|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
OP
|
$25,472.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906810570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$22,924.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,246.04
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21,651.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,009.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14,009.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$15,283.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: Central Health Plan Commercial |
$20,377.60
|
| Rate for Payer: Cigna of CA PPO |
$18,849.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,651.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,188.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,188.80
|
| Rate for Payer: Galaxy Health WC |
$21,651.20
|
| Rate for Payer: Global Benefits Group Commercial |
$15,283.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,924.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19,104.00
|
| Rate for Payer: IEHP medi-cal |
$8,915.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,989.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,094.40
|
| Rate for Payer: Multiplan Commercial |
$19,104.00
|
| Rate for Payer: Networks By Design Commercial |
$16,556.80
|
| Rate for Payer: Prime Health Services Commercial |
$21,651.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15,283.20
|
| Rate for Payer: Riverside University Health MISP |
$10,188.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,283.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,651.20
|
| Rate for Payer: Vantage Medical Group Senior |
$21,651.20
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
OP
|
$25,472.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906820273
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$22,924.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,246.04
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21,651.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,009.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14,009.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$15,283.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: Central Health Plan Commercial |
$20,377.60
|
| Rate for Payer: Cigna of CA PPO |
$18,849.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,651.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,188.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,188.80
|
| Rate for Payer: Galaxy Health WC |
$21,651.20
|
| Rate for Payer: Global Benefits Group Commercial |
$15,283.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,924.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$19,104.00
|
| Rate for Payer: IEHP medi-cal |
$8,915.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,989.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,094.40
|
| Rate for Payer: Multiplan Commercial |
$19,104.00
|
| Rate for Payer: Networks By Design Commercial |
$16,556.80
|
| Rate for Payer: Prime Health Services Commercial |
$21,651.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15,283.20
|
| Rate for Payer: Riverside University Health MISP |
$10,188.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,283.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,651.20
|
| Rate for Payer: Vantage Medical Group Senior |
$21,651.20
|
|
|
HC TRANSCATH TRICUSP VALVE ANNUL
|
Facility
OP
|
$82,271.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906820271
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$74,043.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,472.44
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$69,930.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$45,249.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$45,249.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$49,362.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Central Health Plan Commercial |
$65,816.80
|
| Rate for Payer: Cigna of CA PPO |
$60,880.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69,930.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$74,043.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$61,703.25
|
| Rate for Payer: IEHP medi-cal |
$28,794.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,454.20
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
| Rate for Payer: Networks By Design Commercial |
$53,476.15
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$49,362.60
|
| Rate for Payer: Riverside University Health MISP |
$32,908.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49,362.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69,930.35
|
| Rate for Payer: Vantage Medical Group Senior |
$69,930.35
|
|
|
HC TRANSCATH TRICUSP VALVE ANNUL
|
Facility
IP
|
$82,271.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906820271
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$16,454.20 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Central Health Plan Commercial |
$65,816.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$74,043.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,454.20
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
|
|
HC TRANSCATH TRICUSP VALVE ANNUL
|
Facility
IP
|
$82,271.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906810545
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$16,454.20 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Central Health Plan Commercial |
$65,816.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$74,043.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,454.20
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
|
|
HC TRANSCATH TRICUSP VALVE ANNUL
|
Facility
OP
|
$82,271.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906810545
