|
HC VAD/CATH DECLOT THROMBOLYTIC AGENT
|
Facility
OP
|
$1,608.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
907201300
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$321.60 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$423.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$634.71
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$465.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$423.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$964.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,011.43
|
| Rate for Payer: Blue Shield of California EPN |
$786.31
|
| Rate for Payer: Caremore Medicare Advantage |
$423.14
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,286.40
|
| Rate for Payer: Cigna of CA HMO |
$1,029.12
|
| Rate for Payer: Cigna of CA PPO |
$1,189.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$634.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$571.24
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$423.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$423.14
|
| Rate for Payer: Galaxy Health WC |
$1,366.80
|
| Rate for Payer: Global Benefits Group Commercial |
$964.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1,206.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$693.95
|
| Rate for Payer: IEHP medi-cal |
$698.18
|
| Rate for Payer: IEHP Medicare Advantage |
$423.14
|
| Rate for Payer: Innovage PACE Commercial |
$634.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$423.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$567.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$567.01
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
| Rate for Payer: Prime Health Services Medicare |
$448.53
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$964.80
|
| Rate for Payer: Riverside University Health MISP |
$465.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$964.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$964.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$804.00
|
| Rate for Payer: United Healthcare All Other HMO |
$804.00
|
| Rate for Payer: United Healthcare HMO Rider |
$804.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$804.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$634.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$465.45
|
| Rate for Payer: Vantage Medical Group Senior |
$423.14
|
|
|
HC VAD/CATH DECLOT THROMBOLYTIC AGENT
|
Facility
IP
|
$1,608.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
907201300
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$321.60 |
| Max. Negotiated Rate |
$1,447.20 |
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,286.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$643.20
|
| Rate for Payer: Galaxy Health WC |
$1,366.80
|
| Rate for Payer: Global Benefits Group Commercial |
$964.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
|
|
HC VAD/CATH DECLOT THROMBOLYTIC AGENT
|
Facility
IP
|
$1,608.00
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
907201300
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$321.60 |
| Max. Negotiated Rate |
$1,447.20 |
| Rate for Payer: Cash Price |
$723.60
|
| Rate for Payer: Central Health Plan Commercial |
$1,286.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$643.20
|
| Rate for Payer: Galaxy Health WC |
$1,366.80
|
| Rate for Payer: Global Benefits Group Commercial |
$964.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,447.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,072.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$321.60
|
| Rate for Payer: Multiplan Commercial |
$1,206.00
|
| Rate for Payer: Networks By Design Commercial |
$1,045.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,366.80
|
|
|
HC VAG DEL PLUS ANTE/POST PARTUM
|
Facility
OP
|
$7,005.00
|
|
|
Service Code
|
CPT 59400
|
| Hospital Charge Code |
902400310
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$552.00 |
| Max. Negotiated Rate |
$12,884.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12,884.97
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,954.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,852.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,852.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,407.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,256.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,203.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,406.14
|
| Rate for Payer: Blue Shield of California EPN |
$3,425.44
|
| Rate for Payer: Cash Price |
$3,152.25
|
| Rate for Payer: Cash Price |
$3,152.25
|
| Rate for Payer: Cash Price |
$3,152.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,604.00
|
| Rate for Payer: Cigna of CA HMO |
$4,483.20
|
| Rate for Payer: Cigna of CA PPO |
$5,183.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,954.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,802.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,802.00
|
| Rate for Payer: Galaxy Health WC |
$5,954.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,203.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,304.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,253.75
|
| Rate for Payer: IEHP medi-cal |
$2,451.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,672.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,401.00
|
| Rate for Payer: Multiplan Commercial |
$5,253.75
|
| Rate for Payer: Networks By Design Commercial |
$4,553.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,954.25
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,203.00
|
| Rate for Payer: Riverside University Health MISP |
$2,802.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,203.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,203.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,954.25
|
| Rate for Payer: Vantage Medical Group Senior |
$5,954.25
|
|
|
HC VAG DEL PLUS ANTE/POST PARTUM
|
Facility
IP
|
$7,005.00
|
|
|
Service Code
|
CPT 59400
|
| Hospital Charge Code |
902400310
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,401.00 |
| Max. Negotiated Rate |
$6,304.50 |
| Rate for Payer: Cash Price |
$3,152.25
|
| Rate for Payer: Central Health Plan Commercial |
$5,604.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,802.00
|
| Rate for Payer: Galaxy Health WC |
