|
HC TANGNTL BX SKIN EA SEP/ADD LSN
|
Facility
|
OP
|
$432.00
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
900511103
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$82.61 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$86.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$367.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$237.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$324.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$209.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$253.71
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Central Health Plan Commercial |
$345.60
|
| Rate for Payer: Cigna of CA HMO |
$276.48
|
| Rate for Payer: Cigna of CA PPO |
$319.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$367.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$367.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$367.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$172.80
|
| Rate for Payer: EPIC Health Plan Senior |
$172.80
|
| Rate for Payer: Galaxy Health WC |
$367.20
|
| Rate for Payer: Global Benefits Group Commercial |
$259.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$388.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$82.61
|
| Rate for Payer: InnovAge PACE Commercial |
$216.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$288.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$302.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$302.40
|
| Rate for Payer: Multiplan Commercial |
$324.00
|
| Rate for Payer: Networks By Design Commercial |
$280.80
|
| Rate for Payer: Prime Health Services Commercial |
$367.20
|
| Rate for Payer: Riverside University Health System MISP |
$172.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$259.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$367.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$367.20
|
| Rate for Payer: Vantage Medical Group Senior |
$367.20
|
|
|
HC TANGNTL BX SKIN EA SEP/ADD LSN
|
Facility
|
IP
|
$432.00
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
900511103
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$388.80 |
| Rate for Payer: Adventist Health Commercial |
$86.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Central Health Plan Commercial |
$345.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$172.80
|
| Rate for Payer: EPIC Health Plan Senior |
$172.80
|
| Rate for Payer: Galaxy Health WC |
$367.20
|
| Rate for Payer: Global Benefits Group Commercial |
$259.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$388.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$288.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.40
|
| Rate for Payer: Multiplan Commercial |
$324.00
|
| Rate for Payer: Networks By Design Commercial |
$280.80
|
| Rate for Payer: Prime Health Services Commercial |
$367.20
|
|
|
HC TANGNTL BX SKIN SINGLE LESION
|
Facility
|
IP
|
$864.00
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
900511102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$172.80 |
| Max. Negotiated Rate |
$777.60 |
| Rate for Payer: Adventist Health Commercial |
$172.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Central Health Plan Commercial |
$691.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$345.60
|
| Rate for Payer: EPIC Health Plan Senior |
$345.60
|
| Rate for Payer: Galaxy Health WC |
$734.40
|
| Rate for Payer: Global Benefits Group Commercial |
$518.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$777.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$576.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$329.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$534.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.80
|
| Rate for Payer: Multiplan Commercial |
$648.00
|
| Rate for Payer: Networks By Design Commercial |
$561.60
|
| Rate for Payer: Prime Health Services Commercial |
$734.40
|
|
|
HC TANGNTL BX SKIN SINGLE LESION
|
Facility
|
OP
|
$864.00
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
900511102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$153.68 |
| Max. Negotiated Rate |
$6,333.00 |
| Rate for Payer: Adventist Health Commercial |
$172.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$252.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$252.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$402.27
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Cash Price |
$388.80
|
| Rate for Payer: Central Health Plan Commercial |
$691.20
|
| Rate for Payer: Cigna of CA HMO |
$552.96
|
| Rate for Payer: Cigna of CA PPO |
$639.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$378.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$277.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$252.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.83
|
| Rate for Payer: EPIC Health Plan Senior |
$252.47
|
| Rate for Payer: Galaxy Health WC |
$734.40
|
| Rate for Payer: Global Benefits Group Commercial |
$518.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$777.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$414.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$153.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$252.47
|
| Rate for Payer: InnovAge PACE Commercial |
$378.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$576.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$169.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$252.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$338.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$338.31
|
| Rate for Payer: Multiplan Commercial |
$648.00
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$561.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$252.47
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$734.40
