|
HC THORACENTESIS ASPIRATN W GUID
|
Facility
|
OP
|
$5,764.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
909020158
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$158.81 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$1,152.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$785.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$3,170.20
|
| Rate for Payer: Cash Price |
$3,170.20
|
| Rate for Payer: Cash Price |
$3,170.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,611.20
|
| Rate for Payer: Cigna of CA HMO |
$3,688.96
|
| Rate for Payer: Cigna of CA PPO |
$4,265.36
|
| 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 |
$4,899.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,458.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,187.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,288.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$158.81
|
| 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 |
$3,844.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$785.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,152.80
|
| 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 |
$4,323.00
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$3,746.60
|
| 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 |
$4,899.40
|
| 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 |
$3,458.40
|
| 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: 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 THORACENTESIS ASPIRATN W GUID
|
Facility
|
IP
|
$5,764.00
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
909020158
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,152.80 |
| Max. Negotiated Rate |
$5,187.60 |
| Rate for Payer: Adventist Health Commercial |
$1,152.80
|
| Rate for Payer: Cash Price |
$3,170.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,611.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,305.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,305.60
|
| Rate for Payer: Galaxy Health WC |
$4,899.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,458.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,187.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,844.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,196.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,567.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,152.80
|
| Rate for Payer: Multiplan Commercial |
$4,323.00
|
| Rate for Payer: Networks By Design Commercial |
$3,746.60
|
| Rate for Payer: Prime Health Services Commercial |
$4,899.40
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
IP
|
$3,933.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$786.60 |
| Max. Negotiated Rate |
$3,539.70 |
| Rate for Payer: Adventist Health Commercial |
$786.60
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,146.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,573.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,573.20
|
| Rate for Payer: Galaxy Health WC |
$3,343.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,359.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,539.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,623.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,498.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,434.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$786.60
|
| Rate for Payer: Multiplan Commercial |
$2,949.75
|
| Rate for Payer: Networks By Design Commercial |
$2,556.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,343.05
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
IP
|
$3,933.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$786.60 |
| Max. Negotiated Rate |
$3,539.70 |
| Rate for Payer: Adventist Health Commercial |
$786.60
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,146.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,573.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,573.20
|
| Rate for Payer: Galaxy Health WC |
$3,343.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,359.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,539.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,623.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,498.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,434.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$786.60
|
| Rate for Payer: Multiplan Commercial |
$2,949.75
|
| Rate for Payer: Networks By Design Commercial |
$2,556.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,343.05
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
OP
|
$3,933.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
901200036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.43 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$786.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$785.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$2,163.15
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,146.40
|
| Rate for Payer: Cigna of CA HMO |
$2,517.12
|
| Rate for Payer: Cigna of CA PPO |
$2,910.42
|
| 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 |
$3,343.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,359.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,539.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,288.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$127.43
|
| 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 |
$2,623.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$785.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$786.60
|
| 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 |
$2,949.75
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$2,556.45
|
| 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 |
$3,343.05
|
| 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 |
$2,359.80
|
| 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 THORACENTESIS ASPIRATN WO GUID
|
Facility
|
OP
|
$3,933.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$140.77 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$1,612.53
