|
HC TRANSBRONCHIAL LUNG BIOPSY
|
Facility
|
OP
|
$7,758.00
|
|
|
Service Code
|
CPT 31628
|
| Hospital Charge Code |
900803504
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$362.44 |
| Max. Negotiated Rate |
$7,682.81 |
| Rate for Payer: Adventist Health Commercial |
$1,551.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,684.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,684.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,740.14
|
| Rate for Payer: Blue Shield of California EPN |
$3,095.44
|
| Rate for Payer: Cash Price |
$4,266.90
|
| Rate for Payer: Cash Price |
$4,266.90
|
| Rate for Payer: Cash Price |
$4,266.90
|
| Rate for Payer: Central Health Plan Commercial |
$6,206.40
|
| Rate for Payer: Cigna of CA HMO |
$4,965.12
|
| Rate for Payer: Cigna of CA PPO |
$5,740.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,153.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,684.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,324.26
|
| Rate for Payer: EPIC Health Plan Senior |
$4,684.64
|
| Rate for Payer: Galaxy Health WC |
$6,594.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,654.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,982.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,682.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$362.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,684.64
|
| Rate for Payer: InnovAge PACE Commercial |
$7,026.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,174.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,684.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,551.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,277.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,277.42
|
| Rate for Payer: Multiplan Commercial |
$5,818.50
|
| Rate for Payer: Networks By Design Commercial |
$5,042.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,684.64
|
| Rate for Payer: Prime Health Services Commercial |
$6,594.30
|
| Rate for Payer: Prime Health Services Medicare |
$4,965.72
|
| Rate for Payer: Riverside University Health System MISP |
$5,153.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,654.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,654.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,879.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,879.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,879.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,879.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,684.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,684.64
|
|
|
HC TRANSBRONCHIAL LUNG BIOPSY
|
Facility
|
IP
|
$7,758.00
|
|
|
Service Code
|
CPT 31628
|
| Hospital Charge Code |
900803504
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,551.60 |
| Max. Negotiated Rate |
$6,982.20 |
| Rate for Payer: Adventist Health Commercial |
$1,551.60
|
| Rate for Payer: Cash Price |
$4,266.90
|
| Rate for Payer: Central Health Plan Commercial |
$6,206.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,103.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,103.20
|
| Rate for Payer: Galaxy Health WC |
$6,594.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,654.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,982.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,174.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,955.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,802.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,551.60
|
| Rate for Payer: Multiplan Commercial |
$5,818.50
|
| Rate for Payer: Networks By Design Commercial |
$5,042.70
|
| Rate for Payer: Prime Health Services Commercial |
$6,594.30
|
|
|
HC TRANSBRONCHIAL LUNG BX, ADD'L
|
Facility
|
IP
|
$6,644.00
|
|
|
Service Code
|
CPT 31632
|
| Hospital Charge Code |
900803507
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,328.80 |
| Max. Negotiated Rate |
$5,979.60 |
| Rate for Payer: Adventist Health Commercial |
$1,328.80
|
| Rate for Payer: Cash Price |
$3,654.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,315.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,657.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,657.60
|
| Rate for Payer: Galaxy Health WC |
$5,647.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,986.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,979.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,431.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,531.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,112.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,328.80
|
| Rate for Payer: Multiplan Commercial |
$4,983.00
|
| Rate for Payer: Networks By Design Commercial |
$4,318.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,647.40
|
|
|
HC TRANSBRONCHIAL LUNG BX, ADD'L
|
Facility
|
OP
|
$6,644.00
|
|
|
Service Code
|
CPT 31632
|
| Hospital Charge Code |
900803507
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$101.82 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$1,328.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,647.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,654.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,983.00
|
| 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 |
$4,059.48
|
| Rate for Payer: Blue Shield of California EPN |
$2,650.96
|
| Rate for Payer: Cash Price |
$3,654.20
|
| Rate for Payer: Cash Price |
$3,654.20
|
| Rate for Payer: Cash Price |
$3,654.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,315.20
|
| Rate for Payer: Cigna of CA HMO |
$4,252.16
|
| Rate for Payer: Cigna of CA PPO |
$4,916.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,647.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,647.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,647.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,657.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,657.60
|
| Rate for Payer: Galaxy Health WC |
$5,647.40
|
| Rate for Payer: Global Benefits Group Commercial |
$3,986.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,979.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$101.82
|
| Rate for Payer: InnovAge PACE Commercial |
$3,322.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,431.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$112.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,112.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,328.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,650.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,650.80
