|
HC VENOGRAM ORBITAL
|
Facility
|
OP
|
$11,679.00
|
|
|
Service Code
|
CPT 75880
|
| Hospital Charge Code |
909081659
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$39.80 |
| Max. Negotiated Rate |
$10,511.10 |
| Rate for Payer: Adventist Health Commercial |
$2,335.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$785.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,092.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$785.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$196.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,089.15
|
| Rate for Payer: Blue Shield of California EPN |
$4,636.56
|
| Rate for Payer: Cash Price |
$6,423.45
|
| Rate for Payer: Cash Price |
$6,423.45
|
| Rate for Payer: Central Health Plan Commercial |
$9,343.20
|
| Rate for Payer: Cigna of CA HMO |
$7,474.56
|
| Rate for Payer: Cigna of CA PPO |
$8,642.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$864.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$785.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,060.51
|
| Rate for Payer: EPIC Health Plan Senior |
$785.56
|
| Rate for Payer: Galaxy Health WC |
$9,927.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,007.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,511.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,288.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$785.56
|
| Rate for Payer: InnovAge PACE Commercial |
$1,178.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,789.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$785.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,335.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,052.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,052.65
|
| Rate for Payer: Multiplan Commercial |
$8,759.25
|
| Rate for Payer: Networks By Design Commercial |
$7,591.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$785.56
|
| Rate for Payer: Prime Health Services Commercial |
$9,927.15
|
| Rate for Payer: Prime Health Services Medicare |
$832.69
|
| Rate for Payer: Riverside University Health System MISP |
$864.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,007.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,007.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,688.24
|
| Rate for Payer: United Healthcare All Other HMO |
$1,688.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,688.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,688.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$785.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Vantage Medical Group Senior |
$785.56
|
|
|
HC VENOGRAM RENAL BILAT
|
Facility
|
IP
|
$11,336.00
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
909081636
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,267.20 |
| Max. Negotiated Rate |
$10,202.40 |
| Rate for Payer: Adventist Health Commercial |
$2,267.20
|
| Rate for Payer: Cash Price |
$6,234.80
|
| Rate for Payer: Central Health Plan Commercial |
$9,068.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,534.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4,534.40
|
| Rate for Payer: Galaxy Health WC |
$9,635.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,801.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,202.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,561.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,319.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,016.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,267.20
|
| Rate for Payer: Multiplan Commercial |
$8,502.00
|
| Rate for Payer: Networks By Design Commercial |
$7,368.40
|
| Rate for Payer: Prime Health Services Commercial |
$9,635.60
|
|
|
HC VENOGRAM RENAL BILAT
|
Facility
|
OP
|
$11,336.00
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
909081636
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$532.28 |
| Max. Negotiated Rate |
$10,202.40 |
| Rate for Payer: Adventist Health Commercial |
$2,267.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,884.35
|
| 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 |
$2,622.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$532.28
|
| Rate for Payer: Blue Shield of California Commercial |
$6,880.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,500.39
|
| Rate for Payer: Cash Price |
$6,234.80
|
| Rate for Payer: Cash Price |
$6,234.80
|
| Rate for Payer: Central Health Plan Commercial |
$9,068.80
|
| Rate for Payer: Cigna of CA HMO |
$7,255.04
|
| Rate for Payer: Cigna of CA PPO |
$8,388.64
|
| 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 |
$9,635.60
|
| Rate for Payer: Global Benefits Group Commercial |
$6,801.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,202.40
|
| 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 |
$7,561.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,267.20
|
| 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 |
$8,502.00
|
| Rate for Payer: Networks By Design Commercial |
$7,368.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Prime Health Services Commercial |
$9,635.60
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,801.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,801.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| 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 VENOGRAM RENAL UNILAT
|
Facility
|
OP
|
$7,557.00
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
909081578
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$532.03 |
| Max. Negotiated Rate |
$6,801.30 |
| Rate for Payer: Adventist Health Commercial |
$1,511.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,589.37
|
| 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 |
$2,621.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$532.03
|
| Rate for Payer: Blue Shield of California Commercial |
$4,587.10
|
| Rate for Payer: Blue Shield of California EPN |
$3,000.13
