|
HC TRANSBRONCHIAL LUNG BX, ADD'L
|
Facility
IP
|
$5,642.00
|
|
|
Service Code
|
CPT 31632
|
| Hospital Charge Code |
900803507
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,128.40 |
| Max. Negotiated Rate |
$5,077.80 |
| Rate for Payer: Cash Price |
$2,538.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,513.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,256.80
|
| Rate for Payer: Galaxy Health WC |
$4,795.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,385.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,077.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,763.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,128.40
|
| Rate for Payer: Multiplan Commercial |
$4,231.50
|
| Rate for Payer: Networks By Design Commercial |
$3,667.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,795.70
|
|
|
HC TRANSBRONCHIAL LUNG BX, ADD'L
|
Facility
OP
|
$5,642.00
|
|
|
Service Code
|
CPT 31632
|
| Hospital Charge Code |
900803507
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,128.40 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,795.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,103.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,103.10
|
| 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 |
$3,385.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,548.82
|
| Rate for Payer: Blue Shield of California EPN |
$2,758.94
|
| Rate for Payer: Cash Price |
$2,538.90
|
| Rate for Payer: Cash Price |
$2,538.90
|
| Rate for Payer: Cash Price |
$2,538.90
|
| Rate for Payer: Central Health Plan Commercial |
$4,513.60
|
| Rate for Payer: Cigna of CA HMO |
$3,610.88
|
| Rate for Payer: Cigna of CA PPO |
$4,175.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,795.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,256.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,256.80
|
| Rate for Payer: Galaxy Health WC |
$4,795.70
|
| Rate for Payer: Global Benefits Group Commercial |
$3,385.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,077.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,231.50
|
| Rate for Payer: IEHP medi-cal |
$1,974.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,763.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,128.40
|
| Rate for Payer: Multiplan Commercial |
$4,231.50
|
| Rate for Payer: Networks By Design Commercial |
$3,667.30
|
| Rate for Payer: Prime Health Services Commercial |
$4,795.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,385.20
|
| Rate for Payer: Riverside University Health MISP |
$2,256.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,385.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,385.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,821.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,821.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,821.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,821.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,795.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,795.70
|
|
|
HC TRANSBRONCHIAL NEEDLE BX ADD'L
|
Facility
OP
|
$5,165.00
|
|
|
Service Code
|
CPT 31633
|
| Hospital Charge Code |
900803509
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,033.00 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,390.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,840.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,840.75
|
| 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 |
$3,099.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,248.78
|
| Rate for Payer: Blue Shield of California EPN |
$2,525.68
|
| Rate for Payer: Cash Price |
$2,324.25
|
| Rate for Payer: Cash Price |
$2,324.25
|
| Rate for Payer: Cash Price |
$2,324.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,132.00
|
| Rate for Payer: Cigna of CA HMO |
$3,305.60
|
| Rate for Payer: Cigna of CA PPO |
$3,822.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,390.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,066.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,066.00
|
| Rate for Payer: Galaxy Health WC |
$4,390.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,099.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,648.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,873.75
|
| Rate for Payer: IEHP medi-cal |
$1,807.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,445.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,033.00
|
| Rate for Payer: Multiplan Commercial |
$3,873.75
|
| Rate for Payer: Networks By Design Commercial |
$3,357.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,390.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,099.00
|
| Rate for Payer: Riverside University Health MISP |
$2,066.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,099.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,099.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,582.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,582.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,582.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,582.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,390.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4,390.25
|
|
|
HC TRANSBRONCHIAL NEEDLE BX ADD'L
|
Facility
IP
|
$5,165.00
|
|
|
Service Code
|
CPT 31633
|
| Hospital Charge Code |
900803509
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,033.00 |
| Max. Negotiated Rate |
$4,648.50 |
| Rate for Payer: Cash Price |
$2,324.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,132.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,066.00
|
| Rate for Payer: Galaxy Health WC |
$4,390.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,099.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,648.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,445.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,033.00
|
| Rate for Payer: Multiplan Commercial |
$3,873.75
|
| Rate for Payer: Networks By Design Commercial |
$3,357.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,390.25
|
|
|
HC TRANSBRONCHIAL W/NEEDLE BIOPSY
|
Facility
IP
|
$5,414.00
|
|
|
Service Code
|
CPT 31629
|
| Hospital Charge Code |
900803508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,082.80 |
| Max. Negotiated Rate |
$4,872.60 |
| Rate for Payer: Cash Price |
$2,436.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,331.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,165.60
|
| Rate for Payer: Galaxy Health WC |
$4,601.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,248.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,872.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,611.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,082.80