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$1,833.00
|
| 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: Cash Price |
$2,163.15
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,146.40
|
| Rate for Payer: Cigna of CA HMO |
$2,517.12
|
| Rate for Payer: Cigna of CA PPO |
$2,910.42
|
| 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 |
$3,343.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,359.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,539.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,288.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| 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 |
$2,623.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$785.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$786.60
|
| 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 |
$2,949.75
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$2,556.45
|
| 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 |
$3,343.05
|
| 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 |
$2,359.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,359.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| 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 THORACENTESIS ASPIRATN WO GUID
|
Facility
|
IP
|
$3,933.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
901200036
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$786.60 |
| Max. Negotiated Rate |
$3,539.70 |
| Rate for Payer: Adventist Health Commercial |
$786.60
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,146.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,573.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,573.20
|
| Rate for Payer: Galaxy Health WC |
$3,343.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,359.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,539.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,623.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,498.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,434.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$786.60
|
| Rate for Payer: Multiplan Commercial |
$2,949.75
|
| Rate for Payer: Networks By Design Commercial |
$2,556.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,343.05
|
|
|
HC THORACENTESIS ASPIRATN WO GUID
|
Facility
|
OP
|
$3,933.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.43 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$786.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$785.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$2,163.15
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,146.40
|
| Rate for Payer: Cigna of CA HMO |
$2,517.12
|
| Rate for Payer: Cigna of CA PPO |
$2,910.42
|
| 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 |
$3,343.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,359.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,539.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,288.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$127.43
|
| 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 |
$2,623.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$785.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$786.60
|
| 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 |
$2,949.75
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$2,556.45
|
| 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 |
$3,343.05
|
| 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 |
$2,359.80
|
| 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 THORACENTESIS ASPIRATN WO GUID
|
Facility
|
OP
|
$3,933.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$140.77 |
| Max. Negotiated Rate |
$3,539.70 |
| Rate for Payer: Adventist Health Commercial |
$786.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,146.40
|
| Rate for Payer: Cigna of CA HMO |
$2,517.12
|
| Rate for Payer: Cigna of CA PPO |
$2,910.42
|
| 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 |
$3,343.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,359.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,539.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,288.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| 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 |
$2,623.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$140.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$785.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$786.60
|
| 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 |
$2,949.75
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$2,556.45
|
| 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 |
$3,343.05
|
| 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 |
$2,359.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,966.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,966.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,966.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,966.50
|
| 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 THORACENTESIS ASPIRATN WO GUID
|
Facility
|
IP
|
$3,933.00
|
|
|
Service Code
|
CPT 32554
|
| Hospital Charge Code |
900800117
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$786.60 |
| Max. Negotiated Rate |
$3,539.70 |
| Rate for Payer: Adventist Health Commercial |
$786.60
|
| Rate for Payer: Cash Price |
$2,163.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,146.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,573.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,573.20
|
| Rate for Payer: Galaxy Health WC |
$3,343.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,359.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,539.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,623.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,498.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,434.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$786.60
|
| Rate for Payer: Multiplan Commercial |
$2,949.75
|
