,260.17
|
| Rate for Payer: Prime Health Services WC |
$38,215.11
|
| Rate for Payer: Riverside University Health System MISP |
$27,251.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26,222.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,852.00
|
| Rate for Payer: United Healthcare All Other HMO |
$21,852.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,852.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,852.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$24,773.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Vantage Medical Group Senior |
$24,773.75
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RV PM COMPNT
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0797T
|
| Hospital Charge Code |
906819779
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$40,876.69 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$24,773.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,773.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21,161.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,422.62
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,609.08
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,963.20
|
| Rate for Payer: Cigna of CA HMO |
$27,970.56
|
| Rate for Payer: Cigna of CA PPO |
$32,340.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,251.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,773.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,876.69
|
| Rate for Payer: EPIC Health Plan Senior |
$27,251.12
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$39,333.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$40,628.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,752.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15,864.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34,683.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,740.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$33,196.82
|
| Rate for Payer: Multiplan Commercial |
$32,778.00
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Preferred Health Network WC |
$39,397.02
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
| Rate for Payer: Prime Health Services Medicare |
$26,260.17
|
| Rate for Payer: Prime Health Services WC |
$38,215.11
|
| Rate for Payer: Riverside University Health System MISP |
$27,251.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26,222.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,852.00
|
| Rate for Payer: United Healthcare All Other HMO |
$21,852.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,852.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,852.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$24,773.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Vantage Medical Group Senior |
$24,773.75
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RV PM COMPNT
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0797T
|
| Hospital Charge Code |
906819779
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,740.80 |
| Max. Negotiated Rate |
$39,333.60 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,963.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,481.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,481.60
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$39,333.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,752.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25,785.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,740.80
|
| Rate for Payer: Multiplan Commercial |
$32,778.00
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
|
|
HC TRANSCATH INSRTN SC LEADLESS PMKR RA
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0823T
|
| Hospital Charge Code |
906819773
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,740.80 |
| Max. Negotiated Rate |
$39,333.60 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,963.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,481.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,481.60
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$39,333.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,752.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25,785.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,740.80
|
| Rate for Payer: Multiplan Commercial |
$32,778.00
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
|
|
HC TRANSCATH INSRTN SC LEADLESS PMKR RA
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0823T
|
| Hospital Charge Code |
906819773
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$40,876.69 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$24,773.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,773.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21,161.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,422.62
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$38,609.08
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Cash Price |
$19,666.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,963.20
|
| Rate for Payer: Cigna of CA HMO |
$27,970.56
|
| Rate for Payer: Cigna of CA PPO |
$32,340.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,251.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,773.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,876.69
|
| Rate for Payer: EPIC Health Plan Senior |
$27,251.12
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$39,333.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$40,628.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,752.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15,864.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34,683.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,740.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$33,196.82
|
| Rate for Payer: Multiplan Commercial |
$32,778.00
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Preferred Health Network WC |
$39,397.02
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
| Rate for Payer: Prime Health Services Medicare |
$26,260.17
|
| Rate for Payer: Prime Health Services WC |
$38,215.11
|
| Rate for Payer: Riverside University Health System MISP |
$27,251.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26,222.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,852.00
|
| Rate for Payer: United Healthcare All Other HMO |
$21,852.00
|
| Rate for Payer: United Healthcare HMO Rider |
$21,852.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21,852.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$24,773.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Vantage Medical Group Senior |
$24,773.75
|
|
|
HC TRANSCATH MITRAL VAL REPAIR AD
|
Facility
|
OP
|
$20,568.00
|
|
|
Service Code
|
CPT 33419
|
| Hospital Charge Code |
906811489
