|
HC THORACOSCOPY SX W PLEURODESIS
|
Facility
IP
|
$23,000.00
|
|
|
Service Code
|
CPT 32650
|
| Hospital Charge Code |
909010013
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,600.00 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$10,350.00
|
| Rate for Payer: Cash Price |
$10,350.00
|
| Rate for Payer: Central Health Plan Commercial |
$18,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,200.00
|
| Rate for Payer: Galaxy Health WC |
$19,550.00
|
| Rate for Payer: Global Benefits Group Commercial |
$13,800.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,700.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,341.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,600.00
|
| Rate for Payer: Multiplan Commercial |
$17,250.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$19,550.00
|
|
|
HC THORACOSCOPY SX W PLEURODESIS
|
Facility
OP
|
$23,000.00
|
|
|
Service Code
|
CPT 32650
|
| Hospital Charge Code |
909010013
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,212.08 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,432.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19,550.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12,650.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12,650.00
|
| 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: BCBS Transplant Transplant |
$13,800.00
|
| 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: Cash Price |
$10,350.00
|
| Rate for Payer: Cash Price |
$10,350.00
|
| Rate for Payer: Central Health Plan Commercial |
$18,400.00
|
| Rate for Payer: Cigna of CA PPO |
$17,020.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,550.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,200.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,200.00
|
| Rate for Payer: Galaxy Health WC |
$19,550.00
|
| Rate for Payer: Global Benefits Group Commercial |
$13,800.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,700.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17,250.00
|
| Rate for Payer: IEHP medi-cal |
$8,050.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,341.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,600.00
|
| Rate for Payer: Multiplan Commercial |
$17,250.00
|
| Rate for Payer: Networks By Design Commercial |
$14,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$19,550.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13,800.00
|
| Rate for Payer: Riverside University Health MISP |
$9,200.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19,550.00
|
| Rate for Payer: Vantage Medical Group Senior |
$19,550.00
|
|
|
HC THORACOTOMY CARDIAC
|
Facility
OP
|
$5,244.00
|
|
|
Service Code
|
CPT 32160
|
| Hospital Charge Code |
900501127
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,048.80 |
| Max. Negotiated Rate |
$8,017.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3,958.26
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,457.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,884.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,884.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,146.40
|
| 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: Cash Price |
$2,359.80
|
| Rate for Payer: Cash Price |
$2,359.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,195.20
|
| Rate for Payer: Cigna of CA PPO |
$3,880.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,457.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,097.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,097.60
|
| Rate for Payer: Galaxy Health WC |
$4,457.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,146.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,719.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,933.00
|
| Rate for Payer: IEHP medi-cal |
$1,835.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,497.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,048.80
|
| Rate for Payer: Multiplan Commercial |
$3,933.00
|
| Rate for Payer: Networks By Design Commercial |
$3,408.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,457.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,146.40
|
| Rate for Payer: Riverside University Health MISP |
$2,097.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,146.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,457.40
|
| Rate for Payer: Vantage Medical Group Senior |
$4,457.40
|
|
|
HC THORACOTOMY CARDIAC
|
Facility
IP
|
$5,244.00
|
|
|
Service Code
|
CPT 32160
|
| Hospital Charge Code |
900501127
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,048.80 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$2,359.80
|
| Rate for Payer: Cash Price |
$2,359.80
|
| Rate for Payer: Central Health Plan Commercial |
$4,195.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,097.60
|
| Rate for Payer: Galaxy Health WC |
$4,457.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,146.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,719.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,497.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,048.80
|
| Rate for Payer: Multiplan Commercial |
$3,933.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,457.40
|
|
|
HC THORACOTOMY; WITH EXPLORATION
|
Facility
IP
|
$2,748.00
|
|
|
Service Code
|
CPT 32100
|
| Hospital Charge Code |
900502100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$549.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$1,236.60
|
| Rate for Payer: Cash Price |
$1,236.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,198.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,099.20
|
| Rate for Payer: Galaxy Health WC |
$2,335.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,648.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,473.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,832.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$549.60
|
| Rate for Payer: Multiplan Commercial |
$2,061.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,335.80
|
|
|
HC THORACOTOMY; WITH EXPLORATION
|
Facility
OP
|
