|
HC TRANSCATH PLCMT INT STNT OPEN PERC INIT ART
|
Facility
|
OP
|
$24,620.00
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
906811478
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$674.93 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,924.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,958.69
|
| 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 |
$11,079.00
|
| Rate for Payer: Cash Price |
$11,079.00
|
| Rate for Payer: Cash Price |
$11,079.00
|
| Rate for Payer: Central Health Plan Commercial |
$19,696.00
|
| Rate for Payer: Cigna of CA HMO |
$15,756.80
|
| Rate for Payer: Cigna of CA PPO |
$18,218.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,234.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| 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: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$674.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,633.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$745.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,924.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$18,465.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$16,003.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Preferred Health Network WC |
$23,427.23
|
| Rate for Payer: Prime Health Services Commercial |
$20,927.00
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,772.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,310.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC INIT VEIN
|
Facility
|
IP
|
$22,276.00
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
906811480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,455.20 |
| Max. Negotiated Rate |
$20,048.40 |
| Rate for Payer: Adventist Health Commercial |
$4,455.20
|
| Rate for Payer: Cash Price |
$10,024.20
|
| Rate for Payer: Central Health Plan Commercial |
$17,820.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,593.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,910.40
|
| Rate for Payer: EPIC Health Plan Senior |
$8,910.40
|
| Rate for Payer: Galaxy Health WC |
$18,934.60
|
| Rate for Payer: Global Benefits Group Commercial |
$13,365.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,048.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,145.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,142.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,455.20
|
| Rate for Payer: Multiplan Commercial |
$16,707.00
|
| Rate for Payer: Networks By Design Commercial |
$14,479.40
|
| Rate for Payer: Prime Health Services Commercial |
$18,934.60
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC INIT VEIN
|
Facility
|
OP
|
$22,276.00
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
906811480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$473.22 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,455.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,958.69
|
| 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 |
$10,024.20
|
| Rate for Payer: Cash Price |
$10,024.20
|
| Rate for Payer: Cash Price |
$10,024.20
|
| Rate for Payer: Central Health Plan Commercial |
$17,820.80
|
| Rate for Payer: Cigna of CA HMO |
$14,256.64
|
| Rate for Payer: Cigna of CA PPO |
$16,484.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,593.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$18,934.60
|
| Rate for Payer: Global Benefits Group Commercial |
$13,365.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,048.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$473.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,145.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$522.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,455.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$16,707.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$14,479.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Preferred Health Network WC |
$23,427.23
|
| Rate for Payer: Prime Health Services Commercial |
$18,934.60
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,365.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,138.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC TRANSCATH PULM VALVE IMPLANT
|
Facility
|
IP
|
$63,112.00
|
|
|
Service Code
|
CPT 33477
|
| Hospital Charge Code |
906811427
|
|
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 PULM VALVE IMPLANT
|
Facility
|
OP
|
$63,112.00
|
|
|
Service Code
|
CPT 33477
|
| Hospital Charge Code |
906811427
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$56,800.80 |
| Rate for Payer: Adventist Health Commercial |
$12,622.40
|
| 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 |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$28,400.40
|
| 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: Inland Empire Health Plan (IEHP) medi-cal |
$1,919.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40,076.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,120.70
|
| 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 RENAL DENERVATION
|
Facility
|
OP
|
$16,312.00
|
|
|
Service Code
|
CPT 0338T
|
| Hospital Charge Code |
906811473
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,262.40 |
| Max. Negotiated Rate |
$14,680.80 |
| Rate for Payer: Adventist Health Commercial |
$3,262.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,320.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,922.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,320.30
|
| 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 |
$10,276.56
|
| Rate for Payer: Blue Shield of California EPN |
$6,475.86
|
| Rate for Payer: Cash Price |
$7,340.40
|
| Rate for Payer: Cash Price |
$7,340.40
|
| Rate for Payer: Cash Price |
$7,340.40
|
| Rate for Payer: Central Health Plan Commercial |
$13,049.60
|
| Rate for Payer: Cigna of CA HMO |
$10,439.68
|
| Rate for Payer: Cigna of CA PPO |
$12,070.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,052.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,320.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,418.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,078.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8,052.33
|
| Rate for Payer: Galaxy Health WC |
$13,865.20
|
| Rate for Payer: Global Benefits Group Commercial |
$9,787.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,680.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,005.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,358.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,921.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,248.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,262.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,809.20
|
| Rate for Payer: Multiplan Commercial |
$12,234.00
|
| Rate for Payer: Networks By Design Commercial |
$10,602.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Prime Health Services Commercial |
$13,865.20
|
| Rate for Payer: Prime Health Services Medicare |
$7,759.52
|
| Rate for Payer: Riverside University Health System MISP |
$8,052.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,787.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,787.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$8,156.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,156.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,156.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,320.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Vantage Medical Group Senior |
