|
HC THROMBOLYSIS COMPLETE
|
Facility
IP
|
$10,312.00
|
|
|
Service Code
|
CPT 37214
|
| Hospital Charge Code |
909020157
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,062.40 |
| Max. Negotiated Rate |
$9,280.80 |
| Rate for Payer: Cash Price |
$4,640.40
|
| Rate for Payer: Central Health Plan Commercial |
$8,249.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,124.80
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$6,878.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,062.40
|
| 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
|
|
|
HC THROMBOLYSIS COMPLETE
|
Facility
IP
|
$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: Cash Price |
$4,640.40
|
| Rate for Payer: Central Health Plan Commercial |
$8,249.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,124.80
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$6,878.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,062.40
|
| 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
|
|
|
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
|
|
|
HC THROMBOLYSIS, INTRACORONARY
|
Facility
OP
|
$1,512.00
|
|
|
Service Code
|
CPT 92975
|
| Hospital Charge Code |
906811110
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$302.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,324.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,285.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$831.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$831.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$907.20
|
| 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 |
$680.40
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,209.60
|
| Rate for Payer: Cigna of CA PPO |
$1,118.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,285.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$604.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$604.80
|
| Rate for Payer: Galaxy Health WC |
$1,285.20
|
| Rate for Payer: Global Benefits Group Commercial |
$907.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,360.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,134.00
|
| Rate for Payer: IEHP medi-cal |
$529.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,008.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.40
|
| Rate for Payer: Multiplan Commercial |
$1,134.00
|
| Rate for Payer: Networks By Design Commercial |
$982.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,285.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$907.20
|
| Rate for Payer: Riverside University Health MISP |
$604.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$907.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$907.20
|
| 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 |
$1,285.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,285.20
|
|
|
HC THROMBOLYSIS, INTRACORONARY
|
Facility
IP
|
$1,512.00
|
|
|
Service Code
|
CPT 92975
|
| Hospital Charge Code |
906820029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$302.40 |
| Max. Negotiated Rate |
$1,360.80 |
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,209.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$604.80
|
| Rate for Payer: Galaxy Health WC |
$1,285.20
|
| Rate for Payer: Global Benefits Group Commercial |
$907.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,360.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,008.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.40
|
| Rate for Payer: Multiplan Commercial |
$1,134.00
|
| Rate for Payer: Networks By Design Commercial |
$982.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,285.20
|
|
|
HC THROMBOLYSIS, INTRACORONARY
|
Facility
OP
|
$1,512.00
|
|
|
Service Code
|
CPT 92975
|
| Hospital Charge Code |
906820029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$302.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,324.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1,285.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$831.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$831.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$907.20
|
| 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 |
$680.40
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,209.60
|
| Rate for Payer: Cigna of CA PPO |
$1,118.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,285.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$604.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$604.80
|
| Rate for Payer: Galaxy Health WC |
$1,285.20
|
| Rate for Payer: Global Benefits Group Commercial |
$907.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,360.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,134.00
|
| Rate for Payer: IEHP medi-cal |
$529.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,008.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.40
|
| Rate for Payer: Multiplan Commercial |
$1,134.00
|
| Rate for Payer: Networks By Design Commercial |
$982.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,285.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$907.20
|
| Rate for Payer: Riverside University Health MISP |
$604.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$907.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$907.20
|
| 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 |
$1,285.20
|
| Rate for Payer: Vantage Medical Group Senior |
$1,285.20
|
|
|
HC THROMBOLYSIS, INTRACORONARY
|
Facility
IP
|
$1,512.00
|
|
|
Service Code
|
CPT 92975
|
| Hospital Charge Code |
906811110
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$302.40 |
| Max. Negotiated Rate |
$1,360.80 |
| Rate for Payer: Cash Price |
$680.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,209.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$604.80
|
| Rate for Payer: Galaxy Health WC |
$1,285.20
|
| Rate for Payer: Global Benefits Group Commercial |
$907.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,360.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,008.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$302.40
|
| Rate for Payer: Multiplan Commercial |
$1,134.00
|
| Rate for Payer: Networks By Design Commercial |
$982.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,285.20
|
|
|
HC THROMBOLYSIS VEIN
|
Facility
OP
|
$4,109.00
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
909020155
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$821.80 |
| Max. Negotiated Rate |
$6,571.21 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$2,465.40
|
| Rate for Payer: Blue Shield of California Commercial |
$2,539.36
|
| Rate for Payer: Blue Shield of California EPN |
$1,996.97
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$1,849.05