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$74,043.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,472.44
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$69,930.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$45,249.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$45,249.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$49,362.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Central Health Plan Commercial |
$65,816.80
|
| Rate for Payer: Cigna of CA PPO |
$60,880.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69,930.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$74,043.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$61,703.25
|
| Rate for Payer: IEHP medi-cal |
$28,794.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,454.20
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
| Rate for Payer: Networks By Design Commercial |
$53,476.15
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$49,362.60
|
| Rate for Payer: Riverside University Health MISP |
$32,908.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49,362.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69,930.35
|
| Rate for Payer: Vantage Medical Group Senior |
$69,930.35
|
|
|
HC TRANSCATH TRICUSPVALVE IMPLANT
|
Facility
OP
|
$94,612.00
|
|
|
Service Code
|
CPT 0646T
|
| Hospital Charge Code |
906820300
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,257.00 |
| Max. Negotiated Rate |
$85,150.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10,139.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$80,420.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$52,036.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$52,036.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45,811.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55,896.77
|
| Rate for Payer: BCBS Transplant Transplant |
$56,767.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$42,575.40
|
| Rate for Payer: Cash Price |
$42,575.40
|
| Rate for Payer: Cash Price |
$42,575.40
|
| Rate for Payer: Central Health Plan Commercial |
$75,689.60
|
| Rate for Payer: Cigna of CA PPO |
$70,012.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$80,420.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,844.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$37,844.80
|
| Rate for Payer: Galaxy Health WC |
$80,420.20
|
| Rate for Payer: Global Benefits Group Commercial |
$56,767.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$85,150.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$70,959.00
|
| Rate for Payer: IEHP medi-cal |
$33,114.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63,106.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,922.40
|
| Rate for Payer: Multiplan Commercial |
$70,959.00
|
| Rate for Payer: Networks By Design Commercial |
$61,497.80
|
| Rate for Payer: Prime Health Services Commercial |
$80,420.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$56,767.20
|
| Rate for Payer: Riverside University Health MISP |
$37,844.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56,767.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$80,420.20
|
| Rate for Payer: Vantage Medical Group Senior |
$80,420.20
|
|
|
HC TRANSCATH TRICUSPVALVE IMPLANT
|
Facility
IP
|
$94,612.00
|
|
|
Service Code
|
CPT 0646T
|
| Hospital Charge Code |
906820300
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$18,922.40 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$42,575.40
|
| Rate for Payer: Cash Price |
$42,575.40
|
| Rate for Payer: Central Health Plan Commercial |
$75,689.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,844.80
|
| Rate for Payer: Galaxy Health WC |
$80,420.20
|
| Rate for Payer: Global Benefits Group Commercial |
$56,767.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$85,150.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63,106.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,922.40
|
| Rate for Payer: Multiplan Commercial |
$70,959.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$80,420.20
|
|
|
HC TRANSCATH TRICUSPVALVE IMPLANT
|
Facility
OP
|
$94,612.00
|
|
|
Service Code
|
CPT 0646T
|
| Hospital Charge Code |
906803799
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,257.00 |
| Max. Negotiated Rate |
$85,150.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10,139.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$80,420.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$52,036.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$52,036.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$45,811.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55,896.77
|
| Rate for Payer: BCBS Transplant Transplant |
$56,767.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$42,575.40
|
| Rate for Payer: Cash Price |
$42,575.40
|
| Rate for Payer: Cash Price |
$42,575.40
|
| Rate for Payer: Central Health Plan Commercial |
$75,689.60
|
| Rate for Payer: Cigna of CA PPO |
$70,012.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$80,420.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,844.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$37,844.80
|
| Rate for Payer: Galaxy Health WC |
$80,420.20
|
| Rate for Payer: Global Benefits Group Commercial |
$56,767.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$85,150.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$70,959.00
|
| Rate for Payer: IEHP medi-cal |
$33,114.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63,106.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,922.40
|
| Rate for Payer: Multiplan Commercial |
$70,959.00
|
| Rate for Payer: Networks By Design Commercial |
$61,497.80
|
| Rate for Payer: Prime Health Services Commercial |
$80,420.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$56,767.20
|
| Rate for Payer: Riverside University Health MISP |