| Rate for Payer: Networks By Design Commercial |
$2,556.45
|
| Rate for Payer: Prime Health Services Commercial |
$3,343.05
|
|
|
HC THORACIC FACET JONT INJ,EA ADL
|
Facility
|
OP
|
$3,537.00
|
|
|
Service Code
|
CPT 64491
|
| Hospital Charge Code |
909000231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$137.03 |
| Max. Negotiated Rate |
$5,311.00 |
| Rate for Payer: Adventist Health Commercial |
$707.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,006.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,945.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,652.75
|
| 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 |
$1,945.35
|
| Rate for Payer: Cash Price |
$1,945.35
|
| Rate for Payer: Cash Price |
$1,945.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,829.60
|
| Rate for Payer: Cigna of CA HMO |
$2,263.68
|
| Rate for Payer: Cigna of CA PPO |
$2,617.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,006.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,006.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,006.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,414.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,414.80
|
| Rate for Payer: Galaxy Health WC |
$3,006.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,122.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,183.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$137.03
|
| Rate for Payer: InnovAge PACE Commercial |
$1,768.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,359.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$151.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,189.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$707.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,475.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,475.90
|
| Rate for Payer: Multiplan Commercial |
$2,652.75
|
| Rate for Payer: Networks By Design Commercial |
$2,299.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,006.45
|
| Rate for Payer: Riverside University Health System MISP |
$1,414.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,122.20
|
| 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 |
$3,006.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,006.45
|
| Rate for Payer: Vantage Medical Group Senior |
$3,006.45
|
|
|
HC THORACIC FACET JONT INJ,EA ADL
|
Facility
|
IP
|
$3,537.00
|
|
|
Service Code
|
CPT 64491
|
| Hospital Charge Code |
909000231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$707.40 |
| Max. Negotiated Rate |
$3,183.30 |
| Rate for Payer: Adventist Health Commercial |
$707.40
|
| Rate for Payer: Cash Price |
$1,945.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,829.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,414.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,414.80
|
| Rate for Payer: Galaxy Health WC |
$3,006.45
|
| Rate for Payer: Global Benefits Group Commercial |
$2,122.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,183.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,359.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,347.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,189.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$707.40
|
| Rate for Payer: Multiplan Commercial |
$2,652.75
|
| Rate for Payer: Networks By Design Commercial |
$2,299.05
|
| Rate for Payer: Prime Health Services Commercial |
$3,006.45
|
|
|
HC THORACIC SPINE 2VIEWS
|
Facility
|
OP
|
$1,133.00
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
909001311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$27.46 |
| Max. Negotiated Rate |
$1,019.70 |
| Rate for Payer: Adventist Health Commercial |
$226.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$688.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.46
|
| Rate for Payer: Blue Shield of California Commercial |
$687.73
|
| Rate for Payer: Blue Shield of California EPN |
$449.80
|
| Rate for Payer: Cash Price |
$623.15
|
| Rate for Payer: Cash Price |
$623.15
|
| Rate for Payer: Central Health Plan Commercial |
$906.40
|
| Rate for Payer: Cigna of CA HMO |
$725.12
|
| Rate for Payer: Cigna of CA PPO |
$838.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.41
|
| Rate for Payer: EPIC Health Plan Senior |
$135.12
|
| Rate for Payer: Galaxy Health WC |
$963.05
|
| Rate for Payer: Global Benefits Group Commercial |
$679.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,019.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: InnovAge PACE Commercial |
$202.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$755.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$226.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.06
|
| Rate for Payer: Multiplan Commercial |
$849.75
|
| Rate for Payer: Networks By Design Commercial |
$736.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$963.05
|
| Rate for Payer: Prime Health Services Medicare |
$143.23
|
| Rate for Payer: Riverside University Health System MISP |
$148.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$679.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$679.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$135.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC THORACIC SPINE 2VIEWS
|
Facility
|
IP
|
$1,133.00
|
|
|
Service Code
|
CPT 72070
|
| Hospital Charge Code |
909001311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$226.60 |
| Max. Negotiated Rate |
$1,019.70 |
| Rate for Payer: Adventist Health Commercial |
$226.60
|
| Rate for Payer: Cash Price |
$623.15
|
| Rate for Payer: Central Health Plan Commercial |
$906.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$453.20
|
| Rate for Payer: EPIC Health Plan Senior |
$453.20
|
| Rate for Payer: Galaxy Health WC |
$963.05
|
| Rate for Payer: Global Benefits Group Commercial |
$679.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,019.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$755.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$431.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$701.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$226.60