|
| Rate for Payer: Cash Price |
$4,156.35
|
| Rate for Payer: Cash Price |
$4,156.35
|
| Rate for Payer: Central Health Plan Commercial |
$6,045.60
|
| Rate for Payer: Cigna of CA HMO |
$4,836.48
|
| Rate for Payer: Cigna of CA PPO |
$5,592.18
|
| 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 |
$6,423.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,534.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,801.30
|
| 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 |
$5,040.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,511.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$5,667.75
|
| Rate for Payer: Networks By Design Commercial |
$4,912.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Prime Health Services Commercial |
$6,423.45
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,534.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,534.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| 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 VENOGRAM RENAL UNILAT
|
Facility
|
IP
|
$7,557.00
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
909081578
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,511.40 |
| Max. Negotiated Rate |
$6,801.30 |
| Rate for Payer: Adventist Health Commercial |
$1,511.40
|
| Rate for Payer: Cash Price |
$4,156.35
|
| Rate for Payer: Central Health Plan Commercial |
$6,045.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,022.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,022.80
|
| Rate for Payer: Galaxy Health WC |
$6,423.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,534.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,801.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,040.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,879.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,677.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,511.40
|
| Rate for Payer: Multiplan Commercial |
$5,667.75
|
| Rate for Payer: Networks By Design Commercial |
$4,912.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,423.45
|
|
|
HC VENOGRAM SUPERIOR VENACAVA
|
Facility
|
IP
|
$6,347.00
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
909081634
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,269.40 |
| Max. Negotiated Rate |
$5,712.30 |
| Rate for Payer: Adventist Health Commercial |
$1,269.40
|
| Rate for Payer: Cash Price |
$3,490.85
|
| Rate for Payer: Central Health Plan Commercial |
$5,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,538.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,538.80
|
| Rate for Payer: Galaxy Health WC |
$5,394.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,712.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,418.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,928.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,269.40
|
| Rate for Payer: Multiplan Commercial |
$4,760.25
|
| Rate for Payer: Networks By Design Commercial |
$4,125.55
|
| Rate for Payer: Prime Health Services Commercial |
$5,394.95
|
|
|
HC VENOGRAM SUPERIOR VENACAVA
|
Facility
|
OP
|
$6,347.00
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
909081634
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$187.91 |
| Max. Negotiated Rate |
$5,712.30 |
| Rate for Payer: Adventist Health Commercial |
$1,269.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,973.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,854.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,608.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$529.35
|
| Rate for Payer: Blue Shield of California Commercial |
$3,852.63
|
| Rate for Payer: Blue Shield of California EPN |
$2,519.76
|
| Rate for Payer: Cash Price |
$3,490.85
|
| Rate for Payer: Cash Price |
$3,490.85
|
| Rate for Payer: Central Health Plan Commercial |
$5,077.60
|
| Rate for Payer: Cigna of CA HMO |
$4,062.08
|
| Rate for Payer: Cigna of CA PPO |
$4,696.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,664.63
|
| Rate for Payer: EPIC Health Plan Senior |
$1,973.80
|
| Rate for Payer: Galaxy Health WC |
$5,394.95
|
| Rate for Payer: Global Benefits Group Commercial |
$3,808.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,712.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,237.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$187.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: InnovAge PACE Commercial |
$2,960.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,973.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,269.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,644.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,644.89
|
| Rate for Payer: Multiplan Commercial |
$4,760.25
|
| Rate for Payer: Networks By Design Commercial |
$4,125.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Prime Health Services Commercial |
$5,394.95
|
| Rate for Payer: Prime Health Services Medicare |
$2,092.23
|
| Rate for Payer: Riverside University Health System MISP |
$2,171.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,808.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,808.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,688.24
|
| Rate for Payer: United Healthcare All Other HMO |
$1,688.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,688.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,688.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,973.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
|
HC VENOGRAM SUPERIOR VENACAVA
|
Facility
|
OP
|
$7,467.00
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
906820196
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$187.91 |
| Max. Negotiated Rate |
$6,720.30 |
| Rate for Payer: Adventist Health Commercial |
$1,493.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,973.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,534.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,608.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$529.35