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$128.07 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$4,113.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17,482.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,312.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15,426.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$9,255.60
|
| Rate for Payer: Cash Price |
$9,255.60
|
| Rate for Payer: Cash Price |
$9,255.60
|
| Rate for Payer: Central Health Plan Commercial |
$16,454.40
|
| Rate for Payer: Cigna of CA HMO |
$13,163.52
|
| Rate for Payer: Cigna of CA PPO |
$15,220.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,482.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$17,482.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17,482.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,397.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,227.20
|
| Rate for Payer: EPIC Health Plan Senior |
$8,227.20
|
| Rate for Payer: Galaxy Health WC |
$17,482.80
|
| Rate for Payer: Global Benefits Group Commercial |
$12,340.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,511.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$128.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,060.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$141.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,113.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,397.60
|
| Rate for Payer: Multiplan Commercial |
$15,426.00
|
| Rate for Payer: Networks By Design Commercial |
$13,369.20
|
| Rate for Payer: Prime Health Services Commercial |
$17,482.80
|
| Rate for Payer: Riverside University Health System MISP |
$8,227.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,340.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,284.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17,482.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,482.80
|
| Rate for Payer: Vantage Medical Group Senior |
$17,482.80
|
|
|
HC TRANSCATH MITRAL VAL REPAIR AD
|
Facility
|
IP
|
$20,568.00
|
|
|
Service Code
|
CPT 33419
|
| Hospital Charge Code |
906811489
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,113.60 |
| Max. Negotiated Rate |
$18,511.20 |
| Rate for Payer: Adventist Health Commercial |
$4,113.60
|
| Rate for Payer: Cash Price |
$9,255.60
|
| Rate for Payer: Central Health Plan Commercial |
$16,454.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,397.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,227.20
|
| Rate for Payer: EPIC Health Plan Senior |
$8,227.20
|
| Rate for Payer: Galaxy Health WC |
$17,482.80
|
| Rate for Payer: Global Benefits Group Commercial |
$12,340.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,511.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,060.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,113.60
|
| Rate for Payer: Multiplan Commercial |
$15,426.00
|
| Rate for Payer: Networks By Design Commercial |
$13,369.20
|
| Rate for Payer: Prime Health Services Commercial |
$17,482.80
|
|
|
HC TRANSCATH MITRAL VALVE ANNUL
|
Facility
|
OP
|
$66,433.00
|
|
|
Service Code
|
CPT 0544T
|
| Hospital Charge Code |
906810544
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$59,789.70 |
| Rate for Payer: Adventist Health Commercial |
$13,286.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56,468.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36,538.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49,824.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$29,894.85
|
| Rate for Payer: Cash Price |
$29,894.85
|
| Rate for Payer: Central Health Plan Commercial |
$53,146.40
|
| Rate for Payer: Cigna of CA HMO |
$42,517.12
|
| Rate for Payer: Cigna of CA PPO |
$49,160.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56,468.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$56,468.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56,468.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46,503.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,573.20
|
| Rate for Payer: EPIC Health Plan Senior |
$26,573.20
|
| Rate for Payer: Galaxy Health WC |
$56,468.05
|
| Rate for Payer: Global Benefits Group Commercial |
$39,859.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$59,789.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$42,184.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24,115.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$39,195.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,286.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$46,503.10
|
| Rate for Payer: Multiplan Commercial |
$49,824.75
|
| Rate for Payer: Networks By Design Commercial |
$43,181.45
|
| Rate for Payer: Prime Health Services Commercial |
$56,468.05
|
| Rate for Payer: Riverside University Health System MISP |
$26,573.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39,859.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$33,216.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56,468.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56,468.05
|
| Rate for Payer: Vantage Medical Group Senior |
$56,468.05
|
|
|
HC TRANSCATH MITRAL VALVE ANNUL
|
Facility
|
IP
|
$66,433.00
|
|
|
Service Code
|
CPT 0544T
|
| Hospital Charge Code |
906810544
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13,286.60 |
| Max. Negotiated Rate |
$59,789.70 |
| Rate for Payer: Adventist Health Commercial |
$13,286.60
|
| Rate for Payer: Cash Price |
$29,894.85
|
| Rate for Payer: Central Health Plan Commercial |
$53,146.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46,503.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,573.20
|
| Rate for Payer: EPIC Health Plan Senior |
$26,573.20
|
| Rate for Payer: Galaxy Health WC |
$56,468.05
|
| Rate for Payer: Global Benefits Group Commercial |
$39,859.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$59,789.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$42,184.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$39,195.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,286.60
|
| Rate for Payer: Multiplan Commercial |
$49,824.75
|
| Rate for Payer: Networks By Design Commercial |
$43,181.45
|
| Rate for Payer: Prime Health Services Commercial |
$56,468.05
|
|
|
HC TRANSCATH MITRAL VALVE REPAIR
|
Facility
|
IP
|
$66,433.00
|
|
|
Service Code
|
CPT 33418
|
| Hospital Charge Code |
906811487
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13,286.60 |
| Max. Negotiated Rate |
$59,789.70 |
| Rate for Payer: Adventist Health Commercial |
$13,286.60
|
| Rate for Payer: Cash Price |
$29,894.85
|
| Rate for Payer: Central Health Plan Commercial |
$53,146.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46,503.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,573.20
|
| Rate for Payer: EPIC Health Plan Senior |
$26,573.20
|
| Rate for Payer: Galaxy Health WC |
$56,468.05
|
| Rate for Payer: Global Benefits Group Commercial |