|
| Rate for Payer: Prime Health Services Medicare |
$267.62
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$277.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$518.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$252.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$378.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$277.72
|
| Rate for Payer: Vantage Medical Group Senior |
$252.47
|
|
|
HC TAP BLOCK UNILATERAL INJ
|
Facility
|
OP
|
$1,243.00
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
909081486
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$248.60 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$248.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,056.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$683.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$932.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$559.35
|
| Rate for Payer: Cash Price |
$559.35
|
| Rate for Payer: Central Health Plan Commercial |
$994.40
|
| Rate for Payer: Cigna of CA HMO |
$795.52
|
| Rate for Payer: Cigna of CA PPO |
$919.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,056.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,056.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,056.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$497.20
|
| Rate for Payer: EPIC Health Plan Senior |
$497.20
|
| Rate for Payer: Galaxy Health WC |
$1,056.55
|
| Rate for Payer: Global Benefits Group Commercial |
$745.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,118.70
|
| Rate for Payer: InnovAge PACE Commercial |
$621.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$829.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$769.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$870.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$870.10
|
| Rate for Payer: Multiplan Commercial |
$932.25
|
| Rate for Payer: Networks By Design Commercial |
$807.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,056.55
|
| Rate for Payer: Riverside University Health System MISP |
$497.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$745.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,056.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,056.55
|
| Rate for Payer: Vantage Medical Group Senior |
$1,056.55
|
|
|
HC TAP BLOCK UNILATERAL INJ
|
Facility
|
IP
|
$1,243.00
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
909081486
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$248.60 |
| Max. Negotiated Rate |
$1,118.70 |
| Rate for Payer: Adventist Health Commercial |
$248.60
|
| Rate for Payer: Cash Price |
$559.35
|
| Rate for Payer: Central Health Plan Commercial |
$994.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$497.20
|
| Rate for Payer: EPIC Health Plan Senior |
$497.20
|
| Rate for Payer: Galaxy Health WC |
$1,056.55
|
| Rate for Payer: Global Benefits Group Commercial |
$745.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,118.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$829.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$473.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$769.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.60
|
| Rate for Payer: Multiplan Commercial |
$932.25
|
| Rate for Payer: Networks By Design Commercial |
$807.95
|
| Rate for Payer: Prime Health Services Commercial |
$1,056.55
|
|
|
HC TAPE LEMAITRE GLOW N TELL
|
Facility
|
IP
|
$350.00
|
|
| Hospital Charge Code |
906812678
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
|
|
HC TAPE LEMAITRE GLOW N TELL
|
Facility
|
OP
|
$350.00
|
|
| Hospital Charge Code |
906812678
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$315.00 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$212.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$169.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$205.56
|
| Rate for Payer: Blue Shield of California Commercial |
$213.85
|
| Rate for Payer: Blue Shield of California EPN |
$139.65
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Central Health Plan Commercial |
$280.00
|
| Rate for Payer: Cigna of CA HMO |
$224.00
|
| Rate for Payer: Cigna of CA PPO |
$259.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$315.00
|
| Rate for Payer: InnovAge PACE Commercial |
$175.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$262.50
|
| Rate for Payer: Networks By Design Commercial |
$227.50
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Riverside University Health System MISP |
$140.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.00
|
| Rate for Payer: United Healthcare All Other HMO |
$175.00
|
| Rate for Payer: United Healthcare HMO Rider |
$175.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$175.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
|
HC TARSORRHAPHY
|
Facility
|
IP
|
$7,319.00
|
|
|
Service Code
|
CPT 67880
|
| Hospital Charge Code |
900501730
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,463.80 |
| Max. Negotiated Rate |
$6,587.10 |
| Rate for Payer: Adventist Health Commercial |
$1,463.80
|
| Rate for Payer: Cash Price |
$3,293.55
|
| Rate for Payer: Central Health Plan Commercial |
$5,855.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,927.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,927.60
|
| Rate for Payer: Galaxy Health WC |
$6,221.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,391.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,587.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,881.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,788.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,530.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,463.80
|
| Rate for Payer: Multiplan Commercial |