|
| Rate for Payer: Multiplan Commercial |
$4,983.00
|
| Rate for Payer: Networks By Design Commercial |
$4,318.60
|
| Rate for Payer: Prime Health Services Commercial |
$5,647.40
|
| Rate for Payer: Riverside University Health System MISP |
$2,657.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,986.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,986.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,322.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,322.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,322.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,322.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,647.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,647.40
|
| Rate for Payer: Vantage Medical Group Senior |
$5,647.40
|
|
|
HC TRANSBRONCHIAL NEEDLE BX ADD'L
|
Facility
|
IP
|
$6,083.00
|
|
|
Service Code
|
CPT 31633
|
| Hospital Charge Code |
900803509
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,216.60 |
| Max. Negotiated Rate |
$5,474.70 |
| Rate for Payer: Adventist Health Commercial |
$1,216.60
|
| Rate for Payer: Cash Price |
$3,345.65
|
| Rate for Payer: Central Health Plan Commercial |
$4,866.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,433.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,433.20
|
| Rate for Payer: Galaxy Health WC |
$5,170.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,649.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,474.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,057.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,317.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,765.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,216.60
|
| Rate for Payer: Multiplan Commercial |
$4,562.25
|
| Rate for Payer: Networks By Design Commercial |
$3,953.95
|
| Rate for Payer: Prime Health Services Commercial |
$5,170.55
|
|
|
HC TRANSBRONCHIAL NEEDLE BX ADD'L
|
Facility
|
OP
|
$6,083.00
|
|
|
Service Code
|
CPT 31633
|
| Hospital Charge Code |
900803509
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.51 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Commercial |
$1,216.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,170.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,345.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,562.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,716.71
|
| Rate for Payer: Blue Shield of California EPN |
$2,427.12
|
| Rate for Payer: Cash Price |
$3,345.65
|
| Rate for Payer: Cash Price |
$3,345.65
|
| Rate for Payer: Cash Price |
$3,345.65
|
| Rate for Payer: Central Health Plan Commercial |
$4,866.40
|
| Rate for Payer: Cigna of CA HMO |
$3,893.12
|
| Rate for Payer: Cigna of CA PPO |
$4,501.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,170.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,170.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,170.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,433.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,433.20
|
| Rate for Payer: Galaxy Health WC |
$5,170.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,649.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,474.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$125.51
|
| Rate for Payer: InnovAge PACE Commercial |
$3,041.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,057.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$138.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,765.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,216.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,258.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,258.10
|
| Rate for Payer: Multiplan Commercial |
$4,562.25
|
| Rate for Payer: Networks By Design Commercial |
$3,953.95
|
| Rate for Payer: Prime Health Services Commercial |
$5,170.55
|
| Rate for Payer: Riverside University Health System MISP |
$2,433.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,649.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,649.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,041.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,041.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,041.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,041.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,170.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,170.55
|
| Rate for Payer: Vantage Medical Group Senior |
$5,170.55
|
|
|
HC TRANSBRONCHIAL W/NEEDLE BIOPSY
|
Facility
|
OP
|
$6,376.00
|
|
|
Service Code
|
CPT 31629
|
| Hospital Charge Code |
900803508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$320.18 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,275.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,684.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,684.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$7,464.14
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$3,506.80
|
| Rate for Payer: Cash Price |
$3,506.80
|
| Rate for Payer: Cash Price |
$3,506.80
|
| Rate for Payer: Central Health Plan Commercial |
$5,100.80
|
| Rate for Payer: Cigna of CA HMO |
$4,080.64
|
| Rate for Payer: Cigna of CA PPO |
$4,718.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,153.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,684.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,324.26
|
| Rate for Payer: EPIC Health Plan Senior |
$4,684.64
|
| Rate for Payer: Galaxy Health WC |
$5,419.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,825.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,738.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,682.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$320.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,684.64
|
| Rate for Payer: InnovAge PACE Commercial |
$7,026.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,252.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$353.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,684.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,275.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,277.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,277.42
|
| Rate for Payer: Multiplan Commercial |
$4,782.00
|
| Rate for Payer: Multiplan WC |
$7,464.14
|
| Rate for Payer: Networks By Design Commercial |
$4,144.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,684.64
|
| Rate for Payer: Preferred Health Network WC |
$7,616.47
|
| Rate for Payer: Prime Health Services Commercial |
