|
HC SYTM TORTLEAIR HEAD REPOSITIONING SM 33-38CM
|
Facility
|
OP
|
$183.75
|
|
| Hospital Charge Code |
901607215
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.75 |
| Max. Negotiated Rate |
$165.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$111.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$156.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$101.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$101.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$108.56
|
| Rate for Payer: Blue Distinction Transplant |
$110.25
|
| Rate for Payer: Blue Shield of California Commercial |
$115.58
|
| Rate for Payer: Blue Shield of California EPN |
$89.85
|
| Rate for Payer: Cash Price |
$82.69
|
| Rate for Payer: Central Health Plan Commercial |
$147.00
|
| Rate for Payer: Cigna of CA HMO |
$117.60
|
| Rate for Payer: Cigna of CA PPO |
$135.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$156.19
|
| Rate for Payer: Dignity Health Media |
$156.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$156.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$73.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$73.50
|
| Rate for Payer: Galaxy Health WC |
$156.19
|
| Rate for Payer: Global Benefits Group Commercial |
$110.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$165.38
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$137.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$64.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$122.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.75
|
| Rate for Payer: Multiplan Commercial |
$137.81
|
| Rate for Payer: Networks By Design Commercial |
$119.44
|
| Rate for Payer: Prime Health Services Commercial |
$156.19
|
| Rate for Payer: Riverside University Health System MISP |
$73.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$110.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$110.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$91.88
|
| Rate for Payer: United Healthcare All Other HMO |
$91.88
|
| Rate for Payer: United Healthcare HMO Rider |
$91.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$156.19
|
| Rate for Payer: Vantage Medical Group Senior |
$156.19
|
|
|
HC TANGNTL BX SKIN EA SEP/ADD LSN
|
Facility
|
OP
|
$327.00
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
900511103
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$65.40 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$277.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$179.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$179.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$196.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: Cigna of CA PPO |
$241.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.95
|
| Rate for Payer: Dignity Health Media |
$277.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$245.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$114.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$218.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
| Rate for Payer: Riverside University Health System MISP |
$130.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$196.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.95
|
| Rate for Payer: Vantage Medical Group Senior |
$277.95
|
|
|
HC TANGNTL BX SKIN EA SEP/ADD LSN
|
Facility
|
IP
|
$327.00
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
900511103
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$65.40 |
| Max. Negotiated Rate |
$294.30 |
| Rate for Payer: Cash Price |
$147.15
|
| Rate for Payer: Central Health Plan Commercial |
$261.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.80
|
| Rate for Payer: Galaxy Health WC |
$277.95
|
| Rate for Payer: Global Benefits Group Commercial |
$196.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$294.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$218.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.40
|
| Rate for Payer: Multiplan Commercial |
$245.25
|
| Rate for Payer: Networks By Design Commercial |
$212.55
|
| Rate for Payer: Prime Health Services Commercial |
$277.95
|
|
|
HC TANGNTL BX SKIN SINGLE LESION
|
Facility
|
OP
|
$653.00
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
900511102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.60 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$391.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$293.85
|
| Rate for Payer: Cash Price |
$293.85
|
| Rate for Payer: Central Health Plan Commercial |
$522.40
|
| Rate for Payer: Cigna of CA PPO |
$483.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$555.05
|
| Rate for Payer: Global Benefits Group Commercial |
$391.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$587.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$489.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$412.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: InnovAge PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$435.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$169.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$489.75
|
| Rate for Payer: Networks By Design Commercial |
$424.45
|
| Rate for Payer: Prime Health Services Commercial |
$555.05
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Riverside University Health System MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$391.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC TANGNTL BX SKIN SINGLE LESION
|
Facility
|
IP
|
$653.00
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
900511102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$130.60 |
| Max. Negotiated Rate |
$587.70 |
| Rate for Payer: Cash Price |
$293.85
|
| Rate for Payer: Central Health Plan Commercial |
$522.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$261.20
|
| Rate for Payer: Galaxy Health WC |
$555.05
|
| Rate for Payer: Global Benefits Group Commercial |
$391.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$587.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$435.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$248.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.60
|
| Rate for Payer: Multiplan Commercial |
$489.75
|
| Rate for Payer: Networks By Design Commercial |
$424.45
|
| Rate for Payer: Prime Health Services Commercial |
$555.05
|
|
|
HC TARSORRHAPHY
|
Facility
|
OP
|
$5,912.00
|
|
|
Service Code
|
CPT 67880
|
| Hospital Charge Code |
900501730
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$169.06 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,919.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,547.20
|
| Rate for Payer: Caremore Medicare Advantage |
$2,919.67
|
