|
HC TRANSCATH RMVL REPL SC LEADLESS PMKR RA
|
Facility
|
IP
|
$43,704.00
|
|
|
Service Code
|
CPT 0825T
|
| Hospital Charge Code |
906819775
|
|
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
|
|
|
HC TRANSCATH RMVL SC LEADLESS PMKR RA
|
Facility
|
IP
|
$7,149.00
|
|
|
Service Code
|
CPT 0824T
|
| Hospital Charge Code |
906819774
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,429.80 |
| Max. Negotiated Rate |
$6,434.10 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| Rate for Payer: Cash Price |
$3,931.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,719.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,859.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,859.60
|
| Rate for Payer: Galaxy Health WC |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,434.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,768.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,723.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,425.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.80
|
| Rate for Payer: Multiplan Commercial |
$5,361.75
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
|
|
HC TRANSCATH RMVL SC LEADLESS PMKR RA
|
Facility
|
OP
|
$7,149.00
|
|
|
Service Code
|
CPT 0824T
|
| Hospital Charge Code |
906819774
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Commercial |
$1,429.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| 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 |
$3,461.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,198.61
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$3,931.95
|
| Rate for Payer: Cash Price |
$3,931.95
|
| Rate for Payer: Cash Price |
$3,931.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,719.20
|
| Rate for Payer: Cigna of CA HMO |
$4,575.36
|
| Rate for Payer: Cigna of CA PPO |
$5,290.26
|
| 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 |
$6,076.65
|
| Rate for Payer: Global Benefits Group Commercial |
$4,289.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,434.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| 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 |
$4,768.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,723.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,429.80
|
| 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 |
$5,361.75
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$4,646.85
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$6,076.65
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,289.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,574.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,574.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,574.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,574.50
|
| 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 SEPTAL REDUCT THER
|
Facility
|
IP
|
$23,492.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906820293
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,698.40 |
| Max. Negotiated Rate |
$21,142.80 |
| Rate for Payer: Adventist Health Commercial |
$4,698.40
|
| Rate for Payer: Cash Price |
$12,920.60
|
| Rate for Payer: Central Health Plan Commercial |
$18,793.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,396.80
|
| Rate for Payer: EPIC Health Plan Senior |
$9,396.80
|
| Rate for Payer: Galaxy Health WC |
$19,968.20
|
| Rate for Payer: Global Benefits Group Commercial |
$14,095.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,142.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,669.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,950.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,541.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,698.40
|
| Rate for Payer: Multiplan Commercial |
$17,619.00
|
| Rate for Payer: Networks By Design Commercial |
$15,269.80
|
| Rate for Payer: Prime Health Services Commercial |
$19,968.20
|
|
|
HC TRANSCATH SEPTAL REDUCT THER
|
Facility
|
IP
|
$19,968.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906803583
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,993.60 |
| Max. Negotiated Rate |
$17,971.20 |
| Rate for Payer: Adventist Health Commercial |
$3,993.60
|
| Rate for Payer: Cash Price |
$10,982.40
|
| Rate for Payer: Central Health Plan Commercial |
$15,974.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,987.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7,987.20
|
| Rate for Payer: Galaxy Health WC |
$16,972.80
|
| Rate for Payer: Global Benefits Group Commercial |
$11,980.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,971.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,318.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,607.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,360.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,993.60
|
| Rate for Payer: Multiplan Commercial |
$14,976.00
|
| Rate for Payer: Networks By Design Commercial |
$12,979.20
|
| Rate for Payer: Prime Health Services Commercial |
$16,972.80
|
|
|
HC TRANSCATH SEPTAL REDUCT THER
|
Facility
|
OP
|
$19,968.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906803583
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$865.52 |
| Max. Negotiated Rate |
$17,971.20 |
| Rate for Payer: Adventist Health Commercial |
$3,993.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16,972.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,982.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,976.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9,668.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,727.21
|
| 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 |
$10,982.40
|
| Rate for Payer: Cash Price |
$10,982.40
|
| Rate for Payer: Cash Price |