$2,748.00
|
|
|
Service Code
|
CPT 32100
|
| Hospital Charge Code |
900502100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$549.60 |
| Max. Negotiated Rate |
$13,979.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4,887.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2,335.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,511.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,511.40
|
| 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: BCBS Transplant Transplant |
$1,648.80
|
| 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: Cash Price |
$1,236.60
|
| Rate for Payer: Cash Price |
$1,236.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,198.40
|
| Rate for Payer: Cigna of CA PPO |
$2,033.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,335.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,099.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,099.20
|
| Rate for Payer: Galaxy Health WC |
$2,335.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,648.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,473.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,061.00
|
| Rate for Payer: IEHP medi-cal |
$961.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,832.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$549.60
|
| Rate for Payer: Multiplan Commercial |
$2,061.00
|
| Rate for Payer: Networks By Design Commercial |
$1,786.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,335.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,648.80
|
| Rate for Payer: Riverside University Health MISP |
$1,099.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,648.80
|
| 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 |
$2,335.80
|
| Rate for Payer: Vantage Medical Group Senior |
$2,335.80
|
|
|
HC THRCSCPY DGNSTC LUNGS WO BX
|
Facility
IP
|
$17,391.00
|
|
|
Service Code
|
CPT 32601
|
| Hospital Charge Code |
900831704
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,478.20 |
| Max. Negotiated Rate |
$15,651.90 |
| Rate for Payer: Cash Price |
$7,825.95
|
| Rate for Payer: Central Health Plan Commercial |
$13,912.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,956.40
|
| Rate for Payer: Galaxy Health WC |
$14,782.35
|
| Rate for Payer: Global Benefits Group Commercial |
$10,434.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,651.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,599.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,478.20
|
| Rate for Payer: Multiplan Commercial |
$13,043.25
|
| Rate for Payer: Networks By Design Commercial |
$11,304.15
|
| Rate for Payer: Prime Health Services Commercial |
$14,782.35
|
|
|
HC THRCSCPY DGNSTC LUNGS WO BX
|
Facility
OP
|
$17,391.00
|
|
|
Service Code
|
CPT 32601
|
| Hospital Charge Code |
900831704
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,478.20 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,209.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,209.21
|
| 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: BCBS Transplant Transplant |
$10,434.60
|
| 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: Caremore Medicare Advantage |
$7,209.21
|
| Rate for Payer: Cash Price |
$7,825.95
|
| Rate for Payer: Cash Price |
$7,825.95
|
| Rate for Payer: Central Health Plan Commercial |
$13,912.80
|
| Rate for Payer: Cigna of CA PPO |
$12,869.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,813.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,732.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,209.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,209.21
|
| Rate for Payer: Galaxy Health WC |
$14,782.35
|
| Rate for Payer: Global Benefits Group Commercial |
$10,434.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,651.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13,043.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,823.10
|
| Rate for Payer: IEHP medi-cal |
$11,895.20
|
| Rate for Payer: IEHP Medicare Advantage |
$7,209.21
|
| Rate for Payer: Innovage PACE Commercial |
$10,813.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,599.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,209.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,478.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,660.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,660.34
|
| Rate for Payer: Multiplan Commercial |
$13,043.25
|
| Rate for Payer: Networks By Design Commercial |
$11,304.15
|
| Rate for Payer: Prime Health Services Commercial |
$14,782.35
|
| Rate for Payer: Prime Health Services Medicare |
$7,641.76
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10,434.60
|
| Rate for Payer: Riverside University Health MISP |
$7,930.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,434.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Vantage Medical Group Senior |
$7,209.21
|
|
|
HC THRCSCPY DGNSTC W BX OF PLEURA
|
Facility
OP
|
$17,391.00
|
|
|
Service Code
|
CPT 32609
|
| Hospital Charge Code |
900831705
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,478.20 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,209.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,209.21
|
| 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: BCBS Transplant Transplant |
$10,434.60
|
| 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: Caremore Medicare Advantage |
$7,209.21
|
| Rate for Payer: Cash Price |
$7,825.95
|
| Rate for Payer: Cash Price |
$7,825.95
|
| Rate for Payer: Central Health Plan Commercial |
$13,912.80
|
| Rate for Payer: Cigna of CA PPO |
$12,869.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,813.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,732.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,209.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,209.21
|
| Rate for Payer: Galaxy Health WC |
$14,782.35
|
| Rate for Payer: Global Benefits Group Commercial |
$10,434.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,651.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13,043.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,823.10