| Rate for Payer: Cash Price |
$2,660.40
|
| Rate for Payer: Cash Price |
$2,660.40
|
| Rate for Payer: Cash Price |
$2,660.40
|
| Rate for Payer: Cash Price |
$2,660.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,729.60
|
| Rate for Payer: Cigna of CA PPO |
$4,374.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Dignity Health Media |
$2,919.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,211.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,941.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,919.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,919.67
|
| Rate for Payer: Galaxy Health WC |
$5,025.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,547.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,320.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,434.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,788.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,919.67
|
| Rate for Payer: InnovAge PACE Commercial |
$4,379.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,943.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$169.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,919.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,182.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,912.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,912.36
|
| Rate for Payer: Multiplan Commercial |
$4,434.00
|
| Rate for Payer: Networks By Design Commercial |
$3,842.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,025.20
|
| Rate for Payer: Prime Health Services Medicare |
$3,094.85
|
| Rate for Payer: Riverside University Health System MISP |
$3,211.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,547.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,956.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,956.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,956.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,919.67
|
|
|
HC TARSORRHAPHY
|
Facility
|
IP
|
$5,912.00
|
|
|
Service Code
|
CPT 67880
|
| Hospital Charge Code |
900501730
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,182.40 |
| Max. Negotiated Rate |
$5,320.80 |
| Rate for Payer: Cash Price |
$2,660.40
|
| Rate for Payer: Central Health Plan Commercial |
$4,729.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,364.80
|
| Rate for Payer: Galaxy Health WC |
$5,025.20
|
| Rate for Payer: Global Benefits Group Commercial |
$3,547.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,320.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,943.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,182.40
|
| Rate for Payer: Multiplan Commercial |
$4,434.00
|
| Rate for Payer: Networks By Design Commercial |
$3,842.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,025.20
|
|
|
HC TAVI TAVR
|
Facility
|
IP
|
$139,961.00
|
|
| Hospital Charge Code |
906811453
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$27,992.20 |
| Max. Negotiated Rate |
$125,964.90 |
| Rate for Payer: Cash Price |
$62,982.45
|
| Rate for Payer: Cash Price |
$62,982.45
|
| Rate for Payer: Central Health Plan Commercial |
$111,968.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,984.40
|
| Rate for Payer: Galaxy Health WC |
$118,966.85
|
| Rate for Payer: Global Benefits Group Commercial |
$83,976.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$125,964.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$93,353.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53,325.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27,992.20
|
| Rate for Payer: Multiplan Commercial |
$104,970.75
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$118,966.85
|
|
|
HC TAVI TAVR
|
Facility
|
OP
|
$139,961.00
|
|
| Hospital Charge Code |
906811453
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$125,964.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$84,998.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$118,966.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$76,978.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76,978.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$67,769.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82,688.96
|
| Rate for Payer: Blue Distinction Transplant |
$83,976.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$62,982.45
|
| Rate for Payer: Cash Price |
$62,982.45
|
| Rate for Payer: Central Health Plan Commercial |
$111,968.80
|
| Rate for Payer: Cigna of CA PPO |
$103,571.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$118,966.85
|
| Rate for Payer: Dignity Health Media |
$118,966.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$118,966.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,984.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$55,984.40
|
| Rate for Payer: Galaxy Health WC |
$118,966.85
|
| Rate for Payer: Global Benefits Group Commercial |
$83,976.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$125,964.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$104,970.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48,986.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$93,353.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53,325.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27,992.20
|
| Rate for Payer: Multiplan Commercial |
$104,970.75
|
| Rate for Payer: Networks By Design Commercial |
$90,974.65
|
| Rate for Payer: Prime Health Services Commercial |
$118,966.85
|
| Rate for Payer: Riverside University Health System MISP |
$55,984.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$83,976.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$69,980.50
|
| Rate for Payer: United Healthcare All Other HMO |
$69,980.50
|
| Rate for Payer: United Healthcare HMO Rider |
$69,980.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69,980.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$118,966.85
|
| Rate for Payer: Vantage Medical Group Senior |
$118,966.85
|
|
|
HC TAVR W PROS VALVE CAROTID
|
Facility
|
OP
|
$62,290.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
906820334
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$784.90 |
| Max. Negotiated Rate |
$56,061.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$784.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37,828.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$784.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30,160.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36,800.93
|
| Rate for Payer: Blue Distinction Transplant |
$37,374.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$784.90
|
| Rate for Payer: Cash Price |
$28,030.50
|
| Rate for Payer: Cash Price |
$28,030.50
|