$10,982.40
|
| Rate for Payer: Central Health Plan Commercial |
$15,974.40
|
| Rate for Payer: Cigna of CA HMO |
$12,779.52
|
| Rate for Payer: Cigna of CA PPO |
$14,776.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16,972.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,972.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16,972.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,987.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7,987.20
|
| Rate for Payer: Galaxy Health WC |
$16,972.80
|
| Rate for Payer: Global Benefits Group Commercial |
$11,980.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,971.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$865.52
|
| Rate for Payer: InnovAge PACE Commercial |
$9,984.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,318.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$956.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,360.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,993.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13,977.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13,977.60
|
| Rate for Payer: Multiplan Commercial |
$14,976.00
|
| Rate for Payer: Networks By Design Commercial |
$12,979.20
|
| Rate for Payer: Prime Health Services Commercial |
$16,972.80
|
| Rate for Payer: Riverside University Health System MISP |
$7,987.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,980.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16,972.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,972.80
|
| Rate for Payer: Vantage Medical Group Senior |
$16,972.80
|
|
|
HC TRANSCATH SEPTAL REDUCT THER
|
Facility
|
OP
|
$23,492.00
|
|
|
Service Code
|
CPT 93583
|
| Hospital Charge Code |
906820293
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$865.52 |
| Max. Negotiated Rate |
$21,142.80 |
| Rate for Payer: Adventist Health Commercial |
$4,698.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,968.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12,920.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17,619.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,374.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,796.85
|
| 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 |
$12,920.60
|
| Rate for Payer: Cash Price |
$12,920.60
|
| Rate for Payer: Cash Price |
$12,920.60
|
| Rate for Payer: Central Health Plan Commercial |
$18,793.60
|
| Rate for Payer: Cigna of CA HMO |
$15,034.88
|
| Rate for Payer: Cigna of CA PPO |
$17,384.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,968.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$19,968.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19,968.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,396.80
|
| Rate for Payer: EPIC Health Plan Senior |
$9,396.80
|
| Rate for Payer: Galaxy Health WC |
$19,968.20
|
| Rate for Payer: Global Benefits Group Commercial |
$14,095.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,142.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$865.52
|
| Rate for Payer: InnovAge PACE Commercial |
$11,746.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,669.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$956.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,541.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,698.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,444.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,444.40
|
| Rate for Payer: Multiplan Commercial |
$17,619.00
|
| Rate for Payer: Networks By Design Commercial |
$15,269.80
|
| Rate for Payer: Prime Health Services Commercial |
$19,968.20
|
| Rate for Payer: Riverside University Health System MISP |
$9,396.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,095.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,968.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19,968.20
|
| Rate for Payer: Vantage Medical Group Senior |
$19,968.20
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
|
IP
|
$8,608.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906812173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,721.60 |
| Max. Negotiated Rate |
$7,747.20 |
| Rate for Payer: Adventist Health Commercial |
$1,721.60
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,886.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,443.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,443.20
|
| Rate for Payer: Galaxy Health WC |
$7,316.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,164.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,747.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,741.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,279.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,328.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,721.60
|
| Rate for Payer: Multiplan Commercial |
$6,456.00
|
| Rate for Payer: Networks By Design Commercial |
$5,595.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,316.80
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
|
OP
|
$8,608.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906820133
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,013.86 |
| Max. Negotiated Rate |
$7,747.20 |
| Rate for Payer: Adventist Health Commercial |
$1,721.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,227.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,316.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,734.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,456.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,995.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,013.86
|
| Rate for Payer: Blue Shield of California Commercial |
$5,225.06
|
| Rate for Payer: Blue Shield of California EPN |