|
| Rate for Payer: Multiplan Commercial |
$4,060.50
|
| Rate for Payer: Networks By Design Commercial |
$3,519.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,601.90
|
|
|
HC TRANSBRONCHIAL W/NEEDLE BIOPSY
|
Facility
OP
|
$5,414.00
|
|
|
Service Code
|
CPT 31629
|
| Hospital Charge Code |
900803508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,082.80 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,678.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,678.93
|
| 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 |
$3,248.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$4,678.93
|
| Rate for Payer: Cash Price |
$2,436.30
|
| Rate for Payer: Cash Price |
$2,436.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,331.20
|
| Rate for Payer: Cigna of CA PPO |
$4,006.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,018.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,316.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,678.93
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,678.93
|
| Rate for Payer: Galaxy Health WC |
$4,601.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,248.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,872.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,060.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,673.45
|
| Rate for Payer: IEHP medi-cal |
$7,720.23
|
| Rate for Payer: IEHP Medicare Advantage |
$4,678.93
|
| Rate for Payer: Innovage PACE Commercial |
$7,018.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,611.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,678.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,082.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,269.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,269.77
|
| Rate for Payer: Multiplan Commercial |
$4,060.50
|
| Rate for Payer: Networks By Design Commercial |
$3,519.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,601.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,959.67
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,248.40
|
| Rate for Payer: Riverside University Health MISP |
$5,146.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,248.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,018.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,146.82
|
| Rate for Payer: Vantage Medical Group Senior |
$4,678.93
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
IP
|
$38,623.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906820084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,724.60 |
| Max. Negotiated Rate |
$34,760.70 |
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Central Health Plan Commercial |
$30,898.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,449.20
|
| Rate for Payer: Galaxy Health WC |
$32,829.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,173.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,760.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,761.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,724.60
|
| Rate for Payer: Multiplan Commercial |
$28,967.25
|
| Rate for Payer: Networks By Design Commercial |
$25,104.95
|
| Rate for Payer: Prime Health Services Commercial |
$32,829.55
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
OP
|
$38,623.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906812218
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| 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 |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$23,173.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Central Health Plan Commercial |
$30,898.40
|
| Rate for Payer: Cigna of CA PPO |
$28,581.02
|
| 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 |
$32,829.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,173.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,760.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$28,967.25
|
| 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 |
$25,761.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,724.60
|
| 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 |
$28,967.25
|
| Rate for Payer: Networks By Design Commercial |
$25,104.95
|
| Rate for Payer: Prime Health Services Commercial |
$32,829.55
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23,173.80
|
| Rate for Payer: Riverside University Health MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,173.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23,173.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| 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 TRANS CATH CLOSURE/ASD
|
Facility
IP
|
$38,623.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906812218
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,724.60 |
| Max. Negotiated Rate |
$34,760.70 |
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Central Health Plan Commercial |
$30,898.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,449.20
|
| Rate for Payer: Galaxy Health WC |
$32,829.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,173.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,760.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,761.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,724.60
|
| Rate for Payer: Multiplan Commercial |
$28,967.25
|
| Rate for Payer: Networks By Design Commercial |
$25,104.95
|
| Rate for Payer: Prime Health Services Commercial |
$32,829.55
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
OP
|
$38,623.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906820084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| 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 |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$23,173.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Central Health Plan Commercial |
$30,898.40
|
| Rate for Payer: Cigna of CA PPO |
$28,581.02
|
| 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 |
$32,829.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,173.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,760.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$28,967.25
|
| 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 |
$25,761.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,724.60
|
| 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 |
$28,967.25
|
| Rate for Payer: Networks By Design Commercial |
$25,104.95
|
| Rate for Payer: Prime Health Services Commercial |
$32,829.55
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23,173.80
|
| Rate for Payer: Riverside University Health MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,173.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23,173.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| 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 TRANS CATH CLOSURE/VSD