$7,320.30
|
|
|
HC TRANSCATH RENAL DENERVATION
|
Facility
|
IP
|
$16,312.00
|
|
|
Service Code
|
CPT 0338T
|
| Hospital Charge Code |
906811473
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,262.40 |
| Max. Negotiated Rate |
$14,680.80 |
| Rate for Payer: Adventist Health Commercial |
$3,262.40
|
| Rate for Payer: Cash Price |
$7,340.40
|
| Rate for Payer: Central Health Plan Commercial |
$13,049.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11,418.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,524.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6,524.80
|
| Rate for Payer: Galaxy Health WC |
$13,865.20
|
| Rate for Payer: Global Benefits Group Commercial |
$9,787.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,680.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10,358.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,624.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,262.40
|
| Rate for Payer: Multiplan Commercial |
$12,234.00
|
| Rate for Payer: Networks By Design Commercial |
$10,602.80
|
| Rate for Payer: Prime Health Services Commercial |
$13,865.20
|
|
|
HC TRANSCATH RENAL DENERVATION BILATERAL
|
Facility
|
OP
|
$24,467.00
|
|
|
Service Code
|
CPT 0339T
|
| Hospital Charge Code |
906811474
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$4,893.40 |
| Max. Negotiated Rate |
$22,020.30 |
| Rate for Payer: Adventist Health Commercial |
$4,893.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,320.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,115.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,320.30
|
| 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 |
$15,414.21
|
| Rate for Payer: Blue Shield of California EPN |
$9,713.40
|
| Rate for Payer: Cash Price |
$11,010.15
|
| Rate for Payer: Cash Price |
$11,010.15
|
| Rate for Payer: Cash Price |
$11,010.15
|
| Rate for Payer: Central Health Plan Commercial |
$19,573.60
|
| Rate for Payer: Cigna of CA HMO |
$15,658.88
|
| Rate for Payer: Cigna of CA PPO |
$18,105.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,052.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,320.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,126.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,078.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8,052.33
|
| Rate for Payer: Galaxy Health WC |
$20,796.95
|
| Rate for Payer: Global Benefits Group Commercial |
$14,680.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,020.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,005.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,536.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8,881.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,248.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,893.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,809.20
|
| Rate for Payer: Multiplan Commercial |
$18,350.25
|
| Rate for Payer: Networks By Design Commercial |
$15,903.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Prime Health Services Commercial |
$20,796.95
|
| Rate for Payer: Prime Health Services Medicare |
$7,759.52
|
| Rate for Payer: Riverside University Health System MISP |
$8,052.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,680.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14,680.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,233.50
|
| Rate for Payer: United Healthcare All Other HMO |
$12,233.50
|
| Rate for Payer: United Healthcare HMO Rider |
$12,233.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,233.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,320.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Vantage Medical Group Senior |
$7,320.30
|
|
|
HC TRANSCATH RENAL DENERVATION BILATERAL
|
Facility
|
IP
|
$24,467.00
|
|
|
Service Code
|
CPT 0339T
|
| Hospital Charge Code |
906811474
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$4,893.40 |
| Max. Negotiated Rate |
$22,020.30 |
| Rate for Payer: Adventist Health Commercial |
$4,893.40
|
| Rate for Payer: Cash Price |
$11,010.15
|
| Rate for Payer: Central Health Plan Commercial |
$19,573.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,126.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,786.80
|
| Rate for Payer: EPIC Health Plan Senior |
$9,786.80
|
| Rate for Payer: Galaxy Health WC |
$20,796.95
|
| Rate for Payer: Global Benefits Group Commercial |
$14,680.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,020.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,536.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,435.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,893.40
|
| Rate for Payer: Multiplan Commercial |
$18,350.25
|
| Rate for Payer: Networks By Design Commercial |
$15,903.55
|
| Rate for Payer: Prime Health Services Commercial |
$20,796.95
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
OP
|
$7,149.00
|
|
|
Service Code
|
CPT 0799T
|
| Hospital Charge Code |
906819781
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| 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 |
$3,461.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,158.57
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| 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 |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,719.20
|
| Rate for Payer: Cigna of CA HMO |
$4,575.36
|
| Rate for Payer: Cigna of CA PPO |
$5,290.26
|
| 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 |
$5,004.30
|
| 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 |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,434.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,595.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$5,361.75
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,289.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,574.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,574.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,574.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,574.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
IP
|
$7,149.00
|
|
|
Service Code
|
CPT 0799T
|
| Hospital Charge Code |
906819781
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.80 |
| Max. Negotiated Rate |
$6,434.10 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,719.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,004.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,859.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,859.60
|
| Rate for Payer: Galaxy Health WC |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,434.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,217.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.80
|
| Rate for Payer: Multiplan Commercial |
$5,361.75
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV COMP SYS
|
Facility
|
IP
|
$7,149.00
|
|
|
Service Code
|
CPT 0798T
|
| Hospital Charge Code |
906819780
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.80 |
| Max. Negotiated Rate |