$37,844.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56,767.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$80,420.20
|
| Rate for Payer: Vantage Medical Group Senior |
$80,420.20
|
|
|
HC TRANSCATH TRICUSPVALVE IMPLANT
|
Facility
IP
|
$94,612.00
|
|
|
Service Code
|
CPT 0646T
|
| Hospital Charge Code |
906803799
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$18,922.40 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$42,575.40
|
| Rate for Payer: Cash Price |
$42,575.40
|
| Rate for Payer: Central Health Plan Commercial |
$75,689.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,844.80
|
| Rate for Payer: Galaxy Health WC |
$80,420.20
|
| Rate for Payer: Global Benefits Group Commercial |
$56,767.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$85,150.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63,106.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18,922.40
|
| Rate for Payer: Multiplan Commercial |
$70,959.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$80,420.20
|
|
|
HC TRANSCATH TRICUSP VALVE REPAIR
|
Facility
IP
|
$82,271.00
|
|
|
Service Code
|
CPT 0569T
|
| Hospital Charge Code |
906820272
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$16,454.20 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Central Health Plan Commercial |
$65,816.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$74,043.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,454.20
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
|
|
HC TRANSCATH TRICUSP VALVE REPAIR
|
Facility
OP
|
$82,271.00
|
|
|
Service Code
|
CPT 0569T
|
| Hospital Charge Code |
906810569
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$74,043.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,472.44
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$69,930.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$45,249.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$45,249.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$49,362.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Central Health Plan Commercial |
$65,816.80
|
| Rate for Payer: Cigna of CA PPO |
$60,880.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69,930.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$74,043.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$61,703.25
|
| Rate for Payer: IEHP medi-cal |
$28,794.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,454.20
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
| Rate for Payer: Networks By Design Commercial |
$53,476.15
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$49,362.60
|
| Rate for Payer: Riverside University Health MISP |
$32,908.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49,362.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69,930.35
|
| Rate for Payer: Vantage Medical Group Senior |
$69,930.35
|
|
|
HC TRANSCATH TRICUSP VALVE REPAIR
|
Facility
IP
|
$82,271.00
|
|
|
Service Code
|
CPT 0569T
|
| Hospital Charge Code |
906810569
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$16,454.20 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Central Health Plan Commercial |
$65,816.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$74,043.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,454.20
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
|
|
HC TRANSCATH TRICUSP VALVE REPAIR
|
Facility
OP
|
$82,271.00
|
|
|
Service Code
|
CPT 0569T
|
| Hospital Charge Code |
906820272
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$683.14 |
| Max. Negotiated Rate |
$74,043.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$52,472.44
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$69,930.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$45,249.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$45,249.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: BCBS Transplant Transplant |
$49,362.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Central Health Plan Commercial |
$65,816.80
|
| Rate for Payer: Cigna of CA PPO |
$60,880.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69,930.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$32,908.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$32,908.40
|
| Rate for Payer: Galaxy Health WC |
$69,930.35
|
| Rate for Payer: Global Benefits Group Commercial |
$49,362.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$74,043.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$61,703.25
|
| Rate for Payer: IEHP medi-cal |
$28,794.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54,874.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,454.20
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
| Rate for Payer: Networks By Design Commercial |
$53,476.15
|
| Rate for Payer: Prime Health Services Commercial |
$69,930.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$49,362.60
|
| Rate for Payer: Riverside University Health MISP |
$32,908.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49,362.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69,930.35
|
| Rate for Payer: Vantage Medical Group Senior |
$69,930.35
|
|
|
HC TRANSCRANIAL DUPLEX/DOPPLER
|
Facility
IP
|
$1,349.00
|
|
|
Service Code
|
CPT 93888
|
| Hospital Charge Code |
906601144
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.80 |
| Max. Negotiated Rate |
$1,214.10 |
| Rate for Payer: Cash Price |
$607.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,079.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$539.60
|
| Rate for Payer: Galaxy Health WC |
$1,146.65
|
| Rate for Payer: Global Benefits Group Commercial |
$809.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,214.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$899.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.80
|