$5,419.60
|
| Rate for Payer: Prime Health Services Medicare |
$4,965.72
|
| Rate for Payer: Prime Health Services WC |
$7,387.98
|
| Rate for Payer: Riverside University Health System MISP |
$5,153.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,825.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,684.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,026.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,153.10
|
| Rate for Payer: Vantage Medical Group Senior |
$4,684.64
|
|
|
HC TRANSBRONCHIAL W/NEEDLE BIOPSY
|
Facility
|
IP
|
$6,376.00
|
|
|
Service Code
|
CPT 31629
|
| Hospital Charge Code |
900803508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,275.20 |
| Max. Negotiated Rate |
$5,738.40 |
| Rate for Payer: Adventist Health Commercial |
$1,275.20
|
| Rate for Payer: Cash Price |
$3,506.80
|
| Rate for Payer: Central Health Plan Commercial |
$5,100.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,550.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,550.40
|
| Rate for Payer: Galaxy Health WC |
$5,419.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,825.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,738.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,252.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,429.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,946.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,275.20
|
| Rate for Payer: Multiplan Commercial |
$4,782.00
|
| Rate for Payer: Networks By Design Commercial |
$4,144.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,419.60
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
|
OP
|
$36,692.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906820084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,038.74 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$7,338.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,766.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,549.21
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$20,180.60
|
| Rate for Payer: Cash Price |
$20,180.60
|
| Rate for Payer: Cash Price |
$20,180.60
|
| Rate for Payer: Central Health Plan Commercial |
$29,353.60
|
| Rate for Payer: Cigna of CA HMO |
$23,849.80
|
| Rate for Payer: Cigna of CA PPO |
$27,152.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$31,188.20
|
| Rate for Payer: Global Benefits Group Commercial |
$22,015.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$33,022.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,038.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: InnovAge PACE Commercial |
$34,223.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,473.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,147.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,338.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,573.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$27,519.00
|
| Rate for Payer: Networks By Design Commercial |
$23,849.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Prime Health Services Commercial |
$31,188.20
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22,015.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22,015.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
|
OP
|
$31,188.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906812218
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,038.74 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$6,237.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,101.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,316.71
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$17,153.40
|
| Rate for Payer: Cash Price |
$17,153.40
|
| Rate for Payer: Cash Price |
$17,153.40
|
| Rate for Payer: Central Health Plan Commercial |
$24,950.40
|
| Rate for Payer: Cigna of CA HMO |
$20,272.20
|
| Rate for Payer: Cigna of CA PPO |
$23,079.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$26,509.80
|
| Rate for Payer: Global Benefits Group Commercial |
$18,712.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,069.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,038.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: InnovAge PACE Commercial |
$34,223.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,802.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,147.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,237.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,573.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$23,391.00
|
| Rate for Payer: Networks By Design Commercial |
$20,272.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Prime Health Services Commercial |
$26,509.80
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,712.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18,712.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
|
IP
|
$31,188.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906812218
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,237.60 |
| Max. Negotiated Rate |
$28,069.20 |
| Rate for Payer: Adventist Health Commercial |
$6,237.60
|
| Rate for Payer: Cash Price |
$17,153.40
|
| Rate for Payer: Central Health Plan Commercial |
$24,950.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,475.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12,475.20
|
| Rate for Payer: Galaxy Health WC |
$26,509.80
|
| Rate for Payer: Global Benefits Group Commercial |
$18,712.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,069.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,802.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,882.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,305.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,237.60
|
| Rate for Payer: Multiplan Commercial |
$23,391.00
|
| Rate for Payer: Networks By Design Commercial |
$20,272.20
|
| Rate for Payer: Prime Health Services Commercial |
$26,509.80
|
|
|
HC TRANS CATH CLOSURE/ASD
|
Facility
|
IP
|
$36,692.00
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
906820084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,338.40 |
| Max. Negotiated Rate |
$33,022.80 |
| Rate for Payer: Adventist Health Commercial |
$7,338.40
|
| Rate for Payer: Cash Price |
$20,180.60
|
| Rate for Payer: Central Health Plan Commercial |
$29,353.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,676.80
|
| Rate for Payer: EPIC Health Plan Senior |
$14,676.80
|
| Rate for Payer: Galaxy Health WC |
$31,188.20
|
| Rate for Payer: Global Benefits Group Commercial |