$3,417.38
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,886.40
|
| Rate for Payer: Cigna of CA HMO |
$5,509.12
|
| Rate for Payer: Cigna of CA PPO |
$6,369.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,316.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,316.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,316.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,443.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,443.20
|
| Rate for Payer: Galaxy Health WC |
$7,316.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,164.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,747.20
|
| Rate for Payer: InnovAge PACE Commercial |
$4,304.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,741.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,328.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,721.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,025.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,025.60
|
| Rate for Payer: Multiplan Commercial |
$6,456.00
|
| Rate for Payer: Networks By Design Commercial |
$5,595.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,316.80
|
| Rate for Payer: Riverside University Health System MISP |
$3,443.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,164.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,164.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,304.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,304.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,304.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,304.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,316.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,316.80
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.80
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
|
OP
|
$8,608.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906812173
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,013.86 |
| Max. Negotiated Rate |
$7,747.20 |
| Rate for Payer: Adventist Health Commercial |
$1,721.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,227.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,316.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,734.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,456.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,995.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,013.86
|
| Rate for Payer: Blue Shield of California Commercial |
$5,225.06
|
| Rate for Payer: Blue Shield of California EPN |
$3,417.38
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,886.40
|
| Rate for Payer: Cigna of CA HMO |
$5,509.12
|
| Rate for Payer: Cigna of CA PPO |
$6,369.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,316.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,316.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,316.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,443.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,443.20
|
| Rate for Payer: Galaxy Health WC |
$7,316.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,164.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,747.20
|
| Rate for Payer: InnovAge PACE Commercial |
$4,304.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,741.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,328.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,721.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,025.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,025.60
|
| Rate for Payer: Multiplan Commercial |
$6,456.00
|
| Rate for Payer: Networks By Design Commercial |
$5,595.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,316.80
|
| Rate for Payer: Riverside University Health System MISP |
$3,443.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,164.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,164.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,304.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,304.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,304.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,304.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,316.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,316.80
|
| Rate for Payer: Vantage Medical Group Senior |
$7,316.80
|
|
|
HC TRANSCATH THRPY EMBOLIZATION
|
Facility
|
IP
|
$8,608.00
|
|
|
Service Code
|
CPT 75894
|
| Hospital Charge Code |
906820133
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,721.60 |
| Max. Negotiated Rate |
$7,747.20 |
| Rate for Payer: Adventist Health Commercial |
$1,721.60
|
| Rate for Payer: Cash Price |
$4,734.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,886.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,443.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,443.20
|
| Rate for Payer: Galaxy Health WC |
$7,316.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,164.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,747.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,741.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,279.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,328.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,721.60
|
| Rate for Payer: Multiplan Commercial |
$6,456.00
|
| Rate for Payer: Networks By Design Commercial |
$5,595.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,316.80
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
|
OP
|
$24,198.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906820273
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$21,778.20 |
| Rate for Payer: Adventist Health Commercial |