| Rate for Payer: Multiplan Commercial |
$1,011.75
|
| Rate for Payer: Networks By Design Commercial |
$876.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,146.65
|
|
|
HC TRANSCRANIAL DUPLEX/DOPPLER
|
Facility
IP
|
$2,729.00
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
906601143
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$545.80 |
| Max. Negotiated Rate |
$2,456.10 |
| Rate for Payer: Cash Price |
$1,228.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,183.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,091.60
|
| Rate for Payer: Galaxy Health WC |
$2,319.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,637.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,456.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,820.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$545.80
|
| Rate for Payer: Multiplan Commercial |
$2,046.75
|
| Rate for Payer: Networks By Design Commercial |
$1,773.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,319.65
|
|
|
HC TRANSCRANIAL DUPLEX/DOPPLER
|
Facility
OP
|
$1,349.00
|
|
|
Service Code
|
CPT 93888
|
| Hospital Charge Code |
906601144
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$1,507.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$137.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$378.33
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$642.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$796.99
|
| Rate for Payer: BCBS Transplant Transplant |
$809.40
|
| Rate for Payer: Blue Shield of California Commercial |
$833.68
|
| Rate for Payer: Blue Shield of California EPN |
$655.61
|
| Rate for Payer: Caremore Medicare Advantage |
$137.36
|
| Rate for Payer: Cash Price |
$607.05
|
| Rate for Payer: Cash Price |
$607.05
|
| Rate for Payer: Cash Price |
$607.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,079.20
|
| Rate for Payer: Cigna of CA HMO |
$863.36
|
| Rate for Payer: Cigna of CA PPO |
$998.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$1,146.65
|
| Rate for Payer: Global Benefits Group Commercial |
$809.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,214.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,011.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$225.27
|
| Rate for Payer: IEHP medi-cal |
$226.64
|
| Rate for Payer: IEHP Medicare Advantage |
$137.36
|
| Rate for Payer: Innovage PACE Commercial |
$206.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$899.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$1,011.75
|
| Rate for Payer: Networks By Design Commercial |
$876.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,146.65
|
| Rate for Payer: Prime Health Services Medicare |
$145.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$809.40
|
| Rate for Payer: Riverside University Health MISP |
$151.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$809.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$809.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,507.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,228.00
|
| Rate for Payer: United Healthcare HMO Rider |
$931.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$851.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC TRANSCRANIAL DUPLEX/DOPPLER
|
Facility
OP
|
$2,729.00
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
906601143
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$306.16 |
| Max. Negotiated Rate |
$2,456.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$306.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$931.40
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$306.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$974.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,612.29
|
| Rate for Payer: BCBS Transplant Transplant |
$1,637.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,686.52
|
| Rate for Payer: Blue Shield of California EPN |
$1,326.29
|
| Rate for Payer: Caremore Medicare Advantage |
$306.16
|
| Rate for Payer: Cash Price |
$1,228.05
|
| Rate for Payer: Cash Price |
$1,228.05
|
| Rate for Payer: Cash Price |
$1,228.05
|
| Rate for Payer: Central Health Plan Commercial |
$2,183.20
|
| Rate for Payer: Cigna of CA HMO |
$1,746.56
|
| Rate for Payer: Cigna of CA PPO |
$2,019.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$459.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$413.32
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$306.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$306.16
|
| Rate for Payer: Galaxy Health WC |
$2,319.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,637.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,456.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,046.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$502.10
|
| Rate for Payer: IEHP medi-cal |
$505.16
|
| Rate for Payer: IEHP Medicare Advantage |
$306.16
|
| Rate for Payer: Innovage PACE Commercial |
$459.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,820.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$306.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$545.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$410.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$410.25
|
| Rate for Payer: Multiplan Commercial |
$2,046.75
|
| Rate for Payer: Networks By Design Commercial |
$1,773.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,319.65
|
| Rate for Payer: Prime Health Services Medicare |
$324.53
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,637.40
|
| Rate for Payer: Riverside University Health MISP |
$336.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,637.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,637.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,507.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,228.00
|
| Rate for Payer: United Healthcare HMO Rider |