$22,015.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$33,022.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,473.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,979.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,712.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,338.40
|
| Rate for Payer: Multiplan Commercial |
$27,519.00
|
| Rate for Payer: Networks By Design Commercial |
$23,849.80
|
| Rate for Payer: Prime Health Services Commercial |
$31,188.20
|
|
|
HC TRANS CATH CLOSURE/VSD
|
Facility
|
OP
|
$26,558.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906820085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,308.44 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$5,311.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,859.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,597.51
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$14,606.90
|
| Rate for Payer: Cash Price |
$14,606.90
|
| Rate for Payer: Cash Price |
$14,606.90
|
| Rate for Payer: Central Health Plan Commercial |
$21,246.40
|
| Rate for Payer: Cigna of CA HMO |
$17,262.70
|
| Rate for Payer: Cigna of CA PPO |
$19,652.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$22,574.30
|
| Rate for Payer: Global Benefits Group Commercial |
$15,934.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,902.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,308.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: InnovAge PACE Commercial |
$34,223.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,714.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,445.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,311.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,573.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$19,918.50
|
| Rate for Payer: Networks By Design Commercial |
$17,262.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Prime Health Services Commercial |
$22,574.30
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,934.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,934.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC TRANS CATH CLOSURE/VSD
|
Facility
|
OP
|
$22,574.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906812219
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,308.44 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$4,514.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,930.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,257.71
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$12,415.70
|
| Rate for Payer: Cash Price |
$12,415.70
|
| Rate for Payer: Cash Price |
$12,415.70
|
| Rate for Payer: Central Health Plan Commercial |
$18,059.20
|
| Rate for Payer: Cigna of CA HMO |
$14,673.10
|
| Rate for Payer: Cigna of CA PPO |
$16,704.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$19,187.90
|
| Rate for Payer: Global Benefits Group Commercial |
$13,544.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,316.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,308.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: InnovAge PACE Commercial |
$34,223.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,056.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,445.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,514.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,573.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$16,930.50
|
| Rate for Payer: Networks By Design Commercial |
$14,673.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Prime Health Services Commercial |
$19,187.90
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,544.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13,544.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC TRANS CATH CLOSURE/VSD
|
Facility
|
IP
|
$26,558.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906820085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,311.60 |
| Max. Negotiated Rate |
$23,902.20 |
| Rate for Payer: Adventist Health Commercial |
$5,311.60
|
| Rate for Payer: Cash Price |
$14,606.90
|
| Rate for Payer: Central Health Plan Commercial |
$21,246.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,623.20
|
| Rate for Payer: EPIC Health Plan Senior |
$10,623.20
|
| Rate for Payer: Galaxy Health WC |
$22,574.30
|
| Rate for Payer: Global Benefits Group Commercial |
$15,934.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,902.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,714.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,118.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,439.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,311.60
|
| Rate for Payer: Multiplan Commercial |
$19,918.50
|
| Rate for Payer: Networks By Design Commercial |
$17,262.70
|
| Rate for Payer: Prime Health Services Commercial |
$22,574.30
|
|
|
HC TRANS CATH CLOSURE/VSD
|
Facility
|
IP
|
$22,574.00
|
|
|
Service Code
|
CPT 93581
|
| Hospital Charge Code |
906812219
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,514.80 |
| Max. Negotiated Rate |
$20,316.60 |
| Rate for Payer: Adventist Health Commercial |
$4,514.80
|
| Rate for Payer: Cash Price |
$12,415.70
|
| Rate for Payer: Central Health Plan Commercial |
$18,059.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,029.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9,029.60
|
| Rate for Payer: Galaxy Health WC |
$19,187.90
|
| Rate for Payer: Global Benefits Group Commercial |
$13,544.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,316.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,056.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,600.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,973.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,514.80
|
| Rate for Payer: Multiplan Commercial |
$16,930.50
|
| Rate for Payer: Networks By Design Commercial |
$14,673.10
|
| Rate for Payer: Prime Health Services Commercial |
$19,187.90
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$13,096.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
909081356
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,619.20 |
| Max. Negotiated Rate |
$11,786.40 |
| Rate for Payer: Adventist Health Commercial |
$2,619.20
|
| Rate for Payer: Cash Price |
$7,202.80
|
| Rate for Payer: Central Health Plan Commercial |
$10,476.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,238.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,238.40
|
| Rate for Payer: Galaxy Health WC |