|
| Rate for Payer: Cash Price |
$1,849.05
|
| Rate for Payer: Central Health Plan Commercial |
$3,287.20
|
| Rate for Payer: Cigna of CA HMO |
$2,629.76
|
| Rate for Payer: Cigna of CA PPO |
$3,040.66
|
| 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 |
$3,492.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,465.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,698.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,081.75
|
| 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 |
$2,740.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$821.80
|
| 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 |
$3,081.75
|
| Rate for Payer: Networks By Design Commercial |
$2,670.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,492.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,465.40
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,465.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,465.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,054.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,054.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,054.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,054.50
|
| 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
|
|
|
HC THROMBOLYSIS VEIN
|
Facility
OP
|
$4,109.00
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
906820225
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$821.80 |
| Max. Negotiated Rate |
$6,571.21 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$2,465.40
|
| Rate for Payer: Blue Shield of California Commercial |
$2,539.36
|
| Rate for Payer: Blue Shield of California EPN |
$1,996.97
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$1,849.05
|
| Rate for Payer: Cash Price |
$1,849.05
|
| Rate for Payer: Central Health Plan Commercial |
$3,287.20
|
| Rate for Payer: Cigna of CA HMO |
$2,629.76
|
| Rate for Payer: Cigna of CA PPO |
$3,040.66
|
| 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 |
$3,492.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,465.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,698.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,081.75
|
| 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 |
$2,740.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$821.80
|
| 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 |
$3,081.75
|
| Rate for Payer: Networks By Design Commercial |
$2,670.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,492.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,465.40
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,465.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,465.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,054.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,054.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,054.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,054.50
|
| 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
|
|
|
HC THROMBOLYSIS VEIN
|
Facility
IP
|
$4,109.00
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
906820225
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$821.80 |
| Max. Negotiated Rate |
$3,698.10 |
| Rate for Payer: Cash Price |
$1,849.05
|
| Rate for Payer: Central Health Plan Commercial |
$3,287.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,643.60
|
| Rate for Payer: Galaxy Health WC |
$3,492.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,465.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,698.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,740.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$821.80
|
| Rate for Payer: Multiplan Commercial |
$3,081.75
|
| Rate for Payer: Networks By Design Commercial |
$2,670.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,492.65
|
|
|
HC THROMBOLYSIS VEIN
|
Facility
IP
|
$4,109.00
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
909020155
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$821.80 |
| Max. Negotiated Rate |
$3,698.10 |
| Rate for Payer: Cash Price |
$1,849.05
|
| Rate for Payer: Central Health Plan Commercial |
$3,287.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,643.60
|
| Rate for Payer: Galaxy Health WC |
$3,492.65
|
| Rate for Payer: Global Benefits Group Commercial |
$2,465.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,698.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,740.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$821.80
|
| Rate for Payer: Multiplan Commercial |
$3,081.75
|
| Rate for Payer: Networks By Design Commercial |
$2,670.85
|
| Rate for Payer: Prime Health Services Commercial |
$3,492.65
|
|
|
HC THROMBO SUBSEQUENT DAY
|
Facility
OP
|
$8,724.00
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
909020156
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,744.80 |
| Max. Negotiated Rate |
$8,114.00 |
| 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 |
$5,234.40
|
| Rate for Payer: Blue Shield of California Commercial |
$5,391.43
|
| Rate for Payer: Blue Shield of California EPN |
$4,239.86
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$3,925.80
|
| Rate for Payer: Cash Price |
$3,925.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,979.20
|
| Rate for Payer: Cigna of CA HMO |
$5,583.36
|
| Rate for Payer: Cigna of CA PPO |
$6,455.76
|
| 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 |
$7,415.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,234.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,851.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,543.00
|
| 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 |
$5,818.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,744.80
|
| 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 |
$6,543.00
|
| Rate for Payer: Networks By Design Commercial |
$5,670.60
|
| Rate for Payer: Prime Health Services Commercial |
$7,415.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,234.40
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,234.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,234.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,362.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,362.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,362.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,362.00
|
| 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
|
|
|
HC THROMBO SUBSEQUENT DAY
|
Facility
OP
|
$8,724.00
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
906820226
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,744.80 |
| Max. Negotiated Rate |
$8,114.00 |
| 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 |
$5,234.40
|