$5,489.25
|
| Rate for Payer: Networks By Design Commercial |
$4,757.35
|
| Rate for Payer: Prime Health Services Commercial |
$6,221.15
|
|
|
HC TARSORRHAPHY
|
Facility
|
OP
|
$7,319.00
|
|
|
Service Code
|
CPT 67880
|
| Hospital Charge Code |
900501730
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$169.06 |
| Max. Negotiated Rate |
$8,114.00 |
| Rate for Payer: Adventist Health Commercial |
$1,463.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,260.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,964.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,764.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,723.01
|
| Rate for Payer: Cash Price |
$3,293.55
|
| Rate for Payer: Cash Price |
$3,293.55
|
| Rate for Payer: Cash Price |
$3,293.55
|
| Rate for Payer: Cash Price |
$3,293.55
|
| Rate for Payer: Central Health Plan Commercial |
$5,855.20
|
| Rate for Payer: Cigna of CA HMO |
$4,684.16
|
| Rate for Payer: Cigna of CA PPO |
$5,416.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,260.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,964.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,001.75
|
| Rate for Payer: EPIC Health Plan Senior |
$2,964.26
|
| Rate for Payer: Galaxy Health WC |
$6,221.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,391.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,587.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,861.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,964.26
|
| Rate for Payer: InnovAge PACE Commercial |
$4,446.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,881.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$169.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,964.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,463.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,972.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,972.11
|
| Rate for Payer: Multiplan Commercial |
$5,489.25
|
| Rate for Payer: Multiplan WC |
$4,723.01
|
| Rate for Payer: Networks By Design Commercial |
$4,757.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,964.26
|
| Rate for Payer: Preferred Health Network WC |
$4,819.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,221.15
|
| Rate for Payer: Prime Health Services Medicare |
$3,142.12
|
| Rate for Payer: Prime Health Services WC |
$4,674.82
|
| Rate for Payer: Riverside University Health System MISP |
$3,260.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,391.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,659.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,659.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,659.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,659.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,964.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,446.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,260.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2,964.26
|
|
|
HC TAVI TAVR
|
Facility
|
OP
|
$148,359.00
|
|
| Hospital Charge Code |
906811453
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,113.68 |
| Max. Negotiated Rate |
$133,523.10 |
| Rate for Payer: Adventist Health Commercial |
$29,671.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$126,105.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$81,597.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111,269.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$71,835.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87,131.24
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$66,761.55
|
| Rate for Payer: Cash Price |
$66,761.55
|
| Rate for Payer: Central Health Plan Commercial |
$118,687.20
|
| Rate for Payer: Cigna of CA HMO |
$94,949.76
|
| Rate for Payer: Cigna of CA PPO |
$109,785.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$126,105.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$126,105.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$126,105.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,343.60
|
| Rate for Payer: EPIC Health Plan Senior |
$59,343.60
|
| Rate for Payer: Galaxy Health WC |
$126,105.15
|
| Rate for Payer: Global Benefits Group Commercial |
$89,015.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$133,523.10
|
| Rate for Payer: InnovAge PACE Commercial |
$74,179.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$98,955.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56,524.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$91,834.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29,671.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$103,851.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$103,851.30
|
| Rate for Payer: Multiplan Commercial |
$111,269.25
|
| Rate for Payer: Networks By Design Commercial |
$96,433.35
|
| Rate for Payer: Prime Health Services Commercial |
$126,105.15
|
| Rate for Payer: Riverside University Health System MISP |
$59,343.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$89,015.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$74,179.50
|
| Rate for Payer: United Healthcare All Other HMO |
$74,179.50
|
| Rate for Payer: United Healthcare HMO Rider |
$74,179.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$74,179.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$126,105.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$126,105.15
|
| Rate for Payer: Vantage Medical Group Senior |
$126,105.15
|
|
|
HC TAVI TAVR
|
Facility
|
IP
|
$148,359.00
|
|
| Hospital Charge Code |
906811453
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$29,671.80 |
| Max. Negotiated Rate |
$133,523.10 |
| Rate for Payer: Adventist Health Commercial |
$29,671.80
|
| Rate for Payer: Cash Price |
$66,761.55
|
| Rate for Payer: Central Health Plan Commercial |