|
| Rate for Payer: IEHP medi-cal |
$11,895.20
|
| Rate for Payer: IEHP Medicare Advantage |
$7,209.21
|
| Rate for Payer: Innovage PACE Commercial |
$10,813.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,599.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,209.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,478.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,660.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,660.34
|
| Rate for Payer: Multiplan Commercial |
$13,043.25
|
| Rate for Payer: Networks By Design Commercial |
$11,304.15
|
| Rate for Payer: Prime Health Services Commercial |
$14,782.35
|
| Rate for Payer: Prime Health Services Medicare |
$7,641.76
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10,434.60
|
| Rate for Payer: Riverside University Health MISP |
$7,930.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,434.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Vantage Medical Group Senior |
$7,209.21
|
|
|
HC THRCSCPY DGNSTC W BX OF PLEURA
|
Facility
IP
|
$17,391.00
|
|
|
Service Code
|
CPT 32609
|
| Hospital Charge Code |
900831705
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,478.20 |
| Max. Negotiated Rate |
$15,651.90 |
| Rate for Payer: Cash Price |
$7,825.95
|
| Rate for Payer: Central Health Plan Commercial |
$13,912.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,956.40
|
| Rate for Payer: Galaxy Health WC |
$14,782.35
|
| Rate for Payer: Global Benefits Group Commercial |
$10,434.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,651.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,599.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,478.20
|
| Rate for Payer: Multiplan Commercial |
$13,043.25
|
| Rate for Payer: Networks By Design Commercial |
$11,304.15
|
| Rate for Payer: Prime Health Services Commercial |
$14,782.35
|
|
|
HC THRCSCPY SX W PRTL PLMNRY DCRTCTN
|
Facility
IP
|
$23,000.00
|
|
|
Service Code
|
CPT 32651
|
| Hospital Charge Code |
909010014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,600.00 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$10,350.00
|
| Rate for Payer: Cash Price |
$10,350.00
|
| Rate for Payer: Central Health Plan Commercial |
$18,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,200.00
|
| Rate for Payer: Galaxy Health WC |
$19,550.00
|
| Rate for Payer: Global Benefits Group Commercial |
$13,800.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,700.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,341.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,600.00
|
| Rate for Payer: Multiplan Commercial |
$17,250.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$19,550.00
|
|
|
HC THRCSCPY SX W PRTL PLMNRY DCRTCTN
|
Facility
OP
|
$23,000.00
|
|
|
Service Code
|
CPT 32651
|
| Hospital Charge Code |
909010014
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,212.08 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5,545.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19,550.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12,650.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12,650.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: BCBS Transplant Transplant |
$13,800.00
|
| 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: Cash Price |
$10,350.00
|
| Rate for Payer: Cash Price |
$10,350.00
|
| Rate for Payer: Central Health Plan Commercial |
$18,400.00
|
| Rate for Payer: Cigna of CA PPO |
$17,020.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,550.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,200.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,200.00
|
| Rate for Payer: Galaxy Health WC |
$19,550.00
|
| Rate for Payer: Global Benefits Group Commercial |
$13,800.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,700.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17,250.00
|
| Rate for Payer: IEHP medi-cal |
$8,050.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,341.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,600.00
|
| Rate for Payer: Multiplan Commercial |
$17,250.00
|
| Rate for Payer: Networks By Design Commercial |
$14,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$19,550.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13,800.00
|
| Rate for Payer: Riverside University Health MISP |
$9,200.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19,550.00
|
| Rate for Payer: Vantage Medical Group Senior |
$19,550.00
|
|
|
HC THRCSCPY SX W RMVL IP FB OR FIBRIN DEP
|
Facility
OP
|
$23,000.00
|
|
|
Service Code
|
CPT 32653
|
| Hospital Charge Code |
909010015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,212.08 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5,346.16
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19,550.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12,650.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12,650.00
|
| 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: BCBS Transplant Transplant |
$13,800.00
|
| 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: Cash Price |
$10,350.00
|
| Rate for Payer: Cash Price |
$10,350.00
|
| Rate for Payer: Central Health Plan Commercial |
$18,400.00
|
| Rate for Payer: Cigna of CA PPO |
$17,020.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,550.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,200.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,200.00
|
| Rate for Payer: Galaxy Health WC |
$19,550.00
|
| Rate for Payer: Global Benefits Group Commercial |
$13,800.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,700.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17,250.00
|
| Rate for Payer: IEHP medi-cal |
$8,050.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,341.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,600.00
|
| Rate for Payer: Multiplan Commercial |
$17,250.00
|
| Rate for Payer: Networks By Design Commercial |
$14,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$19,550.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13,800.00