$931.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$851.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$459.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$336.78
|
| Rate for Payer: Vantage Medical Group Senior |
$306.16
|
|
|
HC TRANSDUCER PED A-LINE CVP
|
Facility
OP
|
$242.20
|
|
| Hospital Charge Code |
901604261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.44 |
| Max. Negotiated Rate |
$217.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$147.09
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$205.87
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$133.21
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$133.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$117.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$143.09
|
| Rate for Payer: BCBS Transplant Transplant |
$145.32
|
| Rate for Payer: Blue Shield of California Commercial |
$152.34
|
| Rate for Payer: Blue Shield of California EPN |
$118.44
|
| Rate for Payer: Cash Price |
$108.99
|
| Rate for Payer: Central Health Plan Commercial |
$193.76
|
| Rate for Payer: Cigna of CA HMO |
$155.01
|
| Rate for Payer: Cigna of CA PPO |
$179.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$205.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.88
|
| Rate for Payer: EPIC Health Plan Transplant |
$96.88
|
| Rate for Payer: Galaxy Health WC |
$205.87
|
| Rate for Payer: Global Benefits Group Commercial |
$145.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$217.98
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$181.65
|
| Rate for Payer: IEHP medi-cal |
$84.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$161.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.44
|
| Rate for Payer: Multiplan Commercial |
$181.65
|
| Rate for Payer: Networks By Design Commercial |
$157.43
|
| Rate for Payer: Prime Health Services Commercial |
$205.87
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$145.32
|
| Rate for Payer: Riverside University Health MISP |
$96.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$145.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$145.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.10
|
| Rate for Payer: United Healthcare All Other HMO |
$121.10
|
| Rate for Payer: United Healthcare HMO Rider |
$121.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$121.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$205.87
|
| Rate for Payer: Vantage Medical Group Senior |
$205.87
|
|
|
HC TRANSDUCER PED A-LINE CVP
|
Facility
IP
|
$242.20
|
|
| Hospital Charge Code |
901604261
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$48.44 |
| Max. Negotiated Rate |
$217.98 |
| Rate for Payer: Cash Price |
$108.99
|
| Rate for Payer: Central Health Plan Commercial |
$193.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.88
|
| Rate for Payer: Galaxy Health WC |
$205.87
|
| Rate for Payer: Global Benefits Group Commercial |
$145.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$217.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$161.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.44
|
| Rate for Payer: Multiplan Commercial |
$181.65
|
| Rate for Payer: Networks By Design Commercial |
$157.43
|
| Rate for Payer: Prime Health Services Commercial |
$205.87
|
|
|
HC TRANSESOPHOGEAL CARDIAC OUTPUT
|
Facility
OP
|
$635.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
900800525
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$127.00 |
| Max. Negotiated Rate |
$725.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$195.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$385.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$307.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$375.16
|
| Rate for Payer: BCBS Transplant Transplant |
$381.00
|
| Rate for Payer: Blue Shield of California Commercial |
$392.43
|
| Rate for Payer: Blue Shield of California EPN |
$308.61
|
| Rate for Payer: Caremore Medicare Advantage |
$195.17
|
| Rate for Payer: Cash Price |
$285.75
|
| Rate for Payer: Cash Price |
$285.75
|
| Rate for Payer: Cash Price |
$285.75
|
| Rate for Payer: Central Health Plan Commercial |
$508.00
|
| Rate for Payer: Cigna of CA HMO |
$406.40
|
| Rate for Payer: Cigna of CA PPO |
$469.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$539.75
|
| Rate for Payer: Global Benefits Group Commercial |
$381.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$571.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$476.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.08
|
| Rate for Payer: IEHP medi-cal |
$322.03
|
| Rate for Payer: IEHP Medicare Advantage |
$195.17
|
| Rate for Payer: Innovage PACE Commercial |
$292.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$423.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$476.25
|
| Rate for Payer: Networks By Design Commercial |
$412.75
|
| Rate for Payer: Prime Health Services Commercial |
$539.75
|
| Rate for Payer: Prime Health Services Medicare |
$206.88
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$381.00
|
| Rate for Payer: Riverside University Health MISP |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$381.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$381.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$725.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$696.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$636.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC TRANSESOPHOGEAL CARDIAC OUTPUT
|
Facility
IP
|
$635.00
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
900800525
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$127.00 |
| Max. Negotiated Rate |
$571.50 |
| Rate for Payer: Cash Price |
$285.75
|
| Rate for Payer: Central Health Plan Commercial |