$5,954.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,203.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,304.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,672.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,401.00
|
| Rate for Payer: Multiplan Commercial |
$5,253.75
|
| Rate for Payer: Networks By Design Commercial |
$4,553.25
|
| Rate for Payer: Prime Health Services Commercial |
$5,954.25
|
|
|
HC VAGINAL DELIVERY ONLY
|
Facility
IP
|
$5,305.00
|
|
|
Service Code
|
CPT 59409
|
| Hospital Charge Code |
900501171
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,061.00 |
| Max. Negotiated Rate |
$4,774.50 |
| Rate for Payer: Cash Price |
$2,387.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,244.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,122.00
|
| Rate for Payer: Galaxy Health WC |
$4,509.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,183.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,774.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,538.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,061.00
|
| Rate for Payer: Multiplan Commercial |
$3,978.75
|
| Rate for Payer: Networks By Design Commercial |
$3,448.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,509.25
|
|
|
HC VAGINAL DELIVERY ONLY
|
Facility
OP
|
$5,305.00
|
|
|
Service Code
|
CPT 59409
|
| Hospital Charge Code |
900501171
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$10,256.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,906.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,407.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,256.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,183.00
|
| Rate for Payer: Caremore Medicare Advantage |
$3,906.18
|
| Rate for Payer: Cash Price |
$2,387.25
|
| Rate for Payer: Cash Price |
$2,387.25
|
| Rate for Payer: Cash Price |
$2,387.25
|
| Rate for Payer: Cash Price |
$2,387.25
|
| Rate for Payer: Central Health Plan Commercial |
$4,244.00
|
| Rate for Payer: Cigna of CA PPO |
$3,925.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,859.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,273.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,906.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,906.18
|
| Rate for Payer: Galaxy Health WC |
$4,509.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3,183.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,774.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,978.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,406.14
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$3,906.18
|
| Rate for Payer: Innovage PACE Commercial |
$5,859.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,538.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,906.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,061.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,234.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,234.28
|
| Rate for Payer: Multiplan Commercial |
$3,978.75
|
| Rate for Payer: Networks By Design Commercial |
$3,448.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,509.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,140.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,183.00
|
| Rate for Payer: Riverside University Health MISP |
$4,296.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,183.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,652.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,652.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,652.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,652.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,906.18
|
|
|
HC VAGINAL REPAIR
|
Facility
IP
|
$7,236.00
|
|
|
Service Code
|
CPT 59300
|
| Hospital Charge Code |
902400755
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,447.20 |
| Max. Negotiated Rate |
$6,512.40 |
| Rate for Payer: Cash Price |
$3,256.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,788.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,894.40
|
| Rate for Payer: Galaxy Health WC |
$6,150.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,341.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,512.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,826.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,447.20
|
| Rate for Payer: Multiplan Commercial |
$5,427.00
|
| Rate for Payer: Networks By Design Commercial |
$4,703.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,150.60
|
|
|
HC VAGINAL REPAIR
|
Facility
OP
|
$7,236.00
|
|
|
Service Code
|
CPT 59300
|
| Hospital Charge Code |
902400755
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$552.00 |
| Max. Negotiated Rate |
$7,084.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,906.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,906.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,341.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4,551.44
|
| Rate for Payer: Blue Shield of California EPN |
$3,538.40
|
| Rate for Payer: Caremore Medicare Advantage |
$3,906.18
|
| Rate for Payer: Cash Price |
$3,256.20
|
| Rate for Payer: Cash Price |
$3,256.20
|
| Rate for Payer: Cash Price |
$3,256.20
|
| Rate for Payer: Central Health Plan Commercial |
$5,788.80
|
| Rate for Payer: Cigna of CA HMO |
$4,631.04
|
| Rate for Payer: Cigna of CA PPO |
$5,354.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,859.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,273.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,906.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,906.18
|
| Rate for Payer: Galaxy Health WC |
$6,150.60
|
| Rate for Payer: Global Benefits Group Commercial |
$4,341.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,512.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,427.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,406.14
|
| Rate for Payer: IEHP medi-cal |
$6,445.20
|
| Rate for Payer: IEHP Medicare Advantage |
$3,906.18
|
| Rate for Payer: Innovage PACE Commercial |
$5,859.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,826.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,906.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,447.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,234.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,234.28