| Rate for Payer: Central Health Plan Commercial |
$49,832.00
|
| Rate for Payer: Cigna of CA PPO |
$46,094.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Dignity Health Media |
$784.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$863.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.90
|
| Rate for Payer: Galaxy Health WC |
$52,946.50
|
| Rate for Payer: Global Benefits Group Commercial |
$37,374.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$56,061.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$46,717.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,287.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,295.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$784.90
|
| Rate for Payer: InnovAge PACE Commercial |
$1,177.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41,547.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,458.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.77
|
| Rate for Payer: Multiplan Commercial |
$46,717.50
|
| Rate for Payer: Networks By Design Commercial |
$40,488.50
|
| Rate for Payer: Prime Health Services Commercial |
$52,946.50
|
| Rate for Payer: Prime Health Services Medicare |
$831.99
|
| Rate for Payer: Riverside University Health System MISP |
$863.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37,374.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Vantage Medical Group Senior |
$784.90
|
|
|
HC TAVR W PROS VALVE CAROTID
|
Facility
|
IP
|
$62,290.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
906820334
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,458.00 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$28,030.50
|
| Rate for Payer: Cash Price |
$28,030.50
|
| Rate for Payer: Central Health Plan Commercial |
$49,832.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,916.00
|
| Rate for Payer: Galaxy Health WC |
$52,946.50
|
| Rate for Payer: Global Benefits Group Commercial |
$37,374.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$56,061.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41,547.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23,732.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,458.00
|
| Rate for Payer: Multiplan Commercial |
$46,717.50
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$52,946.50
|
|
|
HC TAVR W PROS VALVE OPN AXLRY
|
Facility
|
IP
|
$63,249.00
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
906820333
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,649.80 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$28,462.05
|
| Rate for Payer: Cash Price |
$28,462.05
|
| Rate for Payer: Central Health Plan Commercial |
$50,599.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,299.60
|
| Rate for Payer: Galaxy Health WC |
$53,761.65
|
| Rate for Payer: Global Benefits Group Commercial |
$37,949.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$56,924.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42,187.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,097.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,649.80
|
| Rate for Payer: Multiplan Commercial |
$47,436.75
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$53,761.65
|
|
|
HC TAVR W PROS VALVE OPN AXLRY
|
Facility
|
OP
|
$63,249.00
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
906820333
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$464.46 |
| Max. Negotiated Rate |
$56,924.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,844.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$53,761.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34,786.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$34,786.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$37,949.40
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Cash Price |
$28,462.05
|
| Rate for Payer: Cash Price |
$28,462.05
|
| Rate for Payer: Central Health Plan Commercial |
$50,599.20
|
| Rate for Payer: Cigna of CA PPO |
$46,804.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$53,761.65
|
| Rate for Payer: Dignity Health Media |
$53,761.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$53,761.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,299.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$25,299.60
|
| Rate for Payer: Galaxy Health WC |
$53,761.65
|
| Rate for Payer: Global Benefits Group Commercial |
$37,949.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$56,924.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$47,436.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,137.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42,187.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$464.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,649.80
|
| Rate for Payer: Multiplan Commercial |
$47,436.75
|
| Rate for Payer: Networks By Design Commercial |
$41,111.85
|
| Rate for Payer: Prime Health Services Commercial |
$53,761.65
|
| Rate for Payer: Riverside University Health System MISP |
$25,299.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37,949.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$53,761.65
|
| Rate for Payer: Vantage Medical Group Senior |
$53,761.65
|
|
|
HC TAVR W PROS VALVE OPN FMRL
|
Facility
|
OP
|
$61,428.00
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
906820332
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,242.36 |
| Max. Negotiated Rate |
$55,285.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7,576.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52,213.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33,785.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33,785.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$36,856.80
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Cash Price |
$27,642.60
|
| Rate for Payer: Cash Price |
$27,642.60
|
| Rate for Payer: Central Health Plan Commercial |
$49,142.40
|
| Rate for Payer: Cigna of CA PPO |
$45,456.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52,213.80
|
| Rate for Payer: Dignity Health Media |
$52,213.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$52,213.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,571.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,571.20
|
| Rate for Payer: Galaxy Health WC |
$52,213.80
|
| Rate for Payer: Global Benefits Group Commercial |
$36,856.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$55,285.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$46,071.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21,499.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40,972.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,242.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,285.60
|