|
| Rate for Payer: Riverside University Health MISP |
$9,200.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19,550.00
|
| Rate for Payer: Vantage Medical Group Senior |
$19,550.00
|
|
|
HC THRCSCPY SX W RMVL IP FB OR FIBRIN DEP
|
Facility
IP
|
$23,000.00
|
|
|
Service Code
|
CPT 32653
|
| Hospital Charge Code |
909010015
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,600.00 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$10,350.00
|
| Rate for Payer: Cash Price |
$10,350.00
|
| Rate for Payer: Central Health Plan Commercial |
$18,400.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,200.00
|
| Rate for Payer: Galaxy Health WC |
$19,550.00
|
| Rate for Payer: Global Benefits Group Commercial |
$13,800.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,700.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,341.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,600.00
|
| Rate for Payer: Multiplan Commercial |
$17,250.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$19,550.00
|
|
|
HC THROMBECTOMY CATH, 6&7F HYDROL
|
Facility
IP
|
$1,440.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909081406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.00 |
| Max. Negotiated Rate |
$1,296.00 |
| Rate for Payer: Blue Shield of California EPN |
$768.96
|
| Rate for Payer: Cash Price |
$648.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,152.00
|
| Rate for Payer: Cigna of CA HMO |
$1,008.00
|
| Rate for Payer: Cigna of CA PPO |
$1,008.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$576.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$576.00
|
| Rate for Payer: Galaxy Health WC |
$1,224.00
|
| Rate for Payer: Global Benefits Group Commercial |
$864.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,296.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$960.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.00
|
| Rate for Payer: Multiplan Commercial |
$1,080.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,224.00
|
|
|
HC THROMBECTOMY CATH, 6&7F HYDROL
|
Facility
OP
|
$1,440.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909081406
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.00 |
| Max. Negotiated Rate |
$5,717.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5,717.49
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,224.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$792.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$792.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$657.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$802.08
|
| Rate for Payer: BCBS Transplant Transplant |
$864.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,080.00
|
| Rate for Payer: Blue Shield of California EPN |
$783.36
|
| Rate for Payer: Cash Price |
$648.00
|
| Rate for Payer: Cash Price |
$648.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,152.00
|
| Rate for Payer: Cigna of CA HMO |
$1,008.00
|
| Rate for Payer: Cigna of CA PPO |
$1,008.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,224.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$576.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$576.00
|
| Rate for Payer: Galaxy Health WC |
$1,224.00
|
| Rate for Payer: Global Benefits Group Commercial |
$864.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,296.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,080.00
|
| Rate for Payer: IEHP medi-cal |
$504.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$960.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$288.00
|
| Rate for Payer: Multiplan Commercial |
$1,080.00
|
| Rate for Payer: Networks By Design Commercial |
$720.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,224.00
|
| Rate for Payer: Riverside University Health MISP |
$576.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$864.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$864.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$720.00
|
| Rate for Payer: United Healthcare All Other HMO |
$720.00
|
| Rate for Payer: United Healthcare HMO Rider |
$720.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$720.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,224.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,224.00
|
|
|
HC THROMBIN TIME
|
Facility
IP
|
$194.00
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
900910021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$174.60 |
| Rate for Payer: Cash Price |
$87.30
|
| Rate for Payer: Central Health Plan Commercial |
$155.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$77.60
|
| Rate for Payer: Galaxy Health WC |
$164.90
|
| Rate for Payer: Global Benefits Group Commercial |
$116.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$174.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$129.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.80
|
| Rate for Payer: Multiplan Commercial |
$145.50
|
| Rate for Payer: Networks By Design Commercial |
$126.10
|
| Rate for Payer: Prime Health Services Commercial |
$164.90
|
|
|
HC THROMBIN TIME
|
Facility
OP
|
$22.00
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
900910021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$51.32 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.40
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8.66
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.35
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$42.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51.32
|
| Rate for Payer: BCBS Transplant Transplant |
$13.20
|
| Rate for Payer: Blue Shield of California Commercial |
$13.60
|
| Rate for Payer: Blue Shield of California EPN |
$10.69
|
| Rate for Payer: Caremore Medicare Advantage |
$5.77
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Cash Price |
$9.90
|
| Rate for Payer: Central Health Plan Commercial |
$17.60
|
| Rate for Payer: Cigna of CA HMO |
$14.08
|
| Rate for Payer: Cigna of CA PPO |