|
| Rate for Payer: Multiplan Commercial |
$849.75
|
| Rate for Payer: Networks By Design Commercial |
$736.45
|
| Rate for Payer: Prime Health Services Commercial |
$963.05
|
|
|
HC THORACIC SPINE 3VIEWS
|
Facility
|
OP
|
$1,241.00
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
909001310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$31.21 |
| Max. Negotiated Rate |
$1,116.90 |
| Rate for Payer: Adventist Health Commercial |
$248.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$753.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$153.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.21
|
| Rate for Payer: Blue Shield of California Commercial |
$753.29
|
| Rate for Payer: Blue Shield of California EPN |
$492.68
|
| Rate for Payer: Cash Price |
$682.55
|
| Rate for Payer: Cash Price |
$682.55
|
| Rate for Payer: Central Health Plan Commercial |
$992.80
|
| Rate for Payer: Cigna of CA HMO |
$794.24
|
| Rate for Payer: Cigna of CA PPO |
$918.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.41
|
| Rate for Payer: EPIC Health Plan Senior |
$135.12
|
| Rate for Payer: Galaxy Health WC |
$1,054.85
|
| Rate for Payer: Global Benefits Group Commercial |
$744.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,116.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$53.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: InnovAge PACE Commercial |
$202.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$827.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.06
|
| Rate for Payer: Multiplan Commercial |
$930.75
|
| Rate for Payer: Networks By Design Commercial |
$806.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,054.85
|
| Rate for Payer: Prime Health Services Medicare |
$143.23
|
| Rate for Payer: Riverside University Health System MISP |
$148.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$744.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$744.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$135.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC THORACIC SPINE 3VIEWS
|
Facility
|
IP
|
$1,241.00
|
|
|
Service Code
|
CPT 72072
|
| Hospital Charge Code |
909001310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$248.20 |
| Max. Negotiated Rate |
$1,116.90 |
| Rate for Payer: Adventist Health Commercial |
$248.20
|
| Rate for Payer: Cash Price |
$682.55
|
| Rate for Payer: Central Health Plan Commercial |
$992.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$496.40
|
| Rate for Payer: EPIC Health Plan Senior |
$496.40
|
| Rate for Payer: Galaxy Health WC |
$1,054.85
|
| Rate for Payer: Global Benefits Group Commercial |
$744.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,116.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$827.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$472.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$768.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$248.20
|
| Rate for Payer: Multiplan Commercial |
$930.75
|
| Rate for Payer: Networks By Design Commercial |
$806.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,054.85
|
|
|
HC THORACIC SPINE 4 VIEWS
|
Facility
|
OP
|
$1,672.00
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
909001313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$1,504.80 |
| Rate for Payer: Adventist Health Commercial |
$334.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$135.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,015.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$189.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.55
|
| Rate for Payer: Blue Shield of California Commercial |
$1,014.90
|
| Rate for Payer: Blue Shield of California EPN |
$663.78
|
| Rate for Payer: Cash Price |
$919.60
|
| Rate for Payer: Cash Price |
$919.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,337.60
|
| Rate for Payer: Cigna of CA HMO |
$1,070.08
|
| Rate for Payer: Cigna of CA PPO |
$1,237.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$202.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$148.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$135.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.41
|
| Rate for Payer: EPIC Health Plan Senior |
$135.12
|
| Rate for Payer: Galaxy Health WC |
$1,421.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,003.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,504.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$221.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$60.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$135.12
|
| Rate for Payer: InnovAge PACE Commercial |
$202.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,115.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$334.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.06
|
| Rate for Payer: Multiplan Commercial |
$1,254.00
|
| Rate for Payer: Networks By Design Commercial |
$1,086.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$135.12
|
| Rate for Payer: Prime Health Services Commercial |
$1,421.20
|
| Rate for Payer: Prime Health Services Medicare |
$143.23
|
| Rate for Payer: Riverside University Health System MISP |
$148.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,003.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,003.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$135.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$202.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.63
|
| Rate for Payer: Vantage Medical Group Senior |
$135.12
|
|
|
HC THORACIC SPINE 4 VIEWS
|
Facility
|
IP
|
$1,672.00
|
|
|
Service Code
|
CPT 72074
|
| Hospital Charge Code |
909001313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$334.40 |
| Max. Negotiated Rate |
$1,504.80 |
| Rate for Payer: Adventist Health Commercial |
$334.40
|
| Rate for Payer: Cash Price |