|
| Rate for Payer: Blue Shield of California Commercial |
$4,532.47
|
| Rate for Payer: Blue Shield of California EPN |
$2,964.40
|
| Rate for Payer: Cash Price |
$4,106.85
|
| Rate for Payer: Cash Price |
$4,106.85
|
| Rate for Payer: Central Health Plan Commercial |
$5,973.60
|
| Rate for Payer: Cigna of CA HMO |
$4,778.88
|
| Rate for Payer: Cigna of CA PPO |
$5,525.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,664.63
|
| Rate for Payer: EPIC Health Plan Senior |
$1,973.80
|
| Rate for Payer: Galaxy Health WC |
$6,346.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,480.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,720.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,237.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$187.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: InnovAge PACE Commercial |
$2,960.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,980.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$207.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,973.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,493.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,644.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,644.89
|
| Rate for Payer: Multiplan Commercial |
$5,600.25
|
| Rate for Payer: Networks By Design Commercial |
$4,853.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Prime Health Services Commercial |
$6,346.95
|
| Rate for Payer: Prime Health Services Medicare |
$2,092.23
|
| Rate for Payer: Riverside University Health System MISP |
$2,171.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,480.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,480.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,688.24
|
| Rate for Payer: United Healthcare All Other HMO |
$1,688.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,688.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,688.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,973.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
|
HC VENOGRAM SUPERIOR VENACAVA
|
Facility
|
IP
|
$7,467.00
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
906820196
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,493.40 |
| Max. Negotiated Rate |
$6,720.30 |
| Rate for Payer: Adventist Health Commercial |
$1,493.40
|
| Rate for Payer: Cash Price |
$4,106.85
|
| Rate for Payer: Central Health Plan Commercial |
$5,973.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,986.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,986.80
|
| Rate for Payer: Galaxy Health WC |
$6,346.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,480.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,720.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,980.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,844.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,622.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,493.40
|
| Rate for Payer: Multiplan Commercial |
$5,600.25
|
| Rate for Payer: Networks By Design Commercial |
$4,853.55
|
| Rate for Payer: Prime Health Services Commercial |
$6,346.95
|
|
|
HC VENOGRAM SUP SAG SINUS
|
Facility
|
IP
|
$4,152.00
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
909081641
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$830.40 |
| Max. Negotiated Rate |
$3,736.80 |
| Rate for Payer: Adventist Health Commercial |
$830.40
|
| Rate for Payer: Cash Price |
$2,283.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,321.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,660.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,660.80
|
| Rate for Payer: Galaxy Health WC |
$3,529.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,491.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,736.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,769.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,581.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,570.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$830.40
|
| Rate for Payer: Multiplan Commercial |
$3,114.00
|
| Rate for Payer: Networks By Design Commercial |
$2,698.80
|
| Rate for Payer: Prime Health Services Commercial |
$3,529.20
|
|
|
HC VENOGRAM SUP SAG SINUS
|
Facility
|
OP
|
$4,152.00
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
909081641
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$229.90 |
| Max. Negotiated Rate |
$6,558.70 |
| Rate for Payer: Adventist Health Commercial |
$830.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,521.51
|
| 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 |
$2,622.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$532.28
|
| Rate for Payer: Blue Shield of California Commercial |
$2,520.26
|
| Rate for Payer: Blue Shield of California EPN |
$1,648.34
|
| Rate for Payer: Cash Price |
$2,283.60
|
| Rate for Payer: Cash Price |
$2,283.60
|
| Rate for Payer: Central Health Plan Commercial |
$3,321.60
|
| Rate for Payer: Cigna of CA HMO |
$2,657.28
|
| Rate for Payer: Cigna of CA PPO |
$3,072.48
|
| 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 |
$3,529.20
|
| Rate for Payer: Global Benefits Group Commercial |
$2,491.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,736.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$229.90
|
| 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 |
$2,769.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$253.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$830.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$3,114.00
|
| Rate for Payer: Networks By Design Commercial |
$2,698.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Prime Health Services Commercial |
$3,529.20
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,491.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,491.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,688.24