|
Facility
OP
|
$27,956.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906820085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| 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 |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$16,773.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$12,580.20
|
| Rate for Payer: Cash Price |
$12,580.20
|
| Rate for Payer: Cash Price |
$12,580.20
|
| Rate for Payer: Central Health Plan Commercial |
$22,364.80
|
| Rate for Payer: Cigna of CA PPO |
$20,687.44
|
| 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 |
$23,762.60
|
| Rate for Payer: Global Benefits Group Commercial |
$16,773.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,160.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20,967.00
|
| 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 |
$18,646.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,591.20
|
| 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 |
$20,967.00
|
| Rate for Payer: Networks By Design Commercial |
$18,171.40
|
| Rate for Payer: Prime Health Services Commercial |
$23,762.60
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16,773.60
|
| Rate for Payer: Riverside University Health MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,773.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,773.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| 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 TRANS CATH CLOSURE/VSD
|
Facility
OP
|
$27,956.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906812219
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$51,156.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| 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 |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$16,773.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$12,580.20
|
| Rate for Payer: Cash Price |
$12,580.20
|
| Rate for Payer: Cash Price |
$12,580.20
|
| Rate for Payer: Central Health Plan Commercial |
$22,364.80
|
| Rate for Payer: Cigna of CA PPO |
$20,687.44
|
| 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 |
$23,762.60
|
| Rate for Payer: Global Benefits Group Commercial |
$16,773.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,160.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20,967.00
|
| 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 |
$18,646.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,591.20
|
| 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 |
$20,967.00
|
| Rate for Payer: Networks By Design Commercial |
$18,171.40
|
| Rate for Payer: Prime Health Services Commercial |
$23,762.60
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16,773.60
|
| Rate for Payer: Riverside University Health MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,773.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,773.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$41,597.00
|
| Rate for Payer: United Healthcare All Other HMO |
$51,156.00
|
| Rate for Payer: United Healthcare HMO Rider |
$35,783.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32,722.00
|
| 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 TRANS CATH CLOSURE/VSD
|
Facility
IP
|
$27,956.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906812219
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,591.20 |
| Max. Negotiated Rate |
$25,160.40 |
| Rate for Payer: Cash Price |
$12,580.20
|
| Rate for Payer: Central Health Plan Commercial |
$22,364.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,182.40
|
| Rate for Payer: Galaxy Health WC |
$23,762.60
|
| Rate for Payer: Global Benefits Group Commercial |
$16,773.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,160.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,646.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,591.20
|
| Rate for Payer: Multiplan Commercial |
$20,967.00
|
| Rate for Payer: Networks By Design Commercial |
$18,171.40
|
| Rate for Payer: Prime Health Services Commercial |
$23,762.60
|
|
|
HC TRANS CATH CLOSURE/VSD
|
Facility
IP
|
$27,956.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906820085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,591.20 |
| Max. Negotiated Rate |
$25,160.40 |
| Rate for Payer: Cash Price |
$12,580.20
|
| Rate for Payer: Central Health Plan Commercial |
$22,364.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,182.40
|
| Rate for Payer: Galaxy Health WC |
$23,762.60
|
| Rate for Payer: Global Benefits Group Commercial |
$16,773.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,160.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,646.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,591.20
|
| Rate for Payer: Multiplan Commercial |
$20,967.00
|
| Rate for Payer: Networks By Design Commercial |
$18,171.40
|
| Rate for Payer: Prime Health Services Commercial |
$23,762.60
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
OP
|
$6,289.00
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
909081664
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,257.80 |
| Max. Negotiated Rate |
$5,660.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,355.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,345.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,458.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,458.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,389.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,914.54
|
| Rate for Payer: BCBS Transplant Transplant |
$3,773.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,886.60
|
| Rate for Payer: Blue Shield of California EPN |
$3,056.45
|
| Rate for Payer: Cash Price |
$2,830.05
|
| Rate for Payer: Cash Price |
$2,830.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,031.20
|
| Rate for Payer: Cigna of CA HMO |
$4,024.96
|
| Rate for Payer: Cigna of CA PPO |
$4,653.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,345.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,515.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,515.60
|
| Rate for Payer: Galaxy Health WC |
$5,345.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,773.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,660.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,716.75
|
| Rate for Payer: IEHP medi-cal |
$2,201.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,194.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,257.80
|
| Rate for Payer: Multiplan Commercial |
$4,716.75
|
| Rate for Payer: Networks By Design Commercial |