$16.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.79
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.77
|
| Rate for Payer: Galaxy Health WC |
$18.70
|
| Rate for Payer: Global Benefits Group Commercial |
$13.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$16.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$9.46
|
| Rate for Payer: IEHP medi-cal |
$9.52
|
| Rate for Payer: IEHP Medicare Advantage |
$5.77
|
| Rate for Payer: Innovage PACE Commercial |
$8.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.73
|
| Rate for Payer: Multiplan Commercial |
$16.50
|
| Rate for Payer: Networks By Design Commercial |
$14.30
|
| Rate for Payer: Prime Health Services Commercial |
$18.70
|
| Rate for Payer: Prime Health Services Medicare |
$6.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: Riverside University Health MISP |
$6.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.67
|
| Rate for Payer: United Healthcare All Other HMO |
$4.67
|
| Rate for Payer: United Healthcare HMO Rider |
$4.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.35
|
| Rate for Payer: Vantage Medical Group Senior |
$5.77
|
|
|
HC THROMBOELASTOGRAPH
|
Facility
IP
|
$561.00
|
|
|
Service Code
|
CPT 85396
|
| Hospital Charge Code |
900912024
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$112.20 |
| Max. Negotiated Rate |
$504.90 |
| Rate for Payer: Cash Price |
$252.45
|
| Rate for Payer: Central Health Plan Commercial |
$448.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$224.40
|
| Rate for Payer: Galaxy Health WC |
$476.85
|
| Rate for Payer: Global Benefits Group Commercial |
$336.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$504.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$374.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.20
|
| Rate for Payer: Multiplan Commercial |
$420.75
|
| Rate for Payer: Networks By Design Commercial |
$364.65
|
| Rate for Payer: Prime Health Services Commercial |
$476.85
|
|
|
HC THROMBOELASTOGRAPH
|
Facility
OP
|
$74.00
|
|
|
Service Code
|
CPT 85396
|
| Hospital Charge Code |
900912024
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$142.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$100.07
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$62.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$40.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$40.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$116.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$142.30
|
| Rate for Payer: BCBS Transplant Transplant |
$44.40
|
| Rate for Payer: Blue Shield of California Commercial |
$45.73
|
| Rate for Payer: Blue Shield of California EPN |
$35.96
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Central Health Plan Commercial |
$59.20
|
| Rate for Payer: Cigna of CA HMO |
$47.36
|
| Rate for Payer: Cigna of CA PPO |
$54.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$62.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$29.60
|
| Rate for Payer: Galaxy Health WC |
$62.90
|
| Rate for Payer: Global Benefits Group Commercial |
$44.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$66.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$55.50
|
| Rate for Payer: IEHP medi-cal |
$25.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$49.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.80
|
| Rate for Payer: Multiplan Commercial |
$55.50
|
| Rate for Payer: Networks By Design Commercial |
$48.10
|
| Rate for Payer: Prime Health Services Commercial |
$62.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$44.40
|
| Rate for Payer: Riverside University Health MISP |
$29.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$44.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$44.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.98
|
| Rate for Payer: United Healthcare All Other HMO |
$15.98
|
| Rate for Payer: United Healthcare HMO Rider |
$15.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$62.90
|
| Rate for Payer: Vantage Medical Group Senior |
$62.90
|
|
|
HC THROMBOLYSIS ART
|
Facility
OP
|
$4,931.00
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
909020164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$986.20 |
| Max. Negotiated Rate |
$11,329.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,866.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,958.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,047.36
|
| Rate for Payer: Blue Shield of California EPN |
$2,396.47
|
| Rate for Payer: Caremore Medicare Advantage |
$6,866.07
|
| Rate for Payer: Cash Price |
$2,218.95
|
| Rate for Payer: Cash Price |
$2,218.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,944.80
|
| Rate for Payer: Cigna of CA HMO |
$3,155.84
|
| Rate for Payer: Cigna of CA PPO |
$3,648.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,269.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,866.07
|
| Rate for Payer: Galaxy Health WC |
$4,191.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,958.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,437.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,698.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,260.35
|
| Rate for Payer: IEHP medi-cal |
$11,329.02
|
| Rate for Payer: IEHP Medicare Advantage |
$6,866.07
|
| Rate for Payer: Innovage PACE Commercial |
$10,299.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,288.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$986.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,200.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,200.53
|
| Rate for Payer: Multiplan Commercial |
$3,698.25
|
| Rate for Payer: Networks By Design Commercial |
$3,205.15
|
| Rate for Payer: Prime Health Services Commercial |
$4,191.35
|
| Rate for Payer: Prime Health Services Medicare |
$7,278.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,958.60
|
| Rate for Payer: Riverside University Health MISP |