$118,687.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$59,343.60
|
| Rate for Payer: EPIC Health Plan Senior |
$59,343.60
|
| Rate for Payer: Galaxy Health WC |
$126,105.15
|
| Rate for Payer: Global Benefits Group Commercial |
$89,015.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$133,523.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$98,955.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56,524.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$91,834.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29,671.80
|
| Rate for Payer: Multiplan Commercial |
$111,269.25
|
| Rate for Payer: Networks By Design Commercial |
$96,433.35
|
| Rate for Payer: Prime Health Services Commercial |
$126,105.15
|
|
|
HC TAVR W PROS VALVE CAROTID
|
Facility
|
IP
|
$52,946.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
906813416
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,589.20 |
| Max. Negotiated Rate |
$47,651.40 |
| Rate for Payer: Adventist Health Commercial |
$10,589.20
|
| Rate for Payer: Cash Price |
$23,825.70
|
| Rate for Payer: Central Health Plan Commercial |
$42,356.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,178.40
|
| Rate for Payer: EPIC Health Plan Senior |
$21,178.40
|
| Rate for Payer: Galaxy Health WC |
$45,004.10
|
| Rate for Payer: Global Benefits Group Commercial |
$31,767.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$47,651.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35,314.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20,172.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,773.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,589.20
|
| Rate for Payer: Multiplan Commercial |
$39,709.50
|
| Rate for Payer: Networks By Design Commercial |
$34,414.90
|
| Rate for Payer: Prime Health Services Commercial |
$45,004.10
|
|
|
HC TAVR W PROS VALVE CAROTID
|
Facility
|
OP
|
$59,176.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
906820334
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$785.56 |
| Max. Negotiated Rate |
$53,258.40 |
| Rate for Payer: Adventist Health Commercial |
$11,835.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$785.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$785.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$26,629.20
|
| Rate for Payer: Cash Price |
$26,629.20
|
| Rate for Payer: Cash Price |
$26,629.20
|
| Rate for Payer: Central Health Plan Commercial |
$47,340.80
|
| Rate for Payer: Cigna of CA HMO |
$37,872.64
|
| Rate for Payer: Cigna of CA PPO |
$43,790.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$864.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$785.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,060.51
|
| Rate for Payer: EPIC Health Plan Senior |
$785.56
|
| Rate for Payer: Galaxy Health WC |
$50,299.60
|
| Rate for Payer: Global Benefits Group Commercial |
$35,505.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$53,258.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,288.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$785.56
|
| Rate for Payer: InnovAge PACE Commercial |
$1,178.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39,470.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$785.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,835.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,052.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,052.65
|
| Rate for Payer: Multiplan Commercial |
$44,382.00
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$38,464.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$785.56
|
| Rate for Payer: Preferred Health Network WC |
$1,277.20
|
| Rate for Payer: Prime Health Services Commercial |
$50,299.60
|
| Rate for Payer: Prime Health Services Medicare |
$832.69
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Riverside University Health System MISP |
$864.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35,505.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$785.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Vantage Medical Group Senior |
$785.56
|
|
|
HC TAVR W PROS VALVE CAROTID
|
Facility
|
OP
|
$52,946.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
906813416
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$785.56 |
| Max. Negotiated Rate |
$47,651.40 |
| Rate for Payer: Adventist Health Commercial |
$10,589.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$785.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$785.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$23,825.70
|
| Rate for Payer: Cash Price |
$23,825.70
|
| Rate for Payer: Cash Price |
$23,825.70
|
| Rate for Payer: Central Health Plan Commercial |
$42,356.80
|
| Rate for Payer: Cigna of CA HMO |
$33,885.44
|
| Rate for Payer: Cigna of CA PPO |
$39,180.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$864.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$785.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,060.51
|
| Rate for Payer: EPIC Health Plan Senior |
$785.56
|
| Rate for Payer: Galaxy Health WC |
$45,004.10
|
| Rate for Payer: Global Benefits Group Commercial |
$31,767.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$47,651.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,288.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$785.56
|
| Rate for Payer: InnovAge PACE Commercial |
$1,178.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35,314.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$785.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,589.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,052.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,052.65
|
| Rate for Payer: Multiplan Commercial |
$39,709.50