$4,839.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,568.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,308.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,148.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,716.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,211.49
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$13,308.90
|
| Rate for Payer: Cash Price |
$13,308.90
|
| Rate for Payer: Central Health Plan Commercial |
$19,358.40
|
| Rate for Payer: Cigna of CA HMO |
$15,486.72
|
| Rate for Payer: Cigna of CA PPO |
$17,906.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,568.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$20,568.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20,568.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,679.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9,679.20
|
| Rate for Payer: Galaxy Health WC |
$20,568.30
|
| Rate for Payer: Global Benefits Group Commercial |
$14,518.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,778.20
|
| Rate for Payer: InnovAge PACE Commercial |
$12,099.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,140.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,219.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,978.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,839.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16,938.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16,938.60
|
| Rate for Payer: Multiplan Commercial |
$18,148.50
|
| Rate for Payer: Networks By Design Commercial |
$15,728.70
|
| Rate for Payer: Prime Health Services Commercial |
$20,568.30
|
| Rate for Payer: Riverside University Health System MISP |
$9,679.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,518.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,568.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20,568.30
|
| Rate for Payer: Vantage Medical Group Senior |
$20,568.30
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
|
IP
|
$20,568.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906810570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,113.60 |
| Max. Negotiated Rate |
$18,511.20 |
| Rate for Payer: Adventist Health Commercial |
$4,113.60
|
| Rate for Payer: Cash Price |
$11,312.40
|
| Rate for Payer: Central Health Plan Commercial |
$16,454.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,227.20
|
| Rate for Payer: EPIC Health Plan Senior |
$8,227.20
|
| Rate for Payer: Galaxy Health WC |
$17,482.80
|
| Rate for Payer: Global Benefits Group Commercial |
$12,340.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,511.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,718.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,836.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,731.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,113.60
|
| Rate for Payer: Multiplan Commercial |
$15,426.00
|
| Rate for Payer: Networks By Design Commercial |
$13,369.20
|
| Rate for Payer: Prime Health Services Commercial |
$17,482.80
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
|
OP
|
$20,568.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906810570
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$18,511.20 |
| Rate for Payer: Adventist Health Commercial |
$4,113.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17,482.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,312.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15,426.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9,959.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,079.59
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$11,312.40
|
| Rate for Payer: Cash Price |
$11,312.40
|
| Rate for Payer: Central Health Plan Commercial |
$16,454.40
|
| Rate for Payer: Cigna of CA HMO |
$13,163.52
|
| Rate for Payer: Cigna of CA PPO |
$15,220.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,482.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$17,482.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17,482.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,227.20
|
| Rate for Payer: EPIC Health Plan Senior |
$8,227.20
|
| Rate for Payer: Galaxy Health WC |
$17,482.80
|
| Rate for Payer: Global Benefits Group Commercial |
$12,340.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,511.20
|
| Rate for Payer: InnovAge PACE Commercial |
$10,284.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,718.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,836.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,731.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,113.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14,397.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14,397.60
|
| Rate for Payer: Multiplan Commercial |
$15,426.00
|
| Rate for Payer: Networks By Design Commercial |
$13,369.20
|
| Rate for Payer: Prime Health Services Commercial |
$17,482.80
|
| Rate for Payer: Riverside University Health System MISP |
$8,227.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,340.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17,482.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,482.80
|
| Rate for Payer: Vantage Medical Group Senior |
$17,482.80
|
|
|
HC TRANSCATH TRICUSP VALVE ADDT
|
Facility
|
IP
|
$24,198.00
|
|
|
Service Code
|
CPT 0570T
|
| Hospital Charge Code |
906820273
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,839.60 |
| Max. Negotiated Rate |
$21,778.20 |
| Rate for Payer: Adventist Health Commercial |
$4,839.60
|
| Rate for Payer: Cash Price |
$13,308.90
|
| Rate for Payer: Central Health Plan Commercial |
$19,358.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,679.20
|
| Rate for Payer: EPIC Health Plan Senior |
$9,679.20
|
| Rate for Payer: Galaxy Health WC |
$20,568.30
|
| Rate for Payer: Global Benefits Group Commercial |
