|
HC TRANSCATH SEPTAL REDUCT THER
|
Facility
|
OP
|
$19,968.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906803583
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$865.52 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$3,993.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16,972.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,982.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,976.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,562.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$8,985.60
|
| Rate for Payer: Cash Price |
$8,985.60
|
| Rate for Payer: Cash Price |
$8,985.60
|
| Rate for Payer: Central Health Plan Commercial |
$15,974.40
|
| Rate for Payer: Cigna of CA HMO |
$12,779.52
|
| Rate for Payer: Cigna of CA PPO |
$14,776.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16,972.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,972.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16,972.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13,977.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,987.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7,987.20
|
| Rate for Payer: Galaxy Health WC |
$16,972.80
|
| Rate for Payer: Global Benefits Group Commercial |
$11,980.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,971.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$865.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,679.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$956.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,781.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,993.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,977.60
|
| Rate for Payer: Multiplan Commercial |
$14,976.00
|
| Rate for Payer: Networks By Design Commercial |
$12,979.20
|
| Rate for Payer: Prime Health Services Commercial |
$16,972.80
|
| Rate for Payer: Riverside University Health System MISP |
$7,987.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,980.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,984.00
|
| 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 |
$16,972.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,972.80
|
| Rate for Payer: Vantage Medical Group Senior |
$16,972.80
|
|
|
HC TRANSCATH SEPTAL REDUCT THER
|
Facility
|
IP
|
$19,968.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906803583
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,993.60 |
| Max. Negotiated Rate |
$17,971.20 |
| Rate for Payer: Adventist Health Commercial |
$3,993.60
|
| Rate for Payer: Cash Price |
$8,985.60
|
| Rate for Payer: Central Health Plan Commercial |
$15,974.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13,977.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,987.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7,987.20
|
| Rate for Payer: Galaxy Health WC |
$16,972.80
|
| Rate for Payer: Global Benefits Group Commercial |
$11,980.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,971.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,679.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,781.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,993.60
|
| Rate for Payer: Multiplan Commercial |
$14,976.00
|
| Rate for Payer: Networks By Design Commercial |
$12,979.20
|
| Rate for Payer: Prime Health Services Commercial |
$16,972.80
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
|
OP
|
$8,608.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906812173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,721.60 |
| Max. Negotiated Rate |
$7,747.20 |
| Rate for Payer: Adventist Health Commercial |
$1,721.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,656.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,316.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,734.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,456.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,995.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,945.04
|
| Rate for Payer: Blue Shield of California Commercial |
$5,423.04
|
| Rate for Payer: Blue Shield of California EPN |
$3,417.38
|
| Rate for Payer: Cash Price |
$3,873.60
|
| Rate for Payer: Cash Price |
$3,873.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,886.40
|
| Rate for Payer: Cigna of CA HMO |
$5,509.12
|
| Rate for Payer: Cigna of CA PPO |
$6,369.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,316.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,316.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,316.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,025.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,443.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,443.20
|
| Rate for Payer: Galaxy Health WC |
$7,316.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,164.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,747.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,466.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,078.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,721.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,025.60
|
| Rate for Payer: Multiplan Commercial |
$6,456.00
|
| Rate for Payer: Networks By Design Commercial |
$5,595.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,316.80
|
| Rate for Payer: Riverside University Health System MISP |
$3,443.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,164.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,164.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,304.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,304.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,304.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,304.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,316.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,316.80
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.80
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
|
IP
|
$8,608.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906812173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,721.60 |