$11,131.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,857.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,786.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,735.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,989.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,106.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,619.20
|
| Rate for Payer: Multiplan Commercial |
$9,822.00
|
| Rate for Payer: Networks By Design Commercial |
$8,512.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,131.60
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$6,289.00
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
909081664
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,257.80 |
| Max. Negotiated Rate |
$5,660.10 |
| Rate for Payer: Adventist Health Commercial |
$1,257.80
|
| Rate for Payer: Cash Price |
$3,458.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,031.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,515.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,515.60
|
| Rate for Payer: Galaxy Health WC |
$5,345.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,773.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,660.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,194.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,396.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,892.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,257.80
|
| Rate for Payer: Multiplan Commercial |
$4,716.75
|
| Rate for Payer: Networks By Design Commercial |
$4,087.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,345.65
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$13,096.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
909081356
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$236.93 |
| Max. Negotiated Rate |
$11,786.40 |
| Rate for Payer: Adventist Health Commercial |
$2,619.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$6,868.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,868.48
|
| 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 |
$7,949.27
|
| Rate for Payer: Blue Shield of California EPN |
$5,199.11
|
| Rate for Payer: Cash Price |
$7,202.80
|
| Rate for Payer: Cash Price |
$7,202.80
|
| Rate for Payer: Cash Price |
$7,202.80
|
| Rate for Payer: Central Health Plan Commercial |
$10,476.80
|
| Rate for Payer: Cigna of CA HMO |
$8,381.44
|
| Rate for Payer: Cigna of CA PPO |
$9,691.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,555.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,868.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,272.45
|
| Rate for Payer: EPIC Health Plan Senior |
$6,868.48
|
| Rate for Payer: Galaxy Health WC |
$11,131.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,857.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,786.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,264.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$236.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,868.48
|
| Rate for Payer: InnovAge PACE Commercial |
$10,302.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,735.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$261.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,868.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,619.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,203.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,203.76
|
| Rate for Payer: Multiplan Commercial |
$9,822.00
|
| Rate for Payer: Networks By Design Commercial |
$8,512.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,868.48
|
| Rate for Payer: Prime Health Services Commercial |
$11,131.60
|
| Rate for Payer: Prime Health Services Medicare |
$7,280.59
|
| Rate for Payer: Riverside University Health System MISP |
$7,555.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,857.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,857.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,548.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,548.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,548.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,548.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,868.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,302.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,555.33
|
| Rate for Payer: Vantage Medical Group Senior |
$6,868.48
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$6,289.00
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
909081664
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$484.94 |
| Max. Negotiated Rate |
$5,660.10 |
| Rate for Payer: Adventist Health Commercial |
$1,257.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,819.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,345.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,458.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,716.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,389.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$484.94
|
| Rate for Payer: Blue Shield of California Commercial |
$3,817.42
|
| Rate for Payer: Blue Shield of California EPN |
$2,496.73
|
| Rate for Payer: Cash Price |
$3,458.95
|
| Rate for Payer: Cash Price |
$3,458.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,031.20
|
| Rate for Payer: Cigna of CA HMO |
$4,024.96
|
| Rate for Payer: Cigna of CA PPO |
$4,653.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,345.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,345.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,345.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,515.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,515.60
|
| Rate for Payer: Galaxy Health WC |
$5,345.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3,773.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,660.10
|
| Rate for Payer: InnovAge PACE Commercial |
$3,144.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,194.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,892.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,257.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,402.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,402.30
|
| Rate for Payer: Multiplan Commercial |
$4,716.75
|
| Rate for Payer: Networks By Design Commercial |
$4,087.85
|
| Rate for Payer: Prime Health Services Commercial |
$5,345.65
|
| Rate for Payer: Riverside University Health System MISP |