$14,518.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,778.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,140.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,219.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,978.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,839.60
|
| Rate for Payer: Multiplan Commercial |
$18,148.50
|
| Rate for Payer: Networks By Design Commercial |
$15,728.70
|
| Rate for Payer: Prime Health Services Commercial |
$20,568.30
|
|
|
HC TRANSCATH TRICUSP VALVE ANNUL
|
Facility
|
IP
|
$78,157.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906820271
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,631.40 |
| Max. Negotiated Rate |
$70,341.30 |
| Rate for Payer: Adventist Health Commercial |
$15,631.40
|
| Rate for Payer: Cash Price |
$42,986.35
|
| Rate for Payer: Central Health Plan Commercial |
$62,525.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,262.80
|
| Rate for Payer: EPIC Health Plan Senior |
$31,262.80
|
| Rate for Payer: Galaxy Health WC |
$66,433.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,894.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$70,341.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52,130.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,777.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,379.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,631.40
|
| Rate for Payer: Multiplan Commercial |
$58,617.75
|
| Rate for Payer: Networks By Design Commercial |
$50,802.05
|
| Rate for Payer: Prime Health Services Commercial |
$66,433.45
|
|
|
HC TRANSCATH TRICUSP VALVE ANNUL
|
Facility
|
OP
|
$66,433.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906810545
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$59,789.70 |
| Rate for Payer: Adventist Health Commercial |
$13,286.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56,468.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36,538.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49,824.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32,166.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39,016.10
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$36,538.15
|
| Rate for Payer: Cash Price |
$36,538.15
|
| Rate for Payer: Central Health Plan Commercial |
$53,146.40
|
| Rate for Payer: Cigna of CA HMO |
$42,517.12
|
| Rate for Payer: Cigna of CA PPO |
$49,160.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56,468.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$56,468.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56,468.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,573.20
|
| Rate for Payer: EPIC Health Plan Senior |
$26,573.20
|
| Rate for Payer: Galaxy Health WC |
$56,468.05
|
| Rate for Payer: Global Benefits Group Commercial |
$39,859.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$59,789.70
|
| Rate for Payer: InnovAge PACE Commercial |
$33,216.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44,310.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25,310.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,122.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,286.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46,503.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,503.10
|
| Rate for Payer: Multiplan Commercial |
$49,824.75
|
| Rate for Payer: Networks By Design Commercial |
$43,181.45
|
| Rate for Payer: Prime Health Services Commercial |
$56,468.05
|
| Rate for Payer: Riverside University Health System MISP |
$26,573.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39,859.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56,468.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56,468.05
|
| Rate for Payer: Vantage Medical Group Senior |
$56,468.05
|
|
|
HC TRANSCATH TRICUSP VALVE ANNUL
|
Facility
|
OP
|
$78,157.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906820271
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$70,341.30 |
| Rate for Payer: Adventist Health Commercial |
$15,631.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$66,433.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42,986.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58,617.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37,843.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,901.61
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$42,986.35
|
| Rate for Payer: Cash Price |
$42,986.35
|
| Rate for Payer: Central Health Plan Commercial |
$62,525.60
|
| Rate for Payer: Cigna of CA HMO |
$50,020.48
|
| Rate for Payer: Cigna of CA PPO |
$57,836.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$66,433.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$66,433.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$66,433.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,262.80
|
| Rate for Payer: EPIC Health Plan Senior |
$31,262.80
|
| Rate for Payer: Galaxy Health WC |
$66,433.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,894.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$70,341.30
|
| Rate for Payer: InnovAge PACE Commercial |
$39,078.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52,130.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,777.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,379.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,631.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,709.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,709.90
|
| Rate for Payer: Multiplan Commercial |
$58,617.75
|
| Rate for Payer: Networks By Design Commercial |
$50,802.05
|
| Rate for Payer: Prime Health Services Commercial |
$66,433.45
|
| Rate for Payer: Riverside University Health System MISP |