$919.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,337.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$668.80
|
| Rate for Payer: EPIC Health Plan Senior |
$668.80
|
| Rate for Payer: Galaxy Health WC |
$1,421.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,003.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,504.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,115.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$637.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,034.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$334.40
|
| Rate for Payer: Multiplan Commercial |
$1,254.00
|
| Rate for Payer: Networks By Design Commercial |
$1,086.80
|
| Rate for Payer: Prime Health Services Commercial |
$1,421.20
|
|
|
HC THORACOSCOPY SX W PLEURODESIS
|
Facility
|
IP
|
$27,088.00
|
|
|
Service Code
|
CPT 32650
|
| Hospital Charge Code |
909010013
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,417.60 |
| Max. Negotiated Rate |
$24,379.20 |
| Rate for Payer: Adventist Health Commercial |
$5,417.60
|
| Rate for Payer: Cash Price |
$14,898.40
|
| Rate for Payer: Central Health Plan Commercial |
$21,670.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,835.20
|
| Rate for Payer: EPIC Health Plan Senior |
$10,835.20
|
| Rate for Payer: Galaxy Health WC |
$23,024.80
|
| Rate for Payer: Global Benefits Group Commercial |
$16,252.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,379.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,067.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,320.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,767.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,417.60
|
| Rate for Payer: Multiplan Commercial |
$20,316.00
|
| Rate for Payer: Networks By Design Commercial |
$17,607.20
|
| Rate for Payer: Prime Health Services Commercial |
$23,024.80
|
|
|
HC THORACOSCOPY SX W PLEURODESIS
|
Facility
|
OP
|
$27,088.00
|
|
|
Service Code
|
CPT 32650
|
| Hospital Charge Code |
909010013
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$671.73 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,417.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23,024.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,898.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,316.00
|
| 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 |
$14,898.40
|
| Rate for Payer: Cash Price |
$14,898.40
|
| Rate for Payer: Cash Price |
$14,898.40
|
| Rate for Payer: Central Health Plan Commercial |
$21,670.40
|
| Rate for Payer: Cigna of CA HMO |
$17,336.32
|
| Rate for Payer: Cigna of CA PPO |
$20,045.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,024.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,024.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,024.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,835.20
|
| Rate for Payer: EPIC Health Plan Senior |
$10,835.20
|
| Rate for Payer: Galaxy Health WC |
$23,024.80
|
| Rate for Payer: Global Benefits Group Commercial |
$16,252.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,379.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$671.73
|
| Rate for Payer: InnovAge PACE Commercial |
$13,544.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,067.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$742.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,767.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,417.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,961.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,961.60
|
| Rate for Payer: Multiplan Commercial |
$20,316.00
|
| Rate for Payer: Networks By Design Commercial |
$17,607.20
|
| Rate for Payer: Prime Health Services Commercial |
$23,024.80
|
| Rate for Payer: Riverside University Health System MISP |
$10,835.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,252.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23,024.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,024.80
|
| Rate for Payer: Vantage Medical Group Senior |
$23,024.80
|
|
|
HC THORACOTOMY CARDIAC
|
Facility
|
OP
|
$6,936.00
|
|
|
Service Code
|
CPT 32160
|
| Hospital Charge Code |
900501127
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$192.11 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,387.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,895.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,814.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,202.00
|
| 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 |
$3,814.80
|
| Rate for Payer: Cash Price |
$3,814.80
|
| Rate for Payer: Cash Price |
$3,814.80
|
| Rate for Payer: Central Health Plan Commercial |
$5,548.80
|
| Rate for Payer: Cigna of CA HMO |
$4,439.04
|
| Rate for Payer: Cigna of CA PPO |
$5,132.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,895.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,895.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,895.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,774.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,774.40
|
| Rate for Payer: Galaxy Health WC |
$5,895.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,161.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,242.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$192.11
|
| Rate for Payer: InnovAge PACE Commercial |
$3,468.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,626.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$212.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,293.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,387.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,855.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,855.20
|
| Rate for Payer: Multiplan Commercial |
$5,202.00
|
| Rate for Payer: Networks By Design Commercial |
$4,508.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,895.60
|
| Rate for Payer: Riverside University Health System MISP |
$2,774.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,161.60
|