| Max. Negotiated Rate |
$7,747.20 |
| Rate for Payer: Adventist Health Commercial |
$1,721.60
|
| Rate for Payer: Cash Price |
$3,873.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,886.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,025.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,443.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,443.20
|
| Rate for Payer: Galaxy Health WC |
$7,316.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,164.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,747.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,466.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,078.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,721.60
|
| Rate for Payer: Multiplan Commercial |
$6,456.00
|
| Rate for Payer: Networks By Design Commercial |
$5,595.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,316.80
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
|
IP
|
$20,568.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906810570
|
|
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 TRICUSP VALVE ADDT
|
Facility
|
OP
|
$20,568.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906810570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$18,511.20 |
| Rate for Payer: Adventist Health Commercial |
$4,113.60
|
| 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: 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: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,060.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7,466.18
|
| 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 |
$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 |
$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 TRICUSP VALVE ANNUL
|
Facility
|
OP
|
$66,433.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906810545
|
|
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 TRICUSP VALVE ANNUL
|
Facility
|
IP
|
$66,433.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906810545
|
|
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 TRICUSPVALVE IMPLANT
|
Facility
|
IP
|
$76,399.00
|
|
|
Service Code
|
CPT 0646T
|
| Hospital Charge Code |
906803799
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,279.80 |
| Max. Negotiated Rate |
$68,759.10 |
| Rate for Payer: Adventist Health Commercial |
$15,279.80
|
| Rate for Payer: Cash Price |
$34,379.55
|
| Rate for Payer: Central Health Plan Commercial |
$61,119.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53,479.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,559.60
|
| Rate for Payer: EPIC Health Plan Senior |
$30,559.60
|
| Rate for Payer: Galaxy Health WC |
$64,939.15
|
| Rate for Payer: Global Benefits Group Commercial |
$45,839.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$68,759.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48,513.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$45,075.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,279.80
|
| Rate for Payer: Multiplan Commercial |
$57,299.25
|
| Rate for Payer: Networks By Design Commercial |
$49,659.35
|
| Rate for Payer: Prime Health Services Commercial |
$64,939.15
|
|
|
HC TRANSCATH TRICUSPVALVE IMPLANT
|
Facility
|
OP
|
$76,399.00
|
|
|
Service Code
|
CPT 0646T
|
| Hospital Charge Code |
906803799
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$68,759.10 |
| Rate for Payer: Adventist Health Commercial |
$15,279.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64,939.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42,019.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$57,299.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,992.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,441.30
|
| 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 |
$34,379.55
|
| Rate for Payer: Cash Price |
$34,379.55
|
| Rate for Payer: Central Health Plan Commercial |
$61,119.20
|
| Rate for Payer: Cigna of CA HMO |
$48,895.36
|
| Rate for Payer: Cigna of CA PPO |
$56,535.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64,939.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$64,939.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64,939.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$53,479.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,559.60
|
| Rate for Payer: EPIC Health Plan Senior |
$30,559.60
|
| Rate for Payer: Galaxy Health WC |
$64,939.15
|
| Rate for Payer: Global Benefits Group Commercial |
$45,839.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$68,759.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$48,513.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$27,732.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$45,075.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,279.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$53,479.30
|
| Rate for Payer: Multiplan Commercial |
$57,299.25
|
| Rate for Payer: Networks By Design Commercial |
$49,659.35
|
| Rate for Payer: Prime Health Services Commercial |
$64,939.15
|
| Rate for Payer: Riverside University Health System MISP |
$30,559.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45,839.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$38,199.50
|
| 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 |
$64,939.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64,939.15
|
| Rate for Payer: Vantage Medical Group Senior |
$64,939.15
|
|
|
HC TRANSCATH TRICUSP VALVE REPAIR
|
Facility
|
OP
|
$66,433.00
|
|
|
Service Code
|
CPT 0569T
|
| Hospital Charge Code |
906810569
|
|
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 TRICUSP VALVE REPAIR
|
Facility
|
IP
|
$66,433.00
|
|
|
Service Code
|
CPT 0569T
|
| Hospital Charge Code |
906810569
|
|
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 TRANSCRANIAL DUPLEX/DOPPLER
|
Facility
|
IP
|
$1,090.00
|
|
|
Service Code
|
CPT 93888
|
| Hospital Charge Code |
906601144
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$218.00 |