|
| Rate for Payer: Multiplan Commercial |
$5,427.00
|
| Rate for Payer: Networks By Design Commercial |
$4,703.40
|
| Rate for Payer: Prime Health Services Commercial |
$6,150.60
|
| Rate for Payer: Prime Health Services Medicare |
$4,140.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,341.60
|
| Rate for Payer: Riverside University Health MISP |
$4,296.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,341.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,341.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,906.18
|
|
|
HC VALPROIC ACID (DEPAKENE)
|
Facility
IP
|
$223.00
|
|
|
Service Code
|
CPT 80164
|
| Hospital Charge Code |
900910927
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.60 |
| Max. Negotiated Rate |
$200.70 |
| Rate for Payer: Cash Price |
$100.35
|
| Rate for Payer: Central Health Plan Commercial |
$178.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$89.20
|
| Rate for Payer: Galaxy Health WC |
$189.55
|
| Rate for Payer: Global Benefits Group Commercial |
$133.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$200.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$148.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.60
|
| Rate for Payer: Multiplan Commercial |
$167.25
|
| Rate for Payer: Networks By Design Commercial |
$144.95
|
| Rate for Payer: Prime Health Services Commercial |
$189.55
|
|
|
HC VALPROIC ACID (DEPAKENE)
|
Facility
OP
|
$50.00
|
|
|
Service Code
|
CPT 80164
|
| Hospital Charge Code |
900910927
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$120.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$13.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$99.40
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.31
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.89
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$98.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$120.20
|
| Rate for Payer: BCBS Transplant Transplant |
$30.00
|
| Rate for Payer: Blue Shield of California Commercial |
$30.90
|
| Rate for Payer: Blue Shield of California EPN |
$24.30
|
| Rate for Payer: Caremore Medicare Advantage |
$13.54
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.54
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22.21
|
| Rate for Payer: IEHP medi-cal |
$22.34
|
| Rate for Payer: IEHP Medicare Advantage |
$13.54
|
| Rate for Payer: Innovage PACE Commercial |
$20.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.14
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Medicare |
$14.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: Riverside University Health MISP |
$14.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.97
|
| Rate for Payer: United Healthcare All Other HMO |
$10.97
|
| Rate for Payer: United Healthcare HMO Rider |
$10.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.89
|
| Rate for Payer: Vantage Medical Group Senior |
$13.54
|
|
|
HC VALVE ANTI-REFLUXALE KIT
|
Facility
IP
|
$33.13
|
|
| Hospital Charge Code |
901605441
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$29.82 |
| Rate for Payer: Cash Price |
$14.91
|
| Rate for Payer: Central Health Plan Commercial |
$26.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.25
|
| Rate for Payer: Galaxy Health WC |
$28.16
|
| Rate for Payer: Global Benefits Group Commercial |
$19.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.63
|
| Rate for Payer: Multiplan Commercial |
$24.85
|
| Rate for Payer: Networks By Design Commercial |
$21.53
|
| Rate for Payer: Prime Health Services Commercial |
$28.16
|
|
|
HC VALVE ANTI-REFLUXALE KIT
|
Facility
OP
|
$33.13
|
|
| Hospital Charge Code |
901605441
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$29.82 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20.12
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.22
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.57
|
| Rate for Payer: BCBS Transplant Transplant |
$19.88
|
| Rate for Payer: Blue Shield of California Commercial |
$20.84
|
| Rate for Payer: Blue Shield of California EPN |
$16.20
|
| Rate for Payer: Cash Price |
$14.91
|
| Rate for Payer: Central Health Plan Commercial |
$26.50
|
| Rate for Payer: Cigna of CA HMO |
$21.20
|
| Rate for Payer: Cigna of CA PPO |
$24.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.25
|
| Rate for Payer: Galaxy Health WC |
$28.16
|
| Rate for Payer: Global Benefits Group Commercial |
$19.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.82
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24.85
|
| Rate for Payer: IEHP medi-cal |
$11.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.63
|
| Rate for Payer: Multiplan Commercial |
$24.85
|
| Rate for Payer: Networks By Design Commercial |
$21.53
|
| Rate for Payer: Prime Health Services Commercial |
$28.16
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19.88
|
| Rate for Payer: Riverside University Health MISP |
$13.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.56
|
| Rate for Payer: United Healthcare All Other HMO |
$16.56
|
| Rate for Payer: United Healthcare HMO Rider |
$16.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.16
|
| Rate for Payer: Vantage Medical Group Senior |
$28.16
|
|
|
HC VALVE HEIMLICH
|
Facility
IP
|
$274.89
|
|
| Hospital Charge Code |
901600145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.98 |
| Max. Negotiated Rate |
$247.40 |
| Rate for Payer: Cash Price |
$123.70
|
| Rate for Payer: Central Health Plan Commercial |
$219.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.96
|
| Rate for Payer: Galaxy Health WC |
$233.66
|
| Rate for Payer: Global Benefits Group Commercial |
$164.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$247.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$183.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.98
|
| Rate for Payer: Multiplan Commercial |
$206.17
|
| Rate for Payer: Networks By Design Commercial |
$178.68
|
| Rate for Payer: Prime Health Services Commercial |
$233.66
|
|
|
HC VALVE HEIMLICH
|
Facility
OP
|
$274.89
|
|
| Hospital Charge Code |
901600145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.98 |
| Max. Negotiated Rate |
$247.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$166.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$233.66