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$34,414.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$785.56
|
| Rate for Payer: Preferred Health Network WC |
$1,277.20
|
| Rate for Payer: Prime Health Services Commercial |
$45,004.10
|
| Rate for Payer: Prime Health Services Medicare |
$832.69
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Riverside University Health System MISP |
$864.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31,767.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$785.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Vantage Medical Group Senior |
$785.56
|
|
|
HC TAVR W PROS VALVE CAROTID
|
Facility
|
IP
|
$59,176.00
|
|
|
Service Code
|
CPT 33999
|
| Hospital Charge Code |
906820334
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$11,835.20 |
| Max. Negotiated Rate |
$53,258.40 |
| Rate for Payer: Adventist Health Commercial |
$11,835.20
|
| Rate for Payer: Cash Price |
$26,629.20
|
| Rate for Payer: Central Health Plan Commercial |
$47,340.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,670.40
|
| Rate for Payer: EPIC Health Plan Senior |
$23,670.40
|
| Rate for Payer: Galaxy Health WC |
$50,299.60
|
| Rate for Payer: Global Benefits Group Commercial |
$35,505.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$53,258.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39,470.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22,546.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,629.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,835.20
|
| Rate for Payer: Multiplan Commercial |
$44,382.00
|
| Rate for Payer: Networks By Design Commercial |
$38,464.40
|
| Rate for Payer: Prime Health Services Commercial |
$50,299.60
|
|
|
HC TAVR W PROS VALVE OPN AXLRY
|
Facility
|
IP
|
$53,762.00
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
906813410
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,752.40 |
| Max. Negotiated Rate |
$48,385.80 |
| Rate for Payer: Adventist Health Commercial |
$10,752.40
|
| Rate for Payer: Cash Price |
$24,192.90
|
| Rate for Payer: Central Health Plan Commercial |
$43,009.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,504.80
|
| Rate for Payer: EPIC Health Plan Senior |
$21,504.80
|
| Rate for Payer: Galaxy Health WC |
$45,697.70
|
| Rate for Payer: Global Benefits Group Commercial |
$32,257.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,385.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35,859.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20,483.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,278.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,752.40
|
| Rate for Payer: Multiplan Commercial |
$40,321.50
|
| Rate for Payer: Networks By Design Commercial |
$34,945.30
|
| Rate for Payer: Prime Health Services Commercial |
$45,697.70
|
|
|
HC TAVR W PROS VALVE OPN AXLRY
|
Facility
|
OP
|
$60,087.00
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
906820333
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$420.71 |
| Max. Negotiated Rate |
$54,078.30 |
| Rate for Payer: Adventist Health Commercial |
$12,017.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51,073.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33,047.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45,065.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$27,039.15
|
| Rate for Payer: Cash Price |
$27,039.15
|
| Rate for Payer: Cash Price |
$27,039.15
|
| Rate for Payer: Central Health Plan Commercial |
$48,069.60
|
| Rate for Payer: Cigna of CA HMO |
$38,455.68
|
| Rate for Payer: Cigna of CA PPO |
$44,464.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51,073.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$51,073.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51,073.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,034.80
|
| Rate for Payer: EPIC Health Plan Senior |
$24,034.80
|
| Rate for Payer: Galaxy Health WC |
$51,073.95
|
| Rate for Payer: Global Benefits Group Commercial |
$36,052.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$54,078.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$420.71
|
| Rate for Payer: InnovAge PACE Commercial |
$30,043.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40,078.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$464.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,193.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,017.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,060.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,060.90
|
| Rate for Payer: Multiplan Commercial |
$45,065.25
|
| Rate for Payer: Networks By Design Commercial |
$39,056.55
|
| Rate for Payer: Prime Health Services Commercial |
$51,073.95
|
| Rate for Payer: Riverside University Health System MISP |
$24,034.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36,052.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51,073.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51,073.95
|
| Rate for Payer: Vantage Medical Group Senior |
$51,073.95
|
|
|
HC TAVR W PROS VALVE OPN AXLRY
|
Facility
|
OP
|
$53,762.00
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
906813410
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$420.71 |
| Max. Negotiated Rate |
$48,385.80 |
| Rate for Payer: Adventist Health Commercial |
$10,752.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$45,697.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29,569.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40,321.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$24,192.90
|
| Rate for Payer: Cash Price |
$24,192.90
|
| Rate for Payer: Cash Price |
$24,192.90
|
| Rate for Payer: Central Health Plan Commercial |
$43,009.60
|
| Rate for Payer: Cigna of CA HMO |