| Max. Negotiated Rate |
$981.00 |
| Rate for Payer: Adventist Health Commercial |
$218.00
|
| Rate for Payer: Cash Price |
$490.50
|
| Rate for Payer: Central Health Plan Commercial |
$872.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$763.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$436.00
|
| Rate for Payer: EPIC Health Plan Senior |
$436.00
|
| Rate for Payer: Galaxy Health WC |
$926.50
|
| Rate for Payer: Global Benefits Group Commercial |
$654.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$981.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$692.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$643.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.00
|
| Rate for Payer: Multiplan Commercial |
$817.50
|
| Rate for Payer: Networks By Design Commercial |
$708.50
|
| Rate for Payer: Prime Health Services Commercial |
$926.50
|
|
|
HC TRANSCRANIAL DUPLEX/DOPPLER
|
Facility
|
OP
|
$1,090.00
|
|
|
Service Code
|
CPT 93888
|
| Hospital Charge Code |
906601144
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$134.46 |
| Max. Negotiated Rate |
$1,588.00 |
| Rate for Payer: Adventist Health Commercial |
$218.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$134.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$404.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$642.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$634.05
|
| Rate for Payer: Blue Shield of California Commercial |
$686.70
|
| Rate for Payer: Blue Shield of California EPN |
$432.73
|
| Rate for Payer: Cash Price |
$490.50
|
| Rate for Payer: Cash Price |
$490.50
|
| Rate for Payer: Cash Price |
$490.50
|
| Rate for Payer: Central Health Plan Commercial |
$872.00
|
| Rate for Payer: Cigna of CA HMO |
$697.60
|
| Rate for Payer: Cigna of CA PPO |
$806.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$201.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$147.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$134.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$763.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.86
|
| Rate for Payer: EPIC Health Plan Senior |
$147.91
|
| Rate for Payer: Galaxy Health WC |
$926.50
|
| Rate for Payer: Global Benefits Group Commercial |
$654.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$981.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$220.51
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$223.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$134.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$692.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$247.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$188.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$218.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$180.18
|
| Rate for Payer: Multiplan Commercial |
$817.50
|
| Rate for Payer: Networks By Design Commercial |
$708.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$134.46
|
| Rate for Payer: Prime Health Services Commercial |
$926.50
|
| Rate for Payer: Prime Health Services Medicare |
$142.53
|
| Rate for Payer: Riverside University Health System MISP |
$147.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$654.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$654.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,588.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,289.00
|
| Rate for Payer: United Healthcare HMO Rider |
$978.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$895.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$134.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$147.91
|
| Rate for Payer: Vantage Medical Group Senior |
$134.46
|
|
|
HC TRANSCRANIAL DUPLEX/DOPPLER
|
Facility
|
IP
|
$2,204.00
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
906601143
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$440.80 |
| Max. Negotiated Rate |
$1,983.60 |
| Rate for Payer: Adventist Health Commercial |
$440.80
|
| Rate for Payer: Cash Price |
$991.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,763.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,542.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$881.60
|
| Rate for Payer: EPIC Health Plan Senior |
$881.60
|
| Rate for Payer: Galaxy Health WC |
$1,873.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,322.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,983.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,399.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,300.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.80
|
| Rate for Payer: Multiplan Commercial |
$1,653.00
|
| Rate for Payer: Networks By Design Commercial |
$1,432.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,873.40
|
|
|
HC TRANSCRANIAL DUPLEX/DOPPLER
|
Facility
|
OP
|
$2,204.00
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
906601143
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$306.88 |
| Max. Negotiated Rate |
$1,983.60 |
| Rate for Payer: Adventist Health Commercial |
$440.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$306.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$996.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$306.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$974.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,282.07
|
| Rate for Payer: Blue Shield of California Commercial |
$1,388.52
|
| Rate for Payer: Blue Shield of California EPN |
$874.99
|
| Rate for Payer: Cash Price |
$991.80
|
| Rate for Payer: Cash Price |
$991.80
|
| Rate for Payer: Cash Price |
$991.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,763.20
|
| Rate for Payer: Cigna of CA HMO |
$1,410.56
|
| Rate for Payer: Cigna of CA PPO |
$1,630.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$460.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$337.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$306.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,542.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$506.35