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$151.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$151.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$133.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.41
|
| Rate for Payer: BCBS Transplant Transplant |
$164.93
|
| Rate for Payer: Blue Shield of California Commercial |
$172.91
|
| Rate for Payer: Blue Shield of California EPN |
$134.42
|
| Rate for Payer: Cash Price |
$123.70
|
| Rate for Payer: Central Health Plan Commercial |
$219.91
|
| Rate for Payer: Cigna of CA HMO |
$175.93
|
| Rate for Payer: Cigna of CA PPO |
$203.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$233.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$109.96
|
| Rate for Payer: Galaxy Health WC |
$233.66
|
| Rate for Payer: Global Benefits Group Commercial |
$164.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$247.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$206.17
|
| Rate for Payer: IEHP medi-cal |
$96.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$183.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.98
|
| Rate for Payer: Multiplan Commercial |
$206.17
|
| Rate for Payer: Networks By Design Commercial |
$178.68
|
| Rate for Payer: Prime Health Services Commercial |
$233.66
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$164.93
|
| Rate for Payer: Riverside University Health MISP |
$109.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$164.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$164.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$137.44
|
| Rate for Payer: United Healthcare All Other HMO |
$137.44
|
| Rate for Payer: United Healthcare HMO Rider |
$137.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$137.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$233.66
|
| Rate for Payer: Vantage Medical Group Senior |
$233.66
|
|
|
HC VALVE PASSY MUIR (PURPLE)
|
Facility
OP
|
$580.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
901605980
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$203.00 |
| Max. Negotiated Rate |
$534.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$534.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$342.66
|
| Rate for Payer: BCBS Transplant Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$435.00
|
| Rate for Payer: Blue Shield of California EPN |
$315.52
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$435.00
|
| Rate for Payer: IEHP medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.80
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC VALVE PASSY MUIR (PURPLE)
|
Facility
IP
|
$580.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
901605980
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Blue Shield of California EPN |
$309.72
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC VALVE PASSY MUIR (PURPLE)
|
Facility
OP
|
$580.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
901603797
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$203.00 |
| Max. Negotiated Rate |
$534.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$534.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$342.66
|
| Rate for Payer: BCBS Transplant Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$435.00
|
| Rate for Payer: Blue Shield of California EPN |
$315.52
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$435.00
|
| Rate for Payer: IEHP medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.80
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Riverside University Health MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC VALVE PASSY MUIR (PURPLE)
|
Facility
IP
|
$580.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
901603797
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Blue Shield of California EPN |
$309.72
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC VALVULOPLASTY, AORTIC
|
Facility
IP
|
$19,142.00
|
|
|
Service Code
|
CPT 92986
|
| Hospital Charge Code |
906820030
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,828.40 |
| Max. Negotiated Rate |
$17,227.80 |
| Rate for Payer: Cash Price |
$8,613.90
|
| Rate for Payer: Central Health Plan Commercial |
$15,313.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,656.80
|
| Rate for Payer: Galaxy Health WC |
$16,270.70
|
| Rate for Payer: Global Benefits Group Commercial |
$11,485.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,227.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,767.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,828.40
|
| Rate for Payer: Multiplan Commercial |
$14,356.50
|
| Rate for Payer: Networks By Design Commercial |
$12,442.30
|
| Rate for Payer: Prime Health Services Commercial |
$16,270.70
|
|
|
HC VALVULOPLASTY, AORTIC
|
Facility
OP
|
$19,142.00
|
|
|
Service Code
|
CPT 92986
|
| Hospital Charge Code |
906820030
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,828.40 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,141.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,988.50
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,141.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$11,485.20
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$7,141.35
|
| Rate for Payer: Cash Price |
$8,613.90
|
| Rate for Payer: Cash Price |
$8,613.90
|
| Rate for Payer: Central Health Plan Commercial |
$15,313.60
|
| Rate for Payer: Cigna of CA PPO |
$14,165.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,712.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,640.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,141.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,141.35
|
| Rate for Payer: Galaxy Health WC |
$16,270.70
|
| Rate for Payer: Global Benefits Group Commercial |
$11,485.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,227.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14,356.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,711.81
|
| Rate for Payer: IEHP medi-cal |
$11,783.23
|
| Rate for Payer: IEHP Medicare Advantage |
$7,141.35
|
| Rate for Payer: Innovage PACE Commercial |
$10,712.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,767.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,141.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,828.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,569.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,569.41