| Rate for Payer: Blue Shield of California Commercial |
$5,391.43
|
| Rate for Payer: Blue Shield of California EPN |
$4,239.86
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$3,925.80
|
| Rate for Payer: Cash Price |
$3,925.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,979.20
|
| Rate for Payer: Cigna of CA HMO |
$5,583.36
|
| Rate for Payer: Cigna of CA PPO |
$6,455.76
|
| 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 |
$7,415.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,234.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,851.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6,543.00
|
| 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 |
$5,818.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,744.80
|
| 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 |
$6,543.00
|
| Rate for Payer: Networks By Design Commercial |
$5,670.60
|
| Rate for Payer: Prime Health Services Commercial |
$7,415.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,234.40
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,234.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,234.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,362.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,362.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,362.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,362.00
|
| 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
|
|
|
HC THROMBO SUBSEQUENT DAY
|
Facility
IP
|
$8,724.00
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
906820226
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,744.80 |
| Max. Negotiated Rate |
$7,851.60 |
| Rate for Payer: Cash Price |
$3,925.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,979.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,489.60
|
| Rate for Payer: Galaxy Health WC |
$7,415.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,234.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,851.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,818.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,744.80
|
| Rate for Payer: Multiplan Commercial |
$6,543.00
|
| Rate for Payer: Networks By Design Commercial |
$5,670.60
|
| Rate for Payer: Prime Health Services Commercial |
$7,415.40
|
|
|
HC THROMBO SUBSEQUENT DAY
|
Facility
IP
|
$8,724.00
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
909020156
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,744.80 |
| Max. Negotiated Rate |
$7,851.60 |
| Rate for Payer: Cash Price |
$3,925.80
|
| Rate for Payer: Central Health Plan Commercial |
$6,979.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,489.60
|
| Rate for Payer: Galaxy Health WC |
$7,415.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5,234.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,851.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,818.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,744.80
|
| Rate for Payer: Multiplan Commercial |
$6,543.00
|
| Rate for Payer: Networks By Design Commercial |
$5,670.60
|
| Rate for Payer: Prime Health Services Commercial |
$7,415.40
|
|
|
HC THROM DIALYSIS CRCT W STNT PLC
|
Facility
OP
|
$52,242.00
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
909036906
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,806.00 |
| Max. Negotiated Rate |
$67,976.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$29,952.68
|
| Rate for Payer: BCBS Transplant Transplant |
$31,345.20
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$23,508.90
|
| Rate for Payer: Cash Price |
$23,508.90
|
| Rate for Payer: Central Health Plan Commercial |
$41,793.60
|
| Rate for Payer: Cigna of CA PPO |
$38,659.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,577.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,908.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$21,908.96
|
| Rate for Payer: Galaxy Health WC |
$44,405.70
|
| Rate for Payer: Global Benefits Group Commercial |
$31,345.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$47,017.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$39,181.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35,930.69
|
| Rate for Payer: IEHP medi-cal |
$36,149.78
|
| Rate for Payer: IEHP Medicare Advantage |
$21,908.96
|
| Rate for Payer: Innovage PACE Commercial |
$32,863.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34,845.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,448.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,358.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,358.01
|
| Rate for Payer: Multiplan Commercial |
$39,181.50
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: Networks By Design Commercial |
$33,957.30
|
| Rate for Payer: Preferred Health Network WC |
$30,563.96
|
| Rate for Payer: Prime Health Services Commercial |
$44,405.70
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Prime Health Services WC |
$29,647.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$31,345.20
|
| Rate for Payer: Riverside University Health MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31,345.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$57,775.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67,976.00
|
| Rate for Payer: United Healthcare HMO Rider |
$54,652.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,976.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Vantage Medical Group Senior |
$21,908.96
|
|
|
HC THROM DIALYSIS CRCT W STNT PLC
|
Facility
IP
|
$52,242.00
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
909036906
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,448.40 |
| Max. Negotiated Rate |
$47,017.80 |
| Rate for Payer: Cash Price |
$23,508.90
|
| Rate for Payer: Central Health Plan Commercial |
$41,793.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,896.80
|
| Rate for Payer: Galaxy Health WC |
$44,405.70
|
| Rate for Payer: Global Benefits Group Commercial |
$31,345.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$47,017.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34,845.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,448.40
|
| Rate for Payer: Multiplan Commercial |
$39,181.50
|
| Rate for Payer: Networks By Design Commercial |
$33,957.30
|
| Rate for Payer: Prime Health Services Commercial |
$44,405.70
|
|
|
HC THROM DIALYSIS CRCT W TRAN BLN
|
Facility
IP
|
$30,234.00
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
909036905
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,046.80 |
| Max. Negotiated Rate |
$27,210.60 |
| Rate for Payer: Cash Price |
$13,605.30
|
| Rate for Payer: Central Health Plan Commercial |
$24,187.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,093.60