|
| Rate for Payer: EPIC Health Plan Senior |
$337.57
|
| Rate for Payer: Galaxy Health WC |
$1,873.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,322.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,983.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$503.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$336.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$306.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,399.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$372.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$429.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$440.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$411.22
|
| Rate for Payer: Multiplan Commercial |
$1,653.00
|
| Rate for Payer: Networks By Design Commercial |
$1,432.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$306.88
|
| Rate for Payer: Prime Health Services Commercial |
$1,873.40
|
| Rate for Payer: Prime Health Services Medicare |
$325.29
|
| Rate for Payer: Riverside University Health System MISP |
$337.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,322.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,322.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,588.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,289.00
|
| Rate for Payer: United Healthcare HMO Rider |
$978.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$895.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$306.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$460.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$337.57
|
| Rate for Payer: Vantage Medical Group Senior |
$306.88
|
|
|
HC TRANSDUCER PED A-LINE CVP
|
Facility
|
OP
|
$241.64
|
|
| Hospital Charge Code |
901604261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.33 |
| Max. Negotiated Rate |
$217.48 |
| Rate for Payer: Adventist Health Commercial |
$48.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$146.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$205.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$132.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$181.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.56
|
| Rate for Payer: Blue Shield of California Commercial |
$153.20
|
| Rate for Payer: Blue Shield of California EPN |
$96.41
|
| Rate for Payer: Cash Price |
$108.74
|
| Rate for Payer: Central Health Plan Commercial |
$193.31
|
| Rate for Payer: Cigna of CA HMO |
$154.65
|
| Rate for Payer: Cigna of CA PPO |
$178.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$205.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$205.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$205.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$169.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.66
|
| Rate for Payer: EPIC Health Plan Senior |
$96.66
|
| Rate for Payer: Galaxy Health WC |
$205.39
|
| Rate for Payer: Global Benefits Group Commercial |
$144.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$217.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$87.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$169.15
|
| Rate for Payer: Multiplan Commercial |
$181.23
|
| Rate for Payer: Networks By Design Commercial |
$157.07
|
| Rate for Payer: Prime Health Services Commercial |
$205.39
|
| Rate for Payer: Riverside University Health System MISP |
$96.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$144.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$144.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$120.82
|
| Rate for Payer: United Healthcare All Other HMO |
$120.82
|
| Rate for Payer: United Healthcare HMO Rider |
$120.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$120.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$205.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$205.39
|
| Rate for Payer: Vantage Medical Group Senior |
$205.39
|
|
|
HC TRANSDUCER PED A-LINE CVP
|
Facility
|
IP
|
$241.64
|
|
| Hospital Charge Code |
901604261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.33 |
| Max. Negotiated Rate |
$217.48 |
| Rate for Payer: Adventist Health Commercial |
$48.33
|
| Rate for Payer: Cash Price |
$108.74
|
| Rate for Payer: Central Health Plan Commercial |
$193.31
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$169.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.66
|
| Rate for Payer: EPIC Health Plan Senior |
$96.66
|
| Rate for Payer: Galaxy Health WC |
$205.39
|
| Rate for Payer: Global Benefits Group Commercial |
$144.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$217.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.33
|
| Rate for Payer: Multiplan Commercial |
$181.23
|
| Rate for Payer: Networks By Design Commercial |
$157.07
|
| Rate for Payer: Prime Health Services Commercial |
$205.39
|
|
|
HC TRANSESOPHOGEAL CARDIAC OUTPUT
|
Facility
|
OP
|
$840.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
900800525
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$165.49 |
| Max. Negotiated Rate |
$764.00 |
| Rate for Payer: Adventist Health Commercial |
$168.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$165.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$510.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$165.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$406.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$488.63
|
| Rate for Payer: Blue Shield of California Commercial |
$529.20
|
| Rate for Payer: Blue Shield of California EPN |
$333.48
|
| Rate for Payer: Cash Price |
$378.00
|
| Rate for Payer: Cash Price |
$378.00
|
| Rate for Payer: Cash Price |
$378.00
|
| Rate for Payer: Central Health Plan Commercial |
$672.00
|
| Rate for Payer: Cigna of CA HMO |
$537.60
|
| Rate for Payer: Cigna of CA PPO |
$621.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$248.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$165.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$588.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$273.06