|
| Rate for Payer: United Healthcare All Other HMO |
$1,688.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,688.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,688.24
|
| 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 VENOGRAPHY AZYGOS HEMIAZYGOS VENOUS
|
Facility
|
OP
|
$2,989.00
|
|
|
Service Code
|
CPT 93585
|
| Hospital Charge Code |
906811585
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$597.80 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$597.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,540.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,643.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,241.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,447.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,755.44
|
| 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 |
$1,643.95
|
| Rate for Payer: Cash Price |
$1,643.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,391.20
|
| Rate for Payer: Cigna of CA HMO |
$1,942.85
|
| Rate for Payer: Cigna of CA PPO |
$2,211.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,540.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,540.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,540.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,195.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,195.60
|
| Rate for Payer: Galaxy Health WC |
$2,540.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,793.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,690.10
|
| Rate for Payer: InnovAge PACE Commercial |
$1,494.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,993.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,850.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$597.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,092.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,092.30
|
| Rate for Payer: Multiplan Commercial |
$2,241.75
|
| Rate for Payer: Networks By Design Commercial |
$1,942.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,540.65
|
| Rate for Payer: Riverside University Health System MISP |
$1,195.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,793.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,793.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,494.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,494.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,494.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,494.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,540.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,540.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,540.65
|
|
|
HC VENOGRAPHY AZYGOS HEMIAZYGOS VENOUS
|
Facility
|
IP
|
$2,989.00
|
|
|
Service Code
|
CPT 93585
|
| Hospital Charge Code |
906811585
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$597.80 |
| Max. Negotiated Rate |
$2,690.10 |
| Rate for Payer: Adventist Health Commercial |
$597.80
|
| Rate for Payer: Cash Price |
$1,643.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,391.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,195.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,195.60
|
| Rate for Payer: Galaxy Health WC |
$2,540.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,793.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,690.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,993.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,138.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,850.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$597.80
|
| Rate for Payer: Multiplan Commercial |
$2,241.75
|
| Rate for Payer: Networks By Design Commercial |
$1,942.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,540.65
|
|
|
HC VENOGRAPHY CONG HEART DEFECT
|
Facility
|
IP
|
$2,989.00
|
|
|
Service Code
|
CPT 93584
|
| Hospital Charge Code |
906811584
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$597.80 |
| Max. Negotiated Rate |
$2,690.10 |
| Rate for Payer: Adventist Health Commercial |
$597.80
|
| Rate for Payer: Cash Price |
$1,643.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,391.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,195.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,195.60
|
| Rate for Payer: Galaxy Health WC |
$2,540.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,793.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,690.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,993.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,138.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,850.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$597.80
|
| Rate for Payer: Multiplan Commercial |
$2,241.75
|
| Rate for Payer: Networks By Design Commercial |
$1,942.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,540.65
|
|
|
HC VENOGRAPHY CONG HEART DEFECT
|
Facility
|
OP
|
$2,989.00
|
|
|
Service Code
|
CPT 93584
|
| Hospital Charge Code |
906811584
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$597.80 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$597.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,540.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,643.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,241.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,447.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,755.44
|
| 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 |
$1,643.95
|
| Rate for Payer: Cash Price |
$1,643.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,391.20
|
| Rate for Payer: Cigna of CA HMO |
$1,942.85
|
| Rate for Payer: Cigna of CA PPO |
$2,211.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,540.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,540.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,540.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,195.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,195.60