$31,262.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46,894.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$66,433.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$66,433.45
|
| Rate for Payer: Vantage Medical Group Senior |
$66,433.45
|
|
|
HC TRANSCATH TRICUSP VALVE ANNUL
|
Facility
|
IP
|
$66,433.00
|
|
|
Service Code
|
CPT 0545T
|
| Hospital Charge Code |
906810545
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13,286.60 |
| Max. Negotiated Rate |
$59,789.70 |
| Rate for Payer: Adventist Health Commercial |
$13,286.60
|
| Rate for Payer: Cash Price |
$36,538.15
|
| Rate for Payer: Central Health Plan Commercial |
$53,146.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,573.20
|
| Rate for Payer: EPIC Health Plan Senior |
$26,573.20
|
| Rate for Payer: Galaxy Health WC |
$56,468.05
|
| Rate for Payer: Global Benefits Group Commercial |
$39,859.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$59,789.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44,310.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25,310.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,122.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,286.60
|
| Rate for Payer: Multiplan Commercial |
$49,824.75
|
| Rate for Payer: Networks By Design Commercial |
$43,181.45
|
| Rate for Payer: Prime Health Services Commercial |
$56,468.05
|
|
|
HC TRANSCATH TRICUSPVALVE IMPLANT
|
Facility
|
OP
|
$76,399.00
|
|
|
Service Code
|
CPT 0646T
|
| Hospital Charge Code |
906803799
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$68,759.10 |
| Rate for Payer: Adventist Health Commercial |
$15,279.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64,939.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42,019.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$57,299.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36,992.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44,869.13
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$42,019.45
|
| Rate for Payer: Cash Price |
$42,019.45
|
| Rate for Payer: Central Health Plan Commercial |
$61,119.20
|
| Rate for Payer: Cigna of CA HMO |
$48,895.36
|
| Rate for Payer: Cigna of CA PPO |
$56,535.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64,939.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$64,939.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64,939.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,559.60
|
| Rate for Payer: EPIC Health Plan Senior |
$30,559.60
|
| Rate for Payer: Galaxy Health WC |
$64,939.15
|
| Rate for Payer: Global Benefits Group Commercial |
$45,839.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$68,759.10
|
| Rate for Payer: InnovAge PACE Commercial |
$38,199.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50,958.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,108.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,290.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,279.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53,479.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,479.30
|
| Rate for Payer: Multiplan Commercial |
$57,299.25
|
| Rate for Payer: Networks By Design Commercial |
$49,659.35
|
| Rate for Payer: Prime Health Services Commercial |
$64,939.15
|
| Rate for Payer: Riverside University Health System MISP |
$30,559.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45,839.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64,939.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64,939.15
|
| Rate for Payer: Vantage Medical Group Senior |
$64,939.15
|
|
|
HC TRANSCATH TRICUSPVALVE IMPLANT
|
Facility
|
IP
|
$89,881.00
|
|
|
Service Code
|
CPT 0646T
|
| Hospital Charge Code |
906820300
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$17,976.20 |
| Max. Negotiated Rate |
$80,892.90 |
| Rate for Payer: Adventist Health Commercial |
$17,976.20
|
| Rate for Payer: Cash Price |
$49,434.55
|
| Rate for Payer: Central Health Plan Commercial |
$71,904.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,952.40
|
| Rate for Payer: EPIC Health Plan Senior |
$35,952.40
|
| Rate for Payer: Galaxy Health WC |
$76,398.85
|
| Rate for Payer: Global Benefits Group Commercial |
$53,928.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$80,892.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59,950.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34,244.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,636.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17,976.20
|
| Rate for Payer: Multiplan Commercial |
$67,410.75
|
| Rate for Payer: Networks By Design Commercial |
$58,422.65
|
| Rate for Payer: Prime Health Services Commercial |
$76,398.85
|
|
|
HC TRANSCATH TRICUSPVALVE IMPLANT
|
Facility
|
OP
|
$89,881.00
|
|
|
Service Code
|
CPT 0646T
|
| Hospital Charge Code |
906820300
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$80,892.90 |
| Rate for Payer: Adventist Health Commercial |
$17,976.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76,398.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$49,434.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67,410.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$43,520.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52,787.11
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$49,434.55
|
| Rate for Payer: Cash Price |
$49,434.55
|
| Rate for Payer: Central Health Plan Commercial |
$71,904.80
|
| Rate for Payer: Cigna of CA HMO |
$57,523.84
|
| Rate for Payer: Cigna of CA PPO |
$66,511.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76,398.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$76,398.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$76,398.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,952.40