$34,407.68
|
| Rate for Payer: Cigna of CA PPO |
$39,783.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$45,697.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$45,697.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$45,697.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,504.80
|
| Rate for Payer: EPIC Health Plan Senior |
$21,504.80
|
| Rate for Payer: Galaxy Health WC |
$45,697.70
|
| Rate for Payer: Global Benefits Group Commercial |
$32,257.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,385.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$420.71
|
| Rate for Payer: InnovAge PACE Commercial |
$26,881.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35,859.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$464.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,278.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,752.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37,633.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,633.40
|
| Rate for Payer: Multiplan Commercial |
$40,321.50
|
| Rate for Payer: Networks By Design Commercial |
$34,945.30
|
| Rate for Payer: Prime Health Services Commercial |
$45,697.70
|
| Rate for Payer: Riverside University Health System MISP |
$21,504.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32,257.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$45,697.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45,697.70
|
| Rate for Payer: Vantage Medical Group Senior |
$45,697.70
|
|
|
HC TAVR W PROS VALVE OPN AXLRY
|
Facility
|
IP
|
$60,087.00
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
906820333
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,017.40 |
| Max. Negotiated Rate |
$54,078.30 |
| Rate for Payer: Adventist Health Commercial |
$12,017.40
|
| Rate for Payer: Cash Price |
$27,039.15
|
| Rate for Payer: Central Health Plan Commercial |
$48,069.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,034.80
|
| Rate for Payer: EPIC Health Plan Senior |
$24,034.80
|
| Rate for Payer: Galaxy Health WC |
$51,073.95
|
| Rate for Payer: Global Benefits Group Commercial |
$36,052.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$54,078.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40,078.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22,893.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,193.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,017.40
|
| Rate for Payer: Multiplan Commercial |
$45,065.25
|
| Rate for Payer: Networks By Design Commercial |
$39,056.55
|
| Rate for Payer: Prime Health Services Commercial |
$51,073.95
|
|
|
HC TAVR W PROS VALVE OPN FMRL
|
Facility
|
OP
|
$52,214.00
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
906813409
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,029.93 |
| Max. Negotiated Rate |
$46,992.60 |
| Rate for Payer: Adventist Health Commercial |
$10,442.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44,381.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28,717.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39,160.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$23,496.30
|
| Rate for Payer: Cash Price |
$23,496.30
|
| Rate for Payer: Cash Price |
$23,496.30
|
| Rate for Payer: Central Health Plan Commercial |
$41,771.20
|
| Rate for Payer: Cigna of CA HMO |
$33,416.96
|
| Rate for Payer: Cigna of CA PPO |
$38,638.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44,381.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$44,381.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$44,381.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,885.60
|
| Rate for Payer: EPIC Health Plan Senior |
$20,885.60
|
| Rate for Payer: Galaxy Health WC |
$44,381.90
|
| Rate for Payer: Global Benefits Group Commercial |
$31,328.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$46,992.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,029.93
|
| Rate for Payer: InnovAge PACE Commercial |
$26,107.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34,826.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,242.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,320.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,442.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36,549.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,549.80
|
| Rate for Payer: Multiplan Commercial |
$39,160.50
|
| Rate for Payer: Networks By Design Commercial |
$33,939.10
|
| Rate for Payer: Prime Health Services Commercial |
$44,381.90
|
| Rate for Payer: Riverside University Health System MISP |
$20,885.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31,328.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44,381.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44,381.90
|
| Rate for Payer: Vantage Medical Group Senior |
$44,381.90
|
|
|
HC TAVR W PROS VALVE OPN FMRL
|
Facility
|
IP
|
$58,357.00
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
906820332
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$11,671.40 |
| Max. Negotiated Rate |
$52,521.30 |
| Rate for Payer: Adventist Health Commercial |
$11,671.40
|
| Rate for Payer: Cash Price |
$26,260.65
|
| Rate for Payer: Central Health Plan Commercial |
$46,685.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,342.80
|
| Rate for Payer: EPIC Health Plan Senior |
$23,342.80
|
| Rate for Payer: Galaxy Health WC |
$49,603.45
|
| Rate for Payer: Global Benefits Group Commercial |
$35,014.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$52,521.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38,924.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22,234.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,122.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,671.40