$4,087.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,345.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,773.40
|
| Rate for Payer: Riverside University Health MISP |
$2,515.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,773.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,773.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,144.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,144.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,144.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,144.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,345.65
|
| Rate for Payer: Vantage Medical Group Senior |
$5,345.65
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
IP
|
$9,903.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
909081356
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,980.60 |
| Max. Negotiated Rate |
$8,912.70 |
| Rate for Payer: Cash Price |
$4,456.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,922.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,961.20
|
| Rate for Payer: Galaxy Health WC |
$8,417.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,941.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,912.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,605.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,980.60
|
| Rate for Payer: Multiplan Commercial |
$7,427.25
|
| Rate for Payer: Networks By Design Commercial |
$6,436.95
|
| Rate for Payer: Prime Health Services Commercial |
$8,417.55
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
IP
|
$6,289.00
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
909081664
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,257.80 |
| Max. Negotiated Rate |
$5,660.10 |
| Rate for Payer: Cash Price |
$2,830.05
|
| Rate for Payer: Central Health Plan Commercial |
$5,031.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,515.60
|
| Rate for Payer: Galaxy Health WC |
$5,345.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,773.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,660.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,194.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,257.80
|
| Rate for Payer: Multiplan Commercial |
$4,716.75
|
| Rate for Payer: Networks By Design Commercial |
$4,087.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,345.65
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
OP
|
$9,903.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
909081356
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,980.60 |
| Max. Negotiated Rate |
$11,329.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,866.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$5,941.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,120.05
|
| Rate for Payer: Blue Shield of California EPN |
$4,812.86
|
| Rate for Payer: Caremore Medicare Advantage |
$6,866.07
|
| Rate for Payer: Cash Price |
$4,456.35
|
| Rate for Payer: Cash Price |
$4,456.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,922.40
|
| Rate for Payer: Cigna of CA HMO |
$6,337.92
|
| Rate for Payer: Cigna of CA PPO |
$7,328.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,269.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,866.07
|
| Rate for Payer: Galaxy Health WC |
$8,417.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,941.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,912.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7,427.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,260.35
|
| Rate for Payer: IEHP medi-cal |
$11,329.02
|
| Rate for Payer: IEHP Medicare Advantage |
$6,866.07
|
| Rate for Payer: Innovage PACE Commercial |
$10,299.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,605.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,980.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,200.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,200.53
|
| Rate for Payer: Multiplan Commercial |
$7,427.25
|
| Rate for Payer: Networks By Design Commercial |
$6,436.95
|
| Rate for Payer: Prime Health Services Commercial |
$8,417.55
|
| Rate for Payer: Prime Health Services Medicare |
$7,278.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5,941.80
|
| Rate for Payer: Riverside University Health MISP |
$7,552.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,941.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,941.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,951.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,951.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,951.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,951.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
OP
|
$21,245.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906811451
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$19,907.00 |
| 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 |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$12,747.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$9,560.25
|
| Rate for Payer: Cash Price |
$9,560.25
|
| Rate for Payer: Central Health Plan Commercial |
$16,996.00
|
| Rate for Payer: Cigna of CA PPO |
$15,721.30
|
| 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 |
$18,058.25
|
| Rate for Payer: Global Benefits Group Commercial |
$12,747.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,120.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15,933.75
|
| 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 |
$14,170.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,249.00
|
| 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 |
$15,933.75
|
| Rate for Payer: Networks By Design Commercial |
$13,809.25
|
| Rate for Payer: Prime Health Services Commercial |
$18,058.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12,747.00
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,747.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,747.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| 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 TRANSCATHETER RETRIEVAL
|
Facility
OP
|
$21,245.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906820253
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$19,907.00 |
| 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 |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$12,747.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$9,560.25
|
| Rate for Payer: Cash Price |
$9,560.25
|
| Rate for Payer: Central Health Plan Commercial |
$16,996.00
|
| Rate for Payer: Cigna of CA PPO |
$15,721.30
|
| 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 |
$18,058.25
|
| Rate for Payer: Global Benefits Group Commercial |
$12,747.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,120.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15,933.75