|
| Rate for Payer: Galaxy Health WC |
$2,540.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,793.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,690.10
|
| Rate for Payer: InnovAge PACE Commercial |
$1,494.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,993.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,850.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$597.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,092.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,092.30
|
| Rate for Payer: Multiplan Commercial |
$2,241.75
|
| Rate for Payer: Networks By Design Commercial |
$1,942.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,540.65
|
| Rate for Payer: Riverside University Health System MISP |
$1,195.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,793.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,793.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,494.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,494.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,494.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,494.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,540.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,540.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,540.65
|
|
|
HC VENOGRAPHY CORONARY SINUS
|
Facility
|
IP
|
$2,989.00
|
|
|
Service Code
|
CPT 93586
|
| Hospital Charge Code |
906811586
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$597.80 |
| Max. Negotiated Rate |
$2,690.10 |
| Rate for Payer: Adventist Health Commercial |
$597.80
|
| Rate for Payer: Cash Price |
$1,643.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,391.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,195.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,195.60
|
| Rate for Payer: Galaxy Health WC |
$2,540.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,793.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,690.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,993.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,138.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,850.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$597.80
|
| Rate for Payer: Multiplan Commercial |
$2,241.75
|
| Rate for Payer: Networks By Design Commercial |
$1,942.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,540.65
|
|
|
HC VENOGRAPHY CORONARY SINUS
|
Facility
|
OP
|
$2,989.00
|
|
|
Service Code
|
CPT 93586
|
| Hospital Charge Code |
906811586
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$597.80 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Commercial |
$597.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,540.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,643.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,241.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,447.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,755.44
|
| 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 |
$1,643.95
|
| Rate for Payer: Cash Price |
$1,643.95
|
| Rate for Payer: Central Health Plan Commercial |
$2,391.20
|
| Rate for Payer: Cigna of CA HMO |
$1,942.85
|
| Rate for Payer: Cigna of CA PPO |
$2,211.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,540.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,540.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,540.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,195.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,195.60
|
| Rate for Payer: Galaxy Health WC |
$2,540.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,793.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,690.10
|
| Rate for Payer: InnovAge PACE Commercial |
$1,494.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,993.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,850.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$597.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,092.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,092.30
|
| Rate for Payer: Multiplan Commercial |
$2,241.75
|
| Rate for Payer: Networks By Design Commercial |
$1,942.85
|
| Rate for Payer: Prime Health Services Commercial |
$2,540.65
|
| Rate for Payer: Riverside University Health System MISP |
$1,195.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,793.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,793.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,494.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,494.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,494.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,494.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,540.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,540.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,540.65
|
|
|
HC VENOUS 1ST ORDER CATH PLCMT
|
Facility
|
OP
|
$733.00
|
|
|
Service Code
|
CPT 36011
|
| Hospital Charge Code |
909081309
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$138.96 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$146.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$623.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$403.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$549.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$354.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$430.49
|
| 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 |
$403.15
|
| Rate for Payer: Cash Price |
$403.15
|
| Rate for Payer: Cash Price |
$403.15
|
| Rate for Payer: Central Health Plan Commercial |
$586.40
|
| Rate for Payer: Cigna of CA HMO |
$469.12
|
| Rate for Payer: Cigna of CA PPO |
$542.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$623.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$623.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$623.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.20
|