$2,515.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,773.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,773.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,144.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,144.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,144.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,144.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,345.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,345.65
|
| Rate for Payer: Vantage Medical Group Senior |
$5,345.65
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
|
IP
|
$24,432.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906820253
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,886.40 |
| Max. Negotiated Rate |
$21,988.80 |
| Rate for Payer: Adventist Health Commercial |
$4,886.40
|
| Rate for Payer: Cash Price |
$13,437.60
|
| Rate for Payer: Central Health Plan Commercial |
$19,545.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,772.80
|
| Rate for Payer: EPIC Health Plan Senior |
$9,772.80
|
| Rate for Payer: Galaxy Health WC |
$20,767.20
|
| Rate for Payer: Global Benefits Group Commercial |
$14,659.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,988.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,296.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,308.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,123.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,886.40
|
| Rate for Payer: Multiplan Commercial |
$18,324.00
|
| Rate for Payer: Networks By Design Commercial |
$15,880.80
|
| Rate for Payer: Prime Health Services Commercial |
$20,767.20
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
|
IP
|
$28,097.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906811451
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,619.40 |
| Max. Negotiated Rate |
$25,287.30 |
| Rate for Payer: Adventist Health Commercial |
$5,619.40
|
| Rate for Payer: Cash Price |
$15,453.35
|
| Rate for Payer: Central Health Plan Commercial |
$22,477.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,238.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11,238.80
|
| Rate for Payer: Galaxy Health WC |
$23,882.45
|
| Rate for Payer: Global Benefits Group Commercial |
$16,858.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,287.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,740.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,704.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17,392.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,619.40
|
| Rate for Payer: Multiplan Commercial |
$21,072.75
|
| Rate for Payer: Networks By Design Commercial |
$18,263.05
|
| Rate for Payer: Prime Health Services Commercial |
$23,882.45
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
|
OP
|
$24,432.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906820253
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$436.09 |
| Max. Negotiated Rate |
$21,988.80 |
| Rate for Payer: Adventist Health Commercial |
$4,886.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$13,437.60
|
| Rate for Payer: Cash Price |
$13,437.60
|
| Rate for Payer: Cash Price |
$13,437.60
|
| Rate for Payer: Central Health Plan Commercial |
$19,545.60
|
| Rate for Payer: Cigna of CA HMO |
$15,880.80
|
| Rate for Payer: Cigna of CA PPO |
$18,079.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$20,767.20
|
| Rate for Payer: Global Benefits Group Commercial |
$14,659.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,988.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$436.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,296.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$481.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,886.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$18,324.00
|
| Rate for Payer: Networks By Design Commercial |
$15,880.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Prime Health Services Commercial |
$20,767.20
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,659.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14,659.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
|
OP
|
$28,097.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906811451
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$436.09 |
| Max. Negotiated Rate |
$25,287.30 |
| Rate for Payer: Adventist Health Commercial |
$5,619.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$15,453.35
|
| Rate for Payer: Cash Price |
$15,453.35
|
| Rate for Payer: Cash Price |
$15,453.35
|
| Rate for Payer: Central Health Plan Commercial |
$22,477.60
|
| Rate for Payer: Cigna of CA HMO |
$18,263.05
|
| Rate for Payer: Cigna of CA PPO |
$20,791.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$23,882.45
|
| Rate for Payer: Global Benefits Group Commercial |
$16,858.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,287.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$436.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,740.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$481.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,619.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$21,072.75
|
| Rate for Payer: Networks By Design Commercial |
$18,263.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Prime Health Services Commercial |
$23,882.45
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,858.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,858.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0796T
|
| Hospital Charge Code |
906819778
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,740.80 |
| Max. Negotiated Rate |
$39,333.60 |
| Rate for Payer: Adventist Health Commercial |
$8,740.80
|
| Rate for Payer: Cash Price |
$24,037.20
|
| Rate for Payer: Central Health Plan Commercial |
$34,963.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,481.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,481.60
|
| Rate for Payer: Galaxy Health WC |
$37,148.40
|
| Rate for Payer: Global Benefits Group Commercial |
$26,222.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$39,333.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29,150.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,651.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,052.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,740.80
|
| Rate for Payer: Multiplan Commercial |
$32,778.00
|
| Rate for Payer: Networks By Design Commercial |
$28,407.60
|
| Rate for Payer: Prime Health Services Commercial |
$37,148.40
|
|