|
| 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 |
$14,170.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,249.00
|
| 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 |
$15,933.75
|
| Rate for Payer: Networks By Design Commercial |
$13,809.25
|
| Rate for Payer: Prime Health Services Commercial |
$18,058.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12,747.00
|
| Rate for Payer: Riverside University Health MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,747.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,747.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| 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 TRANSCATHETER RETRIEVAL
|
Facility
IP
|
$21,245.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906820253
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,249.00 |
| Max. Negotiated Rate |
$19,120.50 |
| Rate for Payer: Cash Price |
$9,560.25
|
| Rate for Payer: Central Health Plan Commercial |
$16,996.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,498.00
|
| Rate for Payer: Galaxy Health WC |
$18,058.25
|
| Rate for Payer: Global Benefits Group Commercial |
$12,747.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,120.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,170.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,249.00
|
| Rate for Payer: Multiplan Commercial |
$15,933.75
|
| Rate for Payer: Networks By Design Commercial |
$13,809.25
|
| Rate for Payer: Prime Health Services Commercial |
$18,058.25
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
IP
|
$21,245.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906811451
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,249.00 |
| Max. Negotiated Rate |
$19,120.50 |
| Rate for Payer: Cash Price |
$9,560.25
|
| Rate for Payer: Central Health Plan Commercial |
$16,996.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,498.00
|
| Rate for Payer: Galaxy Health WC |
$18,058.25
|
| Rate for Payer: Global Benefits Group Commercial |
$12,747.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,120.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,170.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,249.00
|
| Rate for Payer: Multiplan Commercial |
$15,933.75
|
| Rate for Payer: Networks By Design Commercial |
$13,809.25
|
| Rate for Payer: Prime Health Services Commercial |
$18,058.25
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA PM COMPNT
|
Facility
OP
|
$54,122.00
|
|
|
Service Code
|
CPT 0796T
|
| Hospital Charge Code |
906819778
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$48,709.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$24,345.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$26,205.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31,975.28
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$33,283.75
|
| Rate for Payer: BCBS Transplant Transplant |
$32,473.20
|
| 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: Caremore Medicare Advantage |
$24,345.49
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Central Health Plan Commercial |
$43,297.60
|
| Rate for Payer: Cigna of CA PPO |
$40,050.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,866.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$24,345.49
|
| Rate for Payer: Galaxy Health WC |
$46,003.70
|
| Rate for Payer: Global Benefits Group Commercial |
$32,473.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,709.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$40,591.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$39,926.60
|
| Rate for Payer: IEHP medi-cal |
$40,170.06
|
| Rate for Payer: IEHP Medicare Advantage |
$24,345.49
|
| Rate for Payer: Innovage PACE Commercial |
$36,518.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,099.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,345.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,824.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32,622.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32,622.96
|
| Rate for Payer: Multiplan Commercial |
$40,591.50
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: Networks By Design Commercial |
$35,179.30
|
| Rate for Payer: Preferred Health Network WC |
$33,963.01
|
| Rate for Payer: Prime Health Services Commercial |
$46,003.70
|
| Rate for Payer: Prime Health Services Medicare |
$25,806.22
|
| Rate for Payer: Prime Health Services WC |
$32,944.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$32,473.20
|
| Rate for Payer: Riverside University Health MISP |
$26,780.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32,473.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,061.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,061.00
|
| Rate for Payer: United Healthcare HMO Rider |
$27,061.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,061.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA PM COMPNT
|
Facility
IP
|
$54,122.00
|
|
|
Service Code
|
CPT 0796T
|
| Hospital Charge Code |
906819778
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,824.40 |
| Max. Negotiated Rate |
$48,709.80 |
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Central Health Plan Commercial |
$43,297.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,648.80
|
| Rate for Payer: Galaxy Health WC |
$46,003.70
|
| Rate for Payer: Global Benefits Group Commercial |
$32,473.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,709.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,099.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,824.40
|
| Rate for Payer: Multiplan Commercial |
$40,591.50
|
| Rate for Payer: Networks By Design Commercial |
$35,179.30
|
| Rate for Payer: Prime Health Services Commercial |
$46,003.70
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA RV COMP SYS
|
Facility
IP
|
$54,122.00
|
|
|
Service Code
|
CPT 0795T
|
| Hospital Charge Code |
906819777
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$10,824.40 |
| Max. Negotiated Rate |
$48,709.80 |
| Rate for Payer: Cash Price |
$24,354.90
|
| Rate for Payer: Central Health Plan Commercial |
$43,297.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,648.80
|
| Rate for Payer: Galaxy Health WC |
$46,003.70
|
| Rate for Payer: Global Benefits Group Commercial |
$32,473.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,709.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,099.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,824.40
|
| Rate for Payer: Multiplan Commercial |
$40,591.50
|
| Rate for Payer: Networks By Design Commercial |
$35,179.30
|
| Rate for Payer: Prime Health Services Commercial |
$46,003.70
|
|