|
| Rate for Payer: Galaxy Health WC |
$25,698.90
|
| Rate for Payer: Global Benefits Group Commercial |
$18,140.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,210.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,166.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,046.80
|
| Rate for Payer: Multiplan Commercial |
$22,675.50
|
| Rate for Payer: Networks By Design Commercial |
$19,652.10
|
| Rate for Payer: Prime Health Services Commercial |
$25,698.90
|
|
|
HC THROM DIALYSIS CRCT W TRAN BLN
|
Facility
OP
|
$30,234.00
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
909036905
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,046.80 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: BCBS Transplant Transplant |
$18,140.40
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$13,605.30
|
| Rate for Payer: Cash Price |
$13,605.30
|
| Rate for Payer: Central Health Plan Commercial |
$24,187.20
|
| Rate for Payer: Cigna of CA PPO |
$22,373.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$25,698.90
|
| Rate for Payer: Global Benefits Group Commercial |
$18,140.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,210.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22,675.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: IEHP medi-cal |
$22,679.61
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Innovage PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,166.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,046.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$22,675.50
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$19,652.10
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$25,698.90
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18,140.40
|
| Rate for Payer: Riverside University Health MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,140.40
|
| 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 Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC THROM DIALYSIS CRCT W TRAN BLN
|
Facility
IP
|
$30,234.00
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
906820282
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,046.80 |
| Max. Negotiated Rate |
$27,210.60 |
| Rate for Payer: Cash Price |
$13,605.30
|
| Rate for Payer: Central Health Plan Commercial |
$24,187.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,093.60
|
| Rate for Payer: Galaxy Health WC |
$25,698.90
|
| Rate for Payer: Global Benefits Group Commercial |
$18,140.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,210.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,166.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,046.80
|
| Rate for Payer: Multiplan Commercial |
$22,675.50
|
| Rate for Payer: Networks By Design Commercial |
$19,652.10
|
| Rate for Payer: Prime Health Services Commercial |
$25,698.90
|
|
|
HC THROM DIALYSIS CRCT W TRAN BLN
|
Facility
OP
|
$30,234.00
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
906820282
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,046.80 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: BCBS Transplant Transplant |
$18,140.40
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$13,605.30
|
| Rate for Payer: Cash Price |
$13,605.30
|
| Rate for Payer: Central Health Plan Commercial |
$24,187.20
|
| Rate for Payer: Cigna of CA PPO |
$22,373.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$25,698.90
|
| Rate for Payer: Global Benefits Group Commercial |
$18,140.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,210.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22,675.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: IEHP medi-cal |
$22,679.61
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Innovage PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,166.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,046.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$22,675.50
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$19,652.10
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$25,698.90
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18,140.40
|
| Rate for Payer: Riverside University Health MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,140.40
|
| 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 Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC THRPTC INTVN 1ST 15 MIN
|
Facility
IP
|
$60.00
|
|
|
Service Code
|
CPT 97129
|
| Hospital Charge Code |
905107129
|
|
Hospital Revenue Code
|
420
|
| 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: 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 THRPTC INTVN 1ST 15 MIN
|
Facility
OP
|
$60.00
|
|
|
Service Code
|
CPT 97129
|
| Hospital Charge Code |
905107129
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$99.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$51.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$33.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$33.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$36.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$45.00
|
| Rate for Payer: IEHP medi-cal |
$21.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.60
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: Riverside University Health MISP |
$24.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.00
|
| Rate for Payer: Vantage Medical Group Senior |
$51.00
|
|
|
HC THRPTC INTVN 1ST 15 MIN OT
|
Facility
IP
|
$60.00
|
|
|
Service Code
|
CPT 97129
|
| Hospital Charge Code |
905107131
|
|
Hospital Revenue Code
|
430
|
| 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: 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 THRPTC INTVN 1ST 15 MIN OT
|
Facility
OP
|
$60.00
|
|
|
Service Code
|
CPT 97129
|
| Hospital Charge Code |
905107131
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$21.00 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$99.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$51.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$33.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$33.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$36.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Central Health Plan Commercial |
$48.00
|
| Rate for Payer: Cigna of CA HMO |
$38.40
|
| Rate for Payer: Cigna of CA PPO |
$44.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$45.00
|
| Rate for Payer: IEHP medi-cal |
$21.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.60
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: Riverside University Health MISP |
$24.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.00
|
| Rate for Payer: Vantage Medical Group Senior |
$51.00
|
|