| Rate for Payer: EPIC Health Plan Senior |
$293.20
|
| Rate for Payer: Galaxy Health WC |
$623.05
|
| Rate for Payer: Global Benefits Group Commercial |
$439.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$659.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$138.96
|
| Rate for Payer: InnovAge PACE Commercial |
$366.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$488.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$153.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$453.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$513.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$513.10
|
| Rate for Payer: Multiplan Commercial |
$549.75
|
| Rate for Payer: Networks By Design Commercial |
$476.45
|
| Rate for Payer: Prime Health Services Commercial |
$623.05
|
| Rate for Payer: Riverside University Health System MISP |
$293.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$439.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$623.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$623.05
|
| Rate for Payer: Vantage Medical Group Senior |
$623.05
|
|
|
HC VENOUS 1ST ORDER CATH PLCMT
|
Facility
|
IP
|
$733.00
|
|
|
Service Code
|
CPT 36011
|
| Hospital Charge Code |
909081309
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$146.60 |
| Max. Negotiated Rate |
$659.70 |
| Rate for Payer: Adventist Health Commercial |
$146.60
|
| Rate for Payer: Cash Price |
$403.15
|
| Rate for Payer: Central Health Plan Commercial |
$586.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.20
|
| Rate for Payer: EPIC Health Plan Senior |
$293.20
|
| Rate for Payer: Galaxy Health WC |
$623.05
|
| Rate for Payer: Global Benefits Group Commercial |
$439.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$659.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$488.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$279.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$453.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$146.60
|
| Rate for Payer: Multiplan Commercial |
$549.75
|
| Rate for Payer: Networks By Design Commercial |
$476.45
|
| Rate for Payer: Prime Health Services Commercial |
$623.05
|
|
|
HC VENOUS 1ST ORDER CATH PLCMT
|
Facility
|
OP
|
$862.00
|
|
|
Service Code
|
CPT 36011
|
| Hospital Charge Code |
906820169
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$138.96 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$172.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$732.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$474.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$646.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$417.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$506.25
|
| 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 |
$474.10
|
| Rate for Payer: Cash Price |
$474.10
|
| Rate for Payer: Cash Price |
$474.10
|
| Rate for Payer: Central Health Plan Commercial |
$689.60
|
| Rate for Payer: Cigna of CA HMO |
$551.68
|
| Rate for Payer: Cigna of CA PPO |
$637.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$732.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$732.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$732.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.80
|
| Rate for Payer: EPIC Health Plan Senior |
$344.80
|
| Rate for Payer: Galaxy Health WC |
$732.70
|
| Rate for Payer: Global Benefits Group Commercial |
$517.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$775.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$138.96
|
| Rate for Payer: InnovAge PACE Commercial |
$431.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$153.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$533.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$603.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$603.40
|
| Rate for Payer: Multiplan Commercial |
$646.50
|
| Rate for Payer: Networks By Design Commercial |
$560.30
|
| Rate for Payer: Prime Health Services Commercial |
$732.70
|
| Rate for Payer: Riverside University Health System MISP |
$344.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$517.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$732.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$732.70
|
| Rate for Payer: Vantage Medical Group Senior |
$732.70
|
|
|
HC VENOUS 1ST ORDER CATH PLCMT
|
Facility
|
IP
|
$862.00
|
|
|
Service Code
|
CPT 36011
|
| Hospital Charge Code |
906820169
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$172.40 |
| Max. Negotiated Rate |
$775.80 |
| Rate for Payer: Adventist Health Commercial |
$172.40
|
| Rate for Payer: Cash Price |
$474.10
|
| Rate for Payer: Central Health Plan Commercial |
$689.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.80
|
| Rate for Payer: EPIC Health Plan Senior |
$344.80
|
| Rate for Payer: Galaxy Health WC |
$732.70
|
| Rate for Payer: Global Benefits Group Commercial |
$517.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$775.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$574.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$328.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$533.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.40
|
| Rate for Payer: Multiplan Commercial |
$646.50
|
| Rate for Payer: Networks By Design Commercial |
$560.30
|
| Rate for Payer: Prime Health Services Commercial |
$732.70
|
|
|
HC VENOUS 2ND/3RD ORDER CATH P
|
Facility
|
IP
|
$531.00
|
|
|
Service Code
|
CPT 36012
|
| Hospital Charge Code |
906820170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$106.20 |
| Max. Negotiated Rate |
$477.90 |
| Rate for Payer: Adventist Health Commercial |
$106.20
|
| Rate for Payer: Cash Price |
$292.05
|
| Rate for Payer: Central Health Plan Commercial |
$424.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$212.40
|
| Rate for Payer: EPIC Health Plan Senior |
$212.40
|
| Rate for Payer: Galaxy Health WC |
$451.35