$6,434.10 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,719.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,004.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,859.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,859.60
|
| Rate for Payer: Galaxy Health WC |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,434.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,217.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.80
|
| Rate for Payer: Multiplan Commercial |
$5,361.75
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV COMP SYS
|
Facility
|
OP
|
$7,149.00
|
|
|
Service Code
|
CPT 0798T
|
| Hospital Charge Code |
906819780
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| 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 |
$3,461.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,158.57
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| 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 |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,719.20
|
| Rate for Payer: Cigna of CA HMO |
$4,575.36
|
| Rate for Payer: Cigna of CA PPO |
$5,290.26
|
| 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 |
$5,004.30
|
| 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 |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,434.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,595.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$5,361.75
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,289.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,574.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,574.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,574.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,574.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV PM COMPNT
|
Facility
|
IP
|
$7,149.00
|
|
|
Service Code
|
CPT 0800T
|
| Hospital Charge Code |
906819782
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.80 |
| Max. Negotiated Rate |
$6,434.10 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,719.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,004.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,859.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,859.60
|
| Rate for Payer: Galaxy Health WC |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,434.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,217.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.80
|
| Rate for Payer: Multiplan Commercial |
$5,361.75
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV PM COMPNT
|
Facility
|
OP
|
$7,149.00
|
|
|
Service Code
|
CPT 0800T
|
| Hospital Charge Code |
906819782
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| 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 |
$3,461.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,158.57
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| 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 |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,719.20
|
| Rate for Payer: Cigna of CA HMO |
$4,575.36
|
| Rate for Payer: Cigna of CA PPO |
$5,290.26
|
| 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 |
$5,004.30
|
| 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 |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,434.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,595.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$5,361.75
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,289.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,574.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,574.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,574.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,574.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC TRANSCATH RMVL REPL DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0802T
|
| Hospital Charge Code |
906819784
|
|
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 RMVL REPL DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0802T
|
| Hospital Charge Code |
906819784
|
|
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 RMVL REPL DC LEADLESS PMKR RA RV
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0801T
|
| Hospital Charge Code |
906819783
|
|
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 RMVL REPL DC LEADLESS PMKR RA RV
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0801T
|
| Hospital Charge Code |
906819783
|
|
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 RMVL REPL DC LEADLESS PMKR RV PM COMPNT
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0803T
|
| Hospital Charge Code |
906819785
|
|
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 RMVL REPL DC LEADLESS PMKR RV PM COMPNT
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0803T
|
| Hospital Charge Code |
906819785
|
|
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 RMVL REPL SC LEADLESS PMKR RA
|
Facility
|
OP
|
$43,704.00
|
|
|
Service Code
|
CPT 0825T
|
| Hospital Charge Code |
906819775
|
|
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 RMVL REPL SC LEADLESS PMKR RA
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0825T
|
| Hospital Charge Code |
906819775
|
|
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 RMVL SC LEADLESS PMKR RA
|
Facility
|
OP
|
$7,149.00
|
|
|
Service Code
|
CPT 0824T
|
| Hospital Charge Code |
906819774
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| 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 |
$3,461.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,158.57
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| 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 |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,719.20
|
| Rate for Payer: Cigna of CA HMO |
$4,575.36
|
| Rate for Payer: Cigna of CA PPO |
$5,290.26
|
| 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 |
$5,004.30
|
| 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 |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,434.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,595.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$5,361.75
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,289.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,574.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,574.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,574.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,574.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC TRANSCATH RMVL SC LEADLESS PMKR RA
|
Facility
|
IP
|
$7,149.00
|
|
|
Service Code
|
CPT 0824T
|
| Hospital Charge Code |
906819774
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.80 |
| Max. Negotiated Rate |
$6,434.10 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| Rate for Payer: Cash Price |
$3,217.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,719.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,004.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,859.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,859.60
|
| Rate for Payer: Galaxy Health WC |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,434.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,539.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,217.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.80
|
| Rate for Payer: Multiplan Commercial |
$5,361.75
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
|