|
| Rate for Payer: EPIC Health Plan Senior |
$182.04
|
| Rate for Payer: Galaxy Health WC |
$714.00
|
| Rate for Payer: Global Benefits Group Commercial |
$504.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$756.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$271.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$165.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$533.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$221.76
|
| Rate for Payer: Multiplan Commercial |
$630.00
|
| Rate for Payer: Networks By Design Commercial |
$546.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$165.49
|
| Rate for Payer: Prime Health Services Commercial |
$714.00
|
| Rate for Payer: Prime Health Services Medicare |
$175.42
|
| Rate for Payer: Riverside University Health System MISP |
$182.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$504.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$504.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$764.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$731.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$165.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$248.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.04
|
| Rate for Payer: Vantage Medical Group Senior |
$165.49
|
|
|
HC TRANSESOPHOGEAL CARDIAC OUTPUT
|
Facility
|
IP
|
$840.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
900800525
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$168.00 |
| Max. Negotiated Rate |
$756.00 |
| Rate for Payer: Adventist Health Commercial |
$168.00
|
| Rate for Payer: Cash Price |
$378.00
|
| Rate for Payer: Central Health Plan Commercial |
$672.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$588.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$336.00
|
| Rate for Payer: EPIC Health Plan Senior |
$336.00
|
| Rate for Payer: Galaxy Health WC |
$714.00
|
| Rate for Payer: Global Benefits Group Commercial |
$504.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$756.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$533.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$495.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$168.00
|
| Rate for Payer: Multiplan Commercial |
$630.00
|
| Rate for Payer: Networks By Design Commercial |
$546.00
|
| Rate for Payer: Prime Health Services Commercial |
$714.00
|
|
|
HC TRANSFERRIN
|
Facility
|
IP
|
$239.00
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
900910854
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.80 |
| Max. Negotiated Rate |
$215.10 |
| Rate for Payer: Adventist Health Commercial |
$47.80
|
| Rate for Payer: Cash Price |
$107.55
|
| Rate for Payer: Central Health Plan Commercial |
$191.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$167.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.60
|
| Rate for Payer: EPIC Health Plan Senior |
$95.60
|
| Rate for Payer: Galaxy Health WC |
$203.15
|
| Rate for Payer: Global Benefits Group Commercial |
$143.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$215.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$151.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$141.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.80
|
| Rate for Payer: Multiplan Commercial |
$179.25
|
| Rate for Payer: Networks By Design Commercial |
$155.35
|
| Rate for Payer: Prime Health Services Commercial |
$203.15
|
|
|
HC TRANSFERRIN
|
Facility
|
OP
|
$108.00
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
900910854
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.33 |
| Max. Negotiated Rate |
$132.91 |
| Rate for Payer: Adventist Health Commercial |
$21.60
|
| Rate for Payer: Adventist Health Commercial |
$47.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$12.76
|
| Rate for Payer: Adventist Health Medi-Cal |
$12.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$93.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$93.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.91
|
| Rate for Payer: Blue Shield of California Commercial |
$150.57
|
| Rate for Payer: Blue Shield of California Commercial |
$68.04
|
| Rate for Payer: Blue Shield of California EPN |
$94.88
|
| Rate for Payer: Blue Shield of California EPN |
$42.88
|
| Rate for Payer: Cash Price |
$107.55
|
| Rate for Payer: Cash Price |
$107.55
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Central Health Plan Commercial |
$86.40
|
| Rate for Payer: Central Health Plan Commercial |
$191.20
|
| Rate for Payer: Cigna of CA HMO |
$152.96
|
| Rate for Payer: Cigna of CA HMO |
$69.12
|
| Rate for Payer: Cigna of CA PPO |
$176.86
|
| Rate for Payer: Cigna of CA PPO |
$79.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$75.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$167.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.05
|
| Rate for Payer: EPIC Health Plan Senior |
$14.04
|
| Rate for Payer: EPIC Health Plan Senior |
$14.04
|
| Rate for Payer: Galaxy Health WC |
$203.15
|
| Rate for Payer: Galaxy Health WC |
$91.80
|
| Rate for Payer: Global Benefits Group Commercial |
$143.40
|
| Rate for Payer: Global Benefits Group Commercial |
$64.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$215.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$97.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$20.93
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$20.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$68.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$151.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.10
|
| Rate for Payer: Multiplan Commercial |
$179.25
|
| Rate for Payer: Multiplan Commercial |
$81.00
|
| Rate for Payer: Networks By Design Commercial |
$70.20
|
| Rate for Payer: Networks By Design Commercial |
$155.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12.76
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12.76
|
| Rate for Payer: Prime Health Services Commercial |