$7,552.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,958.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,958.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,465.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,465.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,465.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,465.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC THROMBOLYSIS ART
|
Facility
IP
|
$4,931.00
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
909020164
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$986.20 |
| Max. Negotiated Rate |
$4,437.90 |
| Rate for Payer: Cash Price |
$2,218.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,944.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,972.40
|
| Rate for Payer: Galaxy Health WC |
$4,191.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,958.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,437.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,288.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$986.20
|
| Rate for Payer: Multiplan Commercial |
$3,698.25
|
| Rate for Payer: Networks By Design Commercial |
$3,205.15
|
| Rate for Payer: Prime Health Services Commercial |
$4,191.35
|
|
|
HC THROMBOLYSIS ART
|
Facility
OP
|
$4,931.00
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
906820230
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$986.20 |
| Max. Negotiated Rate |
$11,329.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,866.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,958.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,047.36
|
| Rate for Payer: Blue Shield of California EPN |
$2,396.47
|
| Rate for Payer: Caremore Medicare Advantage |
$6,866.07
|
| Rate for Payer: Cash Price |
$2,218.95
|
| Rate for Payer: Cash Price |
$2,218.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,944.80
|
| Rate for Payer: Cigna of CA HMO |
$3,155.84
|
| Rate for Payer: Cigna of CA PPO |
$3,648.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,269.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,866.07
|
| Rate for Payer: Galaxy Health WC |
$4,191.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,958.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,437.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,698.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,260.35
|
| Rate for Payer: IEHP medi-cal |
$11,329.02
|
| Rate for Payer: IEHP Medicare Advantage |
$6,866.07
|
| Rate for Payer: Innovage PACE Commercial |
$10,299.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,288.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$986.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,200.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,200.53
|
| Rate for Payer: Multiplan Commercial |
$3,698.25
|
| Rate for Payer: Networks By Design Commercial |
$3,205.15
|
| Rate for Payer: Prime Health Services Commercial |
$4,191.35
|
| Rate for Payer: Prime Health Services Medicare |
$7,278.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,958.60
|
| Rate for Payer: Riverside University Health MISP |
$7,552.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,958.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,958.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,465.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,465.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,465.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,465.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC THROMBOLYSIS ART
|
Facility
IP
|
$4,931.00
|
|
|
Service Code
|
CPT 37211
|
| Hospital Charge Code |
906820230
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$986.20 |
| Max. Negotiated Rate |
$4,437.90 |
| Rate for Payer: Cash Price |
$2,218.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,944.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,972.40
|
| Rate for Payer: Galaxy Health WC |
$4,191.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,958.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,437.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,288.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$986.20
|
| Rate for Payer: Multiplan Commercial |
$3,698.25
|
| Rate for Payer: Networks By Design Commercial |
$3,205.15
|
| Rate for Payer: Prime Health Services Commercial |
$4,191.35
|
|
|
HC THROMBOLYSIS COMPLETE
|
Facility
OP
|
$10,312.00
|
|
|
Service Code
|
CPT 37214
|
| Hospital Charge Code |
906820227
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,062.40 |
| Max. Negotiated Rate |
$9,280.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$6,187.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,372.82
|
| Rate for Payer: Blue Shield of California EPN |
$5,011.63
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$4,640.40
|
| Rate for Payer: Cash Price |
$4,640.40
|
| Rate for Payer: Central Health Plan Commercial |
$8,249.60
|
| Rate for Payer: Cigna of CA HMO |
$6,599.68
|
| Rate for Payer: Cigna of CA PPO |
$7,630.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$8,765.20
|
| Rate for Payer: Global Benefits Group Commercial |
$6,187.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,280.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,734.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: IEHP medi-cal |
$6,571.21
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Innovage PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,878.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,062.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$7,734.00
|
| Rate for Payer: Networks By Design Commercial |
$6,702.80
|
| Rate for Payer: Prime Health Services Commercial |
$8,765.20
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,187.20
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,187.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,187.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,156.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,156.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,156.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