| Rate for Payer: Multiplan Commercial |
$46,071.00
|
| Rate for Payer: Networks By Design Commercial |
$39,928.20
|
| Rate for Payer: Prime Health Services Commercial |
$52,213.80
|
| Rate for Payer: Riverside University Health System MISP |
$24,571.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36,856.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52,213.80
|
| Rate for Payer: Vantage Medical Group Senior |
$52,213.80
|
|
|
HC TAVR W PROS VALVE OPN FMRL
|
Facility
|
IP
|
$61,428.00
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
906820332
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,285.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$27,642.60
|
| Rate for Payer: Cash Price |
$27,642.60
|
| Rate for Payer: Central Health Plan Commercial |
$49,142.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,571.20
|
| Rate for Payer: Galaxy Health WC |
$52,213.80
|
| Rate for Payer: Global Benefits Group Commercial |
$36,856.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$55,285.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40,972.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23,404.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,285.60
|
| Rate for Payer: Multiplan Commercial |
$46,071.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$52,213.80
|
|
|
HC TAVR W PROS VALVE OPN ILIAC
|
Facility
|
OP
|
$63,684.00
|
|
|
Service Code
|
CPT 33364
|
| Hospital Charge Code |
906820339
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,257.00 |
| Max. Negotiated Rate |
$57,315.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8,356.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$54,131.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35,026.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35,026.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$38,210.40
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Cash Price |
$28,657.80
|
| Rate for Payer: Cash Price |
$28,657.80
|
| Rate for Payer: Central Health Plan Commercial |
$50,947.20
|
| Rate for Payer: Cigna of CA PPO |
$47,126.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54,131.40
|
| Rate for Payer: Dignity Health Media |
$54,131.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$54,131.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,473.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$25,473.60
|
| Rate for Payer: Galaxy Health WC |
$54,131.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38,210.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57,315.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$47,763.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,289.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42,477.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,474.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,736.80
|
| Rate for Payer: Multiplan Commercial |
$47,763.00
|
| Rate for Payer: Networks By Design Commercial |
$41,394.60
|
| Rate for Payer: Prime Health Services Commercial |
$54,131.40
|
| Rate for Payer: Riverside University Health System MISP |
$25,473.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38,210.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54,131.40
|
| Rate for Payer: Vantage Medical Group Senior |
$54,131.40
|
|
|
HC TAVR W PROS VALVE OPN ILIAC
|
Facility
|
IP
|
$63,684.00
|
|
|
Service Code
|
CPT 33364
|
| Hospital Charge Code |
906820339
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,736.80 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$28,657.80
|
| Rate for Payer: Cash Price |
$28,657.80
|
| Rate for Payer: Central Health Plan Commercial |
$50,947.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,473.60
|
| Rate for Payer: Galaxy Health WC |
$54,131.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38,210.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57,315.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42,477.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24,263.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,736.80
|
| Rate for Payer: Multiplan Commercial |
$47,763.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$54,131.40
|
|
|
HC TAVR W PROS VALVE PERC FMRL
|
Facility
|
IP
|
$56,794.00
|
|
|
Service Code
|
CPT 33361
|
| Hospital Charge Code |
906820331
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$11,358.80 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$25,557.30
|
| Rate for Payer: Cash Price |
$25,557.30
|
| Rate for Payer: Central Health Plan Commercial |
$45,435.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,717.60
|
| Rate for Payer: Galaxy Health WC |
$48,274.90
|
| Rate for Payer: Global Benefits Group Commercial |
$34,076.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$51,114.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37,881.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21,638.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,358.80
|
| Rate for Payer: Multiplan Commercial |
$42,595.50
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$48,274.90
|
|
|
HC TAVR W PROS VALVE PERC FMRL
|
Facility
|
OP
|
$56,794.00
|
|
|
Service Code
|
CPT 33361
|
| Hospital Charge Code |
906820331
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$409.56 |
| Max. Negotiated Rate |
$51,114.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,925.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$48,274.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,236.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31,236.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,254.00
|
| Rate for Payer: Blue Distinction Transplant |
$34,076.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$25,557.30
|
| Rate for Payer: Cash Price |
$25,557.30
|
| Rate for Payer: Central Health Plan Commercial |
$45,435.20
|
| Rate for Payer: Cigna of CA PPO |
$42,027.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48,274.90
|
| Rate for Payer: Dignity Health Media |
$48,274.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$48,274.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,717.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$22,717.60
|
| Rate for Payer: Galaxy Health WC |
$48,274.90
|
| Rate for Payer: Global Benefits Group Commercial |
$34,076.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$51,114.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$42,595.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19,877.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37,881.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$409.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,358.80
|
| Rate for Payer: Multiplan Commercial |