$203.15
|
| Rate for Payer: Prime Health Services Commercial |
$91.80
|
| Rate for Payer: Prime Health Services Medicare |
$13.53
|
| Rate for Payer: Prime Health Services Medicare |
$13.53
|
| Rate for Payer: Riverside University Health System MISP |
$14.04
|
| Rate for Payer: Riverside University Health System MISP |
$14.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$64.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$143.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$143.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$64.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.33
|
| Rate for Payer: United Healthcare All Other HMO |
$10.33
|
| Rate for Payer: United Healthcare All Other HMO |
$10.33
|
| Rate for Payer: United Healthcare HMO Rider |
$10.33
|
| Rate for Payer: United Healthcare HMO Rider |
$10.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.33
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.76
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.04
|
| Rate for Payer: Vantage Medical Group Senior |
$12.76
|
| Rate for Payer: Vantage Medical Group Senior |
$12.76
|
|
|
HC TRANSFUS BLOOD/BLOOD COMPONENT
|
Facility
|
IP
|
$3,391.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
907201094
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$678.20 |
| Max. Negotiated Rate |
$3,051.90 |
| Rate for Payer: Adventist Health Commercial |
$678.20
|
| Rate for Payer: Cash Price |
$1,525.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,712.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,373.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,356.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,356.40
|
| Rate for Payer: Galaxy Health WC |
$2,882.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,034.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,051.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,153.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,000.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.20
|
| Rate for Payer: Multiplan Commercial |
$2,543.25
|
| Rate for Payer: Networks By Design Commercial |
$2,204.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,882.35
|
|
|
HC TRANSFUS BLOOD/BLOOD COMPONENT
|
Facility
|
IP
|
$3,391.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
907201094
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$678.20 |
| Max. Negotiated Rate |
$3,051.90 |
| Rate for Payer: Adventist Health Commercial |
$678.20
|
| Rate for Payer: Cash Price |
$1,525.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,712.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,373.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,356.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,356.40
|
| Rate for Payer: Galaxy Health WC |
$2,882.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,034.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,051.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,153.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,000.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.20
|
| Rate for Payer: Multiplan Commercial |
$2,543.25
|
| Rate for Payer: Networks By Design Commercial |
$2,204.15
|
| Rate for Payer: Prime Health Services Commercial |
$2,882.35
|
|
|
HC TRANSFUS BLOOD/BLOOD COMPONENT
|
Facility
|
OP
|
$3,391.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
907201094
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$229.60 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$678.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$567.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$229.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$851.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$624.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$567.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,149.89
|
| Rate for Payer: Blue Shield of California EPN |
$1,353.01
|
| Rate for Payer: Cash Price |
$1,525.95
|
| Rate for Payer: Cash Price |
$1,525.95
|
| Rate for Payer: Cash Price |
$1,525.95
|
| Rate for Payer: Cash Price |
$1,525.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,712.80
|
| Rate for Payer: Cigna of CA HMO |
$2,170.24
|
| Rate for Payer: Cigna of CA PPO |
$2,509.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$851.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$624.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$567.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,373.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.24
|
| Rate for Payer: EPIC Health Plan Senior |
$624.16
|
| Rate for Payer: Galaxy Health WC |
$2,882.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,034.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,051.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$930.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$567.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,153.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,230.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$794.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$760.34
|
| Rate for Payer: Multiplan Commercial |
$2,543.25
|
| Rate for Payer: Networks By Design Commercial |
$2,204.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$567.42
|
| Rate for Payer: Prime Health Services Commercial |
$2,882.35
|
| Rate for Payer: Prime Health Services Medicare |
$601.47
|
| Rate for Payer: Riverside University Health System MISP |
$624.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,034.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,034.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$676.00
|
| Rate for Payer: United Healthcare All Other HMO |
$663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$567.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$851.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$624.16
|
| Rate for Payer: Vantage Medical Group Senior |
$567.42
|
|