|
| Rate for Payer: EPIC Health Plan Senior |
$35,952.40
|
| Rate for Payer: Galaxy Health WC |
$76,398.85
|
| Rate for Payer: Global Benefits Group Commercial |
$53,928.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$80,892.90
|
| Rate for Payer: InnovAge PACE Commercial |
$44,940.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59,950.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34,244.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,636.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17,976.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62,916.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62,916.70
|
| Rate for Payer: Multiplan Commercial |
$67,410.75
|
| Rate for Payer: Networks By Design Commercial |
$58,422.65
|
| Rate for Payer: Prime Health Services Commercial |
$76,398.85
|
| Rate for Payer: Riverside University Health System MISP |
$35,952.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$53,928.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76,398.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$76,398.85
|
| Rate for Payer: Vantage Medical Group Senior |
$76,398.85
|
|
|
HC TRANSCATH TRICUSPVALVE IMPLANT
|
Facility
|
IP
|
$76,399.00
|
|
|
Service Code
|
CPT 0646T
|
| Hospital Charge Code |
906803799
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$15,279.80 |
| Max. Negotiated Rate |
$68,759.10 |
| Rate for Payer: Adventist Health Commercial |
$15,279.80
|
| Rate for Payer: Cash Price |
$42,019.45
|
| Rate for Payer: Central Health Plan Commercial |
$61,119.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,559.60
|
| Rate for Payer: EPIC Health Plan Senior |
$30,559.60
|
| Rate for Payer: Galaxy Health WC |
$64,939.15
|
| Rate for Payer: Global Benefits Group Commercial |
$45,839.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$68,759.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50,958.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,108.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,290.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,279.80
|
| Rate for Payer: Multiplan Commercial |
$57,299.25
|
| Rate for Payer: Networks By Design Commercial |
$49,659.35
|
| Rate for Payer: Prime Health Services Commercial |
$64,939.15
|
|
|
HC TRANSCATH TRICUSP VALVE REPAIR
|
Facility
|
OP
|
$78,157.00
|
|
|
Service Code
|
CPT 0569T
|
| Hospital Charge Code |
906820272
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$70,341.30 |
| Rate for Payer: Adventist Health Commercial |
$15,631.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$66,433.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42,986.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$58,617.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$37,843.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45,901.61
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$42,986.35
|
| Rate for Payer: Cash Price |
$42,986.35
|
| Rate for Payer: Central Health Plan Commercial |
$62,525.60
|
| Rate for Payer: Cigna of CA HMO |
$50,020.48
|
| Rate for Payer: Cigna of CA PPO |
$57,836.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$66,433.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$66,433.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$66,433.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$31,262.80
|
| Rate for Payer: EPIC Health Plan Senior |
$31,262.80
|
| Rate for Payer: Galaxy Health WC |
$66,433.45
|
| Rate for Payer: Global Benefits Group Commercial |
$46,894.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$70,341.30
|
| Rate for Payer: InnovAge PACE Commercial |
$39,078.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$52,130.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29,777.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,379.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,631.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$54,709.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,709.90
|
| Rate for Payer: Multiplan Commercial |
$58,617.75
|
| Rate for Payer: Networks By Design Commercial |
$50,802.05
|
| Rate for Payer: Prime Health Services Commercial |
$66,433.45
|
| Rate for Payer: Riverside University Health System MISP |
$31,262.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46,894.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$66,433.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$66,433.45
|
| Rate for Payer: Vantage Medical Group Senior |
$66,433.45
|
|
|
HC TRANSCATH TRICUSP VALVE REPAIR
|
Facility
|
IP
|
$66,433.00
|
|
|
Service Code
|
CPT 0569T
|
| Hospital Charge Code |
906810569
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$13,286.60 |
| Max. Negotiated Rate |
$59,789.70 |
| Rate for Payer: Adventist Health Commercial |
$13,286.60
|
| Rate for Payer: Cash Price |
$36,538.15
|
| Rate for Payer: Central Health Plan Commercial |
$53,146.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,573.20
|
| Rate for Payer: EPIC Health Plan Senior |
$26,573.20
|
| Rate for Payer: Galaxy Health WC |
$56,468.05
|
| Rate for Payer: Global Benefits Group Commercial |
$39,859.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$59,789.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44,310.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25,310.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,122.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,286.60
|
| Rate for Payer: Multiplan Commercial |
$49,824.75
|
| Rate for Payer: Networks By Design Commercial |
$43,181.45
|
| Rate for Payer: Prime Health Services Commercial |
$56,468.05
|
|