$39,859.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$59,789.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$42,184.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$39,195.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,286.60
|
| Rate for Payer: Multiplan Commercial |
$49,824.75
|
| Rate for Payer: Networks By Design Commercial |
$43,181.45
|
| Rate for Payer: Prime Health Services Commercial |
$56,468.05
|
|
|
HC TRANSCATH MITRAL VALVE REPAIR
|
Facility
|
OP
|
$66,433.00
|
|
|
Service Code
|
CPT 33418
|
| Hospital Charge Code |
906811487
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$59,789.70 |
| Rate for Payer: Adventist Health Commercial |
$13,286.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56,468.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36,538.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49,824.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$29,894.85
|
| Rate for Payer: Cash Price |
$29,894.85
|
| Rate for Payer: Cash Price |
$29,894.85
|
| Rate for Payer: Central Health Plan Commercial |
$53,146.40
|
| Rate for Payer: Cigna of CA HMO |
$42,517.12
|
| Rate for Payer: Cigna of CA PPO |
$49,160.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56,468.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$56,468.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56,468.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46,503.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,573.20
|
| Rate for Payer: EPIC Health Plan Senior |
$26,573.20
|
| Rate for Payer: Galaxy Health WC |
$56,468.05
|
| Rate for Payer: Global Benefits Group Commercial |
$39,859.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$59,789.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,742.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$42,184.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,029.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$39,195.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,286.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$46,503.10
|
| Rate for Payer: Multiplan Commercial |
$49,824.75
|
| Rate for Payer: Networks By Design Commercial |
$43,181.45
|
| Rate for Payer: Prime Health Services Commercial |
$56,468.05
|
| Rate for Payer: Riverside University Health System MISP |
$26,573.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39,859.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$33,216.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56,468.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56,468.05
|
| Rate for Payer: Vantage Medical Group Senior |
$56,468.05
|
|
|
HC TRANSCATH MITRAL VLVE IMPL/REP
|
Facility
|
IP
|
$63,112.00
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
906800483
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,622.40 |
| Max. Negotiated Rate |
$56,800.80 |
| Rate for Payer: Adventist Health Commercial |
$12,622.40
|
| Rate for Payer: Cash Price |
$28,400.40
|
| Rate for Payer: Central Health Plan Commercial |
$50,489.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44,178.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,244.80
|
| Rate for Payer: EPIC Health Plan Senior |
$25,244.80
|
| Rate for Payer: Galaxy Health WC |
$53,645.20
|
| Rate for Payer: Global Benefits Group Commercial |
$37,867.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$56,800.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40,076.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37,236.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,622.40
|
| Rate for Payer: Multiplan Commercial |
$47,334.00
|
| Rate for Payer: Networks By Design Commercial |
$41,022.80
|
| Rate for Payer: Prime Health Services Commercial |
$53,645.20
|
|
|
HC TRANSCATH MITRAL VLVE IMPL/REP
|
Facility
|
OP
|
$63,112.00
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
906800483
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,069.82 |
| Max. Negotiated Rate |
$56,800.80 |
| Rate for Payer: Adventist Health Commercial |
$12,622.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$53,645.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34,711.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47,334.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$28,400.40
|
| Rate for Payer: Cash Price |
$28,400.40
|
| Rate for Payer: Central Health Plan Commercial |
$50,489.60
|
| Rate for Payer: Cigna of CA HMO |
$40,391.68
|
| Rate for Payer: Cigna of CA PPO |
$46,702.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$53,645.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$53,645.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$53,645.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44,178.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,244.80
|
| Rate for Payer: EPIC Health Plan Senior |
$25,244.80
|
| Rate for Payer: Galaxy Health WC |
$53,645.20
|
| Rate for Payer: Global Benefits Group Commercial |
$37,867.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$56,800.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40,076.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22,909.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37,236.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,622.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$44,178.40
|
| Rate for Payer: Multiplan Commercial |
$47,334.00
|
| Rate for Payer: Networks By Design Commercial |
$41,022.80
|
| Rate for Payer: Prime Health Services Commercial |
$53,645.20
|
| Rate for Payer: Riverside University Health System MISP |
$25,244.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37,867.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,556.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$53,645.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$53,645.20
|
| Rate for Payer: Vantage Medical Group Senior |
$53,645.20
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC ADDL ART
|
Facility
|
OP
|
$11,340.00
|
|
|
Service Code
|
CPT 37237
|
| Hospital Charge Code |
906811479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$62.76 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,268.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,639.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6,237.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,505.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,228.07
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$5,103.00
|
| Rate for Payer: Cash Price |
$5,103.00
|
| Rate for Payer: Cash Price |
$5,103.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,072.00
|
| Rate for Payer: Cigna of CA HMO |
$7,257.60
|
| Rate for Payer: Cigna of CA PPO |