|
| Rate for Payer: Global Benefits Group Commercial |
$318.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$477.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$354.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$202.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$328.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.20
|
| Rate for Payer: Multiplan Commercial |
$398.25
|
| Rate for Payer: Networks By Design Commercial |
$345.15
|
| Rate for Payer: Prime Health Services Commercial |
$451.35
|
|
|
HC VENOUS 2ND/3RD ORDER CATH P
|
Facility
|
OP
|
$531.00
|
|
|
Service Code
|
CPT 36012
|
| Hospital Charge Code |
906820170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$106.20 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$106.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$451.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$292.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$398.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$257.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$311.86
|
| 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 |
$292.05
|
| Rate for Payer: Cash Price |
$292.05
|
| Rate for Payer: Cash Price |
$292.05
|
| Rate for Payer: Central Health Plan Commercial |
$424.80
|
| Rate for Payer: Cigna of CA HMO |
$339.84
|
| Rate for Payer: Cigna of CA PPO |
$392.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$451.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$451.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$451.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$212.40
|
| Rate for Payer: EPIC Health Plan Senior |
$212.40
|
| Rate for Payer: Galaxy Health WC |
$451.35
|
| Rate for Payer: Global Benefits Group Commercial |
$318.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$477.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$195.31
|
| Rate for Payer: InnovAge PACE Commercial |
$265.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$354.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$215.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$328.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$106.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.70
|
| Rate for Payer: Multiplan Commercial |
$398.25
|
| Rate for Payer: Networks By Design Commercial |
$345.15
|
| Rate for Payer: Prime Health Services Commercial |
$451.35
|
| Rate for Payer: Riverside University Health System MISP |
$212.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$318.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$451.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$451.35
|
| Rate for Payer: Vantage Medical Group Senior |
$451.35
|
|
|
HC VENOUS 2ND/3RD ORDER CATH P
|
Facility
|
OP
|
$451.00
|
|
|
Service Code
|
CPT 36012
|
| Hospital Charge Code |
909081310
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$90.20 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$90.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$383.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$248.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$338.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$218.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$264.87
|
| 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 |
$248.05
|
| Rate for Payer: Cash Price |
$248.05
|
| Rate for Payer: Cash Price |
$248.05
|
| Rate for Payer: Central Health Plan Commercial |
$360.80
|
| Rate for Payer: Cigna of CA HMO |
$288.64
|
| Rate for Payer: Cigna of CA PPO |
$333.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$383.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$383.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$383.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.40
|
| Rate for Payer: EPIC Health Plan Senior |
$180.40
|
| Rate for Payer: Galaxy Health WC |
$383.35
|
| Rate for Payer: Global Benefits Group Commercial |
$270.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$405.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$195.31
|
| Rate for Payer: InnovAge PACE Commercial |
$225.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$300.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$215.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$279.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$315.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$315.70
|
| Rate for Payer: Multiplan Commercial |
$338.25
|
| Rate for Payer: Networks By Design Commercial |
$293.15
|
| Rate for Payer: Prime Health Services Commercial |
$383.35
|
| Rate for Payer: Riverside University Health System MISP |
$180.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$270.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$383.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$383.35
|
| Rate for Payer: Vantage Medical Group Senior |
$383.35
|
|
|
HC VENOUS 2ND/3RD ORDER CATH P
|
Facility
|
IP
|
$451.00
|
|
|
Service Code
|
CPT 36012
|
| Hospital Charge Code |
909081310
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$90.20 |
| Max. Negotiated Rate |
$405.90 |
| Rate for Payer: Adventist Health Commercial |
$90.20
|
| Rate for Payer: Cash Price |
$248.05
|
| Rate for Payer: Central Health Plan Commercial |
$360.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.40
|
| Rate for Payer: EPIC Health Plan Senior |
$180.40
|
| Rate for Payer: Galaxy Health WC |
$383.35
|
| Rate for Payer: Global Benefits Group Commercial |
$270.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$405.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$300.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$279.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.20
|
| Rate for Payer: Multiplan Commercial |
$338.25
|
| Rate for Payer: Networks By Design Commercial |
$293.15
|
| Rate for Payer: Prime Health Services Commercial |
$383.35
|
|