|
| Rate for Payer: Multiplan Commercial |
$43,767.75
|
| Rate for Payer: Networks By Design Commercial |
$37,932.05
|
| Rate for Payer: Prime Health Services Commercial |
$49,603.45
|
|
|
HC TAVR W PROS VALVE OPN FMRL
|
Facility
|
IP
|
$52,214.00
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
906813409
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,442.80 |
| Max. Negotiated Rate |
$46,992.60 |
| Rate for Payer: Adventist Health Commercial |
$10,442.80
|
| Rate for Payer: Cash Price |
$23,496.30
|
| Rate for Payer: Central Health Plan Commercial |
$41,771.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,885.60
|
| Rate for Payer: EPIC Health Plan Senior |
$20,885.60
|
| Rate for Payer: Galaxy Health WC |
$44,381.90
|
| Rate for Payer: Global Benefits Group Commercial |
$31,328.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$46,992.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34,826.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19,893.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,320.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,442.80
|
| Rate for Payer: Multiplan Commercial |
$39,160.50
|
| Rate for Payer: Networks By Design Commercial |
$33,939.10
|
| Rate for Payer: Prime Health Services Commercial |
$44,381.90
|
|
|
HC TAVR W PROS VALVE OPN FMRL
|
Facility
|
OP
|
$58,357.00
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
906820332
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,029.93 |
| Max. Negotiated Rate |
$52,521.30 |
| Rate for Payer: Adventist Health Commercial |
$11,671.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$49,603.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32,096.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43,767.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$26,260.65
|
| Rate for Payer: Cash Price |
$26,260.65
|
| Rate for Payer: Cash Price |
$26,260.65
|
| Rate for Payer: Central Health Plan Commercial |
$46,685.60
|
| Rate for Payer: Cigna of CA HMO |
$37,348.48
|
| Rate for Payer: Cigna of CA PPO |
$43,184.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$49,603.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$49,603.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$49,603.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,342.80
|
| Rate for Payer: EPIC Health Plan Senior |
$23,342.80
|
| Rate for Payer: Galaxy Health WC |
$49,603.45
|
| Rate for Payer: Global Benefits Group Commercial |
$35,014.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$52,521.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,029.93
|
| Rate for Payer: InnovAge PACE Commercial |
$29,178.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38,924.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,242.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36,122.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,671.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40,849.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,849.90
|
| Rate for Payer: Multiplan Commercial |
$43,767.75
|
| Rate for Payer: Networks By Design Commercial |
$37,932.05
|
| Rate for Payer: Prime Health Services Commercial |
$49,603.45
|
| Rate for Payer: Riverside University Health System MISP |
$23,342.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35,014.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$49,603.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$49,603.45
|
| Rate for Payer: Vantage Medical Group Senior |
$49,603.45
|
|
|
HC TAVR W PROS VALVE OPN ILIAC
|
Facility
|
OP
|
$60,500.00
|
|
|
Service Code
|
CPT 33364
|
| Hospital Charge Code |
906820339
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,239.97 |
| Max. Negotiated Rate |
$54,450.00 |
| Rate for Payer: Adventist Health Commercial |
$12,100.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51,425.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33,275.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45,375.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$27,225.00
|
| Rate for Payer: Cash Price |
$27,225.00
|
| Rate for Payer: Cash Price |
$27,225.00
|
| Rate for Payer: Central Health Plan Commercial |
$48,400.00
|
| Rate for Payer: Cigna of CA HMO |
$38,720.00
|
| Rate for Payer: Cigna of CA PPO |
$44,770.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51,425.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$51,425.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51,425.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,200.00
|
| Rate for Payer: EPIC Health Plan Senior |
$24,200.00
|
| Rate for Payer: Galaxy Health WC |
$51,425.00
|
| Rate for Payer: Global Benefits Group Commercial |
$36,300.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$54,450.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,239.97
|
| Rate for Payer: InnovAge PACE Commercial |
$30,250.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40,353.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,474.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,449.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,100.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42,350.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,350.00
|
| Rate for Payer: Multiplan Commercial |
$45,375.00
|
| Rate for Payer: Networks By Design Commercial |
$39,325.00
|
| Rate for Payer: Prime Health Services Commercial |
$51,425.00
|
| Rate for Payer: Riverside University Health System MISP |
$24,200.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36,300.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51,425.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51,425.00
|
| Rate for Payer: Vantage Medical Group Senior |
$51,425.00
|
|