| 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: Vantage Medical Group Commercial/Exchange |
$5,895.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,895.60
|
| Rate for Payer: Vantage Medical Group Senior |
$5,895.60
|
|
|
HC THORACOTOMY CARDIAC
|
Facility
|
IP
|
$6,936.00
|
|
|
Service Code
|
CPT 32160
|
| Hospital Charge Code |
900501127
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,387.20 |
| Max. Negotiated Rate |
$6,242.40 |
| Rate for Payer: Adventist Health Commercial |
$1,387.20
|
| Rate for Payer: Cash Price |
$3,814.80
|
| Rate for Payer: Central Health Plan Commercial |
$5,548.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,774.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,774.40
|
| Rate for Payer: Galaxy Health WC |
$5,895.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,161.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,242.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,626.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,642.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,293.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,387.20
|
| Rate for Payer: Multiplan Commercial |
$5,202.00
|
| Rate for Payer: Networks By Design Commercial |
$4,508.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,895.60
|
|
|
HC THORACOTOMY; WITH EXPLORATION
|
Facility
|
IP
|
$3,634.00
|
|
|
Service Code
|
CPT 32100
|
| Hospital Charge Code |
900502100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$726.80 |
| Max. Negotiated Rate |
$3,270.60 |
| Rate for Payer: Adventist Health Commercial |
$726.80
|
| Rate for Payer: Cash Price |
$1,998.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,907.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,453.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,453.60
|
| Rate for Payer: Galaxy Health WC |
$3,088.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,180.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,270.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,423.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,384.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,249.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$726.80
|
| Rate for Payer: Multiplan Commercial |
$2,725.50
|
| Rate for Payer: Networks By Design Commercial |
$2,362.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,088.90
|
|
|
HC THORACOTOMY; WITH EXPLORATION
|
Facility
|
OP
|
$3,634.00
|
|
|
Service Code
|
CPT 32100
|
| Hospital Charge Code |
900502100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$174.18 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$726.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,088.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,998.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,725.50
|
| 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 |
$1,998.70
|
| Rate for Payer: Cash Price |
$1,998.70
|
| Rate for Payer: Cash Price |
$1,998.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,907.20
|
| Rate for Payer: Cigna of CA HMO |
$2,325.76
|
| Rate for Payer: Cigna of CA PPO |
$2,689.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,088.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,088.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,088.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,453.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,453.60
|
| Rate for Payer: Galaxy Health WC |
$3,088.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2,180.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,270.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$174.18
|
| Rate for Payer: InnovAge PACE Commercial |
$1,817.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,423.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,249.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$726.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,543.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,543.80
|
| Rate for Payer: Multiplan Commercial |
$2,725.50
|
| Rate for Payer: Networks By Design Commercial |
$2,362.10
|
| Rate for Payer: Prime Health Services Commercial |
$3,088.90
|
| Rate for Payer: Riverside University Health System MISP |
$1,453.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,180.40
|
| 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 |
$3,088.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,088.90
|
| Rate for Payer: Vantage Medical Group Senior |
$3,088.90
|
|
|
HC THORA KIT PLEURAL SEAL
|
Facility
|
IP
|
$296.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
900831718
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$59.20 |
| Max. Negotiated Rate |
$266.40 |
| Rate for Payer: Adventist Health Commercial |
$59.20
|
| Rate for Payer: Blue Shield of California Commercial |
$228.81
|
| Rate for Payer: Blue Shield of California EPN |
$149.18
|
| Rate for Payer: Cash Price |
$162.80
|
| Rate for Payer: Central Health Plan Commercial |
$236.80
|
| Rate for Payer: Cigna of CA HMO |
$207.20
|
| Rate for Payer: Cigna of CA PPO |
$207.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.40
|
| Rate for Payer: EPIC Health Plan Senior |
$118.40
|
| Rate for Payer: Galaxy Health WC |
$251.60
|
| Rate for Payer: Global Benefits Group Commercial |
$177.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$266.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$197.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$112.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$183.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.20
|
| Rate for Payer: Multiplan Commercial |
$222.00
|
| Rate for Payer: Networks By Design Commercial |
$148.00
|
| Rate for Payer: Prime Health Services Commercial |
$251.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$111.09
|
| Rate for Payer: United Healthcare All Other HMO |
$108.13
|
| Rate for Payer: United Healthcare HMO Rider |
$105.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$96.94
|
|