$8,391.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,639.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,639.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,639.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,938.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,536.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,536.00
|
| Rate for Payer: Galaxy Health WC |
$9,639.00
|
| Rate for Payer: Global Benefits Group Commercial |
$6,804.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,206.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$62.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,200.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$69.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,690.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,268.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7,938.00
|
| Rate for Payer: Multiplan Commercial |
$8,505.00
|
| Rate for Payer: Networks By Design Commercial |
$7,371.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,639.00
|
| Rate for Payer: Riverside University Health System MISP |
$4,536.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,804.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,670.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,639.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,639.00
|
| Rate for Payer: Vantage Medical Group Senior |
$9,639.00
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC ADDL ART
|
Facility
|
IP
|
$11,340.00
|
|
|
Service Code
|
CPT 37237
|
| Hospital Charge Code |
906811479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,268.00 |
| Max. Negotiated Rate |
$10,206.00 |
| Rate for Payer: Adventist Health Commercial |
$2,268.00
|
| Rate for Payer: Cash Price |
$5,103.00
|
| Rate for Payer: Central Health Plan Commercial |
$9,072.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,938.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,536.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,536.00
|
| Rate for Payer: Galaxy Health WC |
$9,639.00
|
| Rate for Payer: Global Benefits Group Commercial |
$6,804.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,206.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,200.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,690.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,268.00
|
| Rate for Payer: Multiplan Commercial |
$8,505.00
|
| Rate for Payer: Networks By Design Commercial |
$7,371.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,639.00
|
|
|
HC TRANSCATH PLCMT INT STNT OPENPERC ADDL VEIN
|
Facility
|
OP
|
$10,774.00
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
906811481
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$43.55 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,154.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,157.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,925.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,080.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,228.07
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$4,848.30
|
| Rate for Payer: Cash Price |
$4,848.30
|
| Rate for Payer: Cash Price |
$4,848.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,619.20
|
| Rate for Payer: Cigna of CA HMO |
$6,895.36
|
| Rate for Payer: Cigna of CA PPO |
$7,972.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,157.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,157.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9,157.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,541.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,309.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,309.60
|
| Rate for Payer: Galaxy Health WC |
$9,157.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,464.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,696.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$43.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,841.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$48.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,356.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,154.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7,541.80
|
| Rate for Payer: Multiplan Commercial |
$8,080.50
|
| Rate for Payer: Networks By Design Commercial |
$7,003.10
|
| Rate for Payer: Prime Health Services Commercial |
$9,157.90
|
| Rate for Payer: Riverside University Health System MISP |
$4,309.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,464.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,387.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,157.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,157.90
|
| Rate for Payer: Vantage Medical Group Senior |
$9,157.90
|
|
|
HC TRANSCATH PLCMT INT STNT OPENPERC ADDL VEIN
|
Facility
|
IP
|
$10,774.00
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
906811481
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,154.80 |
| Max. Negotiated Rate |
$9,696.60 |
| Rate for Payer: Adventist Health Commercial |
$2,154.80
|
| Rate for Payer: Cash Price |
$4,848.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,619.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,541.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,309.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,309.60
|
| Rate for Payer: Galaxy Health WC |
$9,157.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,464.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,696.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,841.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,356.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,154.80
|
| Rate for Payer: Multiplan Commercial |
$8,080.50
|
| Rate for Payer: Networks By Design Commercial |
$7,003.10
|
| Rate for Payer: Prime Health Services Commercial |
$9,157.90
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC INIT ART
|
Facility
|
IP
|
$24,620.00
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
906811478
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,924.00 |
| Max. Negotiated Rate |
$22,158.00 |
| Rate for Payer: Adventist Health Commercial |
$4,924.00
|
| Rate for Payer: Cash Price |
$11,079.00
|
| Rate for Payer: Central Health Plan Commercial |
$19,696.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,234.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,848.00
|
| Rate for Payer: EPIC Health Plan Senior |
$9,848.00
|
| Rate for Payer: Galaxy Health WC |
$20,927.00
|
| Rate for Payer: Global Benefits Group Commercial |
$14,772.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,158.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,633.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,525.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,924.00
|
| Rate for Payer: Multiplan Commercial |
$18,465.00
|
| Rate for Payer: Networks By Design Commercial |
$16,003.00
|
| Rate for Payer: Prime Health Services Commercial |
$20,927.00
|
|