$508.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.00
|
| Rate for Payer: Galaxy Health WC |
$539.75
|
| Rate for Payer: Global Benefits Group Commercial |
$381.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$571.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$423.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.00
|
| Rate for Payer: Multiplan Commercial |
$476.25
|
| Rate for Payer: Networks By Design Commercial |
$412.75
|
| Rate for Payer: Prime Health Services Commercial |
$539.75
|
|
|
HC TRANSFERRIN
|
Facility
OP
|
$49.00
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
900910854
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$116.61 |
| Rate for Payer: Adventist Health Medi-Cal |
$12.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$93.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$95.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$116.61
|
| Rate for Payer: BCBS Transplant Transplant |
$29.40
|
| Rate for Payer: Blue Shield of California Commercial |
$30.28
|
| Rate for Payer: Blue Shield of California EPN |
$23.81
|
| Rate for Payer: Caremore Medicare Advantage |
$12.76
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Central Health Plan Commercial |
$39.20
|
| Rate for Payer: Cigna of CA HMO |
$31.36
|
| Rate for Payer: Cigna of CA PPO |
$36.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.23
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$12.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.76
|
| Rate for Payer: Galaxy Health WC |
$41.65
|
| Rate for Payer: Global Benefits Group Commercial |
$29.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$36.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$20.93
|
| Rate for Payer: IEHP medi-cal |
$21.05
|
| Rate for Payer: IEHP Medicare Advantage |
$12.76
|
| Rate for Payer: Innovage PACE Commercial |
$19.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.10
|
| Rate for Payer: Multiplan Commercial |
$36.75
|
| Rate for Payer: Networks By Design Commercial |
$31.85
|
| Rate for Payer: Prime Health Services Commercial |
$41.65
|
| Rate for Payer: Prime Health Services Medicare |
$13.53
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$29.40
|
| Rate for Payer: Riverside University Health MISP |
$14.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.33
|
| Rate for Payer: United Healthcare All Other HMO |
$10.33
|
| Rate for Payer: United Healthcare HMO Rider |
$10.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.04
|
| Rate for Payer: Vantage Medical Group Senior |
$12.76
|
|
|
HC TRANSFERRIN
|
Facility
IP
|
$216.00
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
900910854
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.20 |
| Max. Negotiated Rate |
$194.40 |
| Rate for Payer: Cash Price |
$97.20
|
| Rate for Payer: Central Health Plan Commercial |
$172.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.40
|
| Rate for Payer: Galaxy Health WC |
$183.60
|
| Rate for Payer: Global Benefits Group Commercial |
$129.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$194.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$144.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.20
|
| Rate for Payer: Multiplan Commercial |
$162.00
|
| Rate for Payer: Networks By Design Commercial |
$140.40
|
| Rate for Payer: Prime Health Services Commercial |
$183.60
|
|
|
HC TRANSFUS BLOOD/BLOOD COMPONENT
|
Facility
OP
|
$2,564.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
906536430
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$512.80 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$542.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$542.38
|
| 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 |
$1,538.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1,612.76
|
| Rate for Payer: Blue Shield of California EPN |
$1,253.80
|
| Rate for Payer: Caremore Medicare Advantage |
$542.38
|
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Cash Price |
$1,153.80
|
| Rate for Payer: Central Health Plan Commercial |
$2,051.20
|
| Rate for Payer: Cigna of CA HMO |
$1,640.96
|
| Rate for Payer: Cigna of CA PPO |
$1,897.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$813.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$732.21
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$542.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$542.38
|
| Rate for Payer: Galaxy Health WC |
$2,179.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1,538.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,307.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,923.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$889.50
|
| Rate for Payer: IEHP medi-cal |
$894.93
|
| Rate for Payer: IEHP Medicare Advantage |
$542.38
|
| Rate for Payer: Innovage PACE Commercial |
$813.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,710.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$542.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$512.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$726.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$726.79
|
| Rate for Payer: Multiplan Commercial |
$1,923.00
|
| Rate for Payer: Networks By Design Commercial |
$1,666.60
|
| Rate for Payer: Prime Health Services Commercial |
$2,179.40
|
| Rate for Payer: Prime Health Services Medicare |
$574.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1,538.40
|
| Rate for Payer: Riverside University Health MISP |
$596.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,538.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,538.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,282.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$813.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$596.62
|
| Rate for Payer: Vantage Medical Group Senior |
$542.38
|
|