$42,595.50
|
| Rate for Payer: Networks By Design Commercial |
$36,916.10
|
| Rate for Payer: Prime Health Services Commercial |
$48,274.90
|
| Rate for Payer: Riverside University Health System MISP |
$22,717.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34,076.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48,274.90
|
| Rate for Payer: Vantage Medical Group Senior |
$48,274.90
|
|
|
HC TAVR W PROS VALVE TRNSAORTIC
|
Facility
|
OP
|
$67,098.00
|
|
|
Service Code
|
CPT 33365
|
| Hospital Charge Code |
906820340
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$539.01 |
| Max. Negotiated Rate |
$60,388.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,105.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$57,033.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36,903.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36,903.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$40,258.80
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Cash Price |
$30,194.10
|
| Rate for Payer: Cash Price |
$30,194.10
|
| Rate for Payer: Central Health Plan Commercial |
$53,678.40
|
| Rate for Payer: Cigna of CA PPO |
$49,652.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$57,033.30
|
| Rate for Payer: Dignity Health Media |
$57,033.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$57,033.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,839.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$26,839.20
|
| Rate for Payer: Galaxy Health WC |
$57,033.30
|
| Rate for Payer: Global Benefits Group Commercial |
$40,258.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$60,388.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$50,323.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23,484.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44,754.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$539.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,419.60
|
| Rate for Payer: Multiplan Commercial |
$50,323.50
|
| Rate for Payer: Networks By Design Commercial |
$43,613.70
|
| Rate for Payer: Prime Health Services Commercial |
$57,033.30
|
| Rate for Payer: Riverside University Health System MISP |
$26,839.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40,258.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$57,033.30
|
| Rate for Payer: Vantage Medical Group Senior |
$57,033.30
|
|
|
HC TAVR W PROS VALVE TRNSAORTIC
|
Facility
|
IP
|
$67,098.00
|
|
|
Service Code
|
CPT 33365
|
| Hospital Charge Code |
906820340
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13,419.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$30,194.10
|
| Rate for Payer: Cash Price |
$30,194.10
|
| Rate for Payer: Central Health Plan Commercial |
$53,678.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,839.20
|
| Rate for Payer: Galaxy Health WC |
$57,033.30
|
| Rate for Payer: Global Benefits Group Commercial |
$40,258.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$60,388.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44,754.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25,564.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,419.60
|
| Rate for Payer: Multiplan Commercial |
$50,323.50
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$57,033.30
|
|
|
HC TAVR W PROS VALVE TRNSAPICAL
|
Facility
|
IP
|
$61,488.00
|
|
|
Service Code
|
CPT 33366
|
| Hospital Charge Code |
906820341
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,297.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$27,669.60
|
| Rate for Payer: Cash Price |
$27,669.60
|
| Rate for Payer: Central Health Plan Commercial |
$49,190.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,595.20
|
| Rate for Payer: Galaxy Health WC |
$52,264.80
|
| Rate for Payer: Global Benefits Group Commercial |
$36,892.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$55,339.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41,012.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23,426.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,297.60
|
| Rate for Payer: Multiplan Commercial |
$46,116.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$52,264.80
|
|
|
HC TAVR W PROS VALVE TRNSAPICAL
|
Facility
|
OP
|
$61,488.00
|
|
|
Service Code
|
CPT 33366
|
| Hospital Charge Code |
906820341
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$55,339.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10,271.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52,264.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33,818.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33,818.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,254.00
|
| Rate for Payer: Blue Distinction Transplant |
$36,892.80
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Cash Price |
$27,669.60
|
| Rate for Payer: Cash Price |
$27,669.60
|
| Rate for Payer: Central Health Plan Commercial |
$49,190.40
|
| Rate for Payer: Cigna of CA PPO |
$45,501.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52,264.80
|
| Rate for Payer: Dignity Health Media |
$52,264.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$52,264.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,595.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,595.20
|
| Rate for Payer: Galaxy Health WC |
$52,264.80
|
| Rate for Payer: Global Benefits Group Commercial |
$36,892.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$55,339.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$46,116.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21,520.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41,012.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,053.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,297.60
|
| Rate for Payer: Multiplan Commercial |
$46,116.00
|
| Rate for Payer: Networks By Design Commercial |
$39,967.20
|
| Rate for Payer: Prime Health Services Commercial |
$52,264.80
|
| Rate for Payer: Riverside University Health System MISP |
$24,595.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36,892.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52,264.80
|
| Rate for Payer: Vantage Medical Group Senior |
$52,264.80
|
|
|
HC TB INTRADERMAL TEST
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
900501583
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
|
|
HC TB INTRADERMAL TEST
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
900501583
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$54.00 |
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: Galaxy Health WC |
$51.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$39.00
|
| Rate for Payer: Prime Health Services Commercial |
$51.00
|
|