|
| Rate for Payer: Multiplan Commercial |
$14,356.50
|
| Rate for Payer: Networks By Design Commercial |
$12,442.30
|
| Rate for Payer: Prime Health Services Commercial |
$16,270.70
|
| Rate for Payer: Prime Health Services Medicare |
$7,569.83
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11,485.20
|
| Rate for Payer: Riverside University Health MISP |
$7,855.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,485.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,485.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7,141.35
|
|
|
HC VALVULOPLASTY, AORTIC
|
Facility
IP
|
$19,142.00
|
|
|
Service Code
|
CPT 92986
|
| Hospital Charge Code |
906811113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,828.40 |
| Max. Negotiated Rate |
$17,227.80 |
| Rate for Payer: Cash Price |
$8,613.90
|
| Rate for Payer: Central Health Plan Commercial |
$15,313.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,656.80
|
| Rate for Payer: Galaxy Health WC |
$16,270.70
|
| Rate for Payer: Global Benefits Group Commercial |
$11,485.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,227.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,767.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,828.40
|
| Rate for Payer: Multiplan Commercial |
$14,356.50
|
| Rate for Payer: Networks By Design Commercial |
$12,442.30
|
| Rate for Payer: Prime Health Services Commercial |
$16,270.70
|
|
|
HC VALVULOPLASTY, AORTIC
|
Facility
OP
|
$19,142.00
|
|
|
Service Code
|
CPT 92986
|
| Hospital Charge Code |
906811113
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,828.40 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,141.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,988.50
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,141.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$11,485.20
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$7,141.35
|
| Rate for Payer: Cash Price |
$8,613.90
|
| Rate for Payer: Cash Price |
$8,613.90
|
| Rate for Payer: Central Health Plan Commercial |
$15,313.60
|
| Rate for Payer: Cigna of CA PPO |
$14,165.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,712.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,640.82
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,141.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,141.35
|
| Rate for Payer: Galaxy Health WC |
$16,270.70
|
| Rate for Payer: Global Benefits Group Commercial |
$11,485.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,227.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14,356.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,711.81
|
| Rate for Payer: IEHP medi-cal |
$11,783.23
|
| Rate for Payer: IEHP Medicare Advantage |
$7,141.35
|
| Rate for Payer: Innovage PACE Commercial |
$10,712.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,767.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,141.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,828.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,569.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,569.41
|
| Rate for Payer: Multiplan Commercial |
$14,356.50
|
| Rate for Payer: Networks By Design Commercial |
$12,442.30
|
| Rate for Payer: Prime Health Services Commercial |
$16,270.70
|
| Rate for Payer: Prime Health Services Medicare |
$7,569.83
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11,485.20
|
| Rate for Payer: Riverside University Health MISP |
$7,855.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,485.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,485.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,712.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,855.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7,141.35
|
|
|
HC VALVULOPLASTY, MITRAL
|
Facility
OP
|
$12,761.00
|
|
|
Service Code
|
CPT 92987
|
| Hospital Charge Code |
906811138
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,552.20 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,244.05
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$7,656.60
|
| Rate for Payer: Blue Shield of California Commercial |
$12,373.72
|
| Rate for Payer: Blue Shield of California EPN |
$8,887.36
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$5,742.45
|
| Rate for Payer: Cash Price |
$5,742.45
|
| Rate for Payer: Central Health Plan Commercial |
$10,208.80
|
| Rate for Payer: Cigna of CA PPO |
$9,443.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$10,846.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7,656.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,484.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,570.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: IEHP medi-cal |
$22,679.61
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Innovage PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,511.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,552.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$9,570.75
|
| Rate for Payer: Networks By Design Commercial |
$8,294.65
|
| Rate for Payer: Prime Health Services Commercial |
$10,846.85
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,656.60
|
| Rate for Payer: Riverside University Health MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,656.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,656.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC VALVULOPLASTY, MITRAL
|
Facility
IP
|
$12,761.00
|
|
|
Service Code
|
CPT 92987
|
| Hospital Charge Code |
906811138
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,552.20 |
| Max. Negotiated Rate |
$11,484.90 |
| Rate for Payer: Cash Price |
$5,742.45
|
| Rate for Payer: Central Health Plan Commercial |
$10,208.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,104.40
|
| Rate for Payer: Galaxy Health WC |
$10,846.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7,656.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,484.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,511.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,552.20
|
| Rate for Payer: Multiplan Commercial |
$9,570.75
|
| Rate for Payer: Networks By Design Commercial |
$8,294.65
|
| Rate for Payer: Prime Health Services Commercial |
$10,846.85
|
|
