|
HC AORTOGRAPH ABDOMINAL
|
Facility
|
IP
|
$12,696.00
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
909081602
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,539.20 |
| Max. Negotiated Rate |
$11,426.40 |
| Rate for Payer: Adventist Health Commercial |
$2,539.20
|
| Rate for Payer: Cash Price |
$5,713.20
|
| Rate for Payer: Central Health Plan Commercial |
$10,156.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,887.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,078.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5,078.40
|
| Rate for Payer: Galaxy Health WC |
$10,791.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,617.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,426.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,061.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,490.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,539.20
|
| Rate for Payer: Multiplan Commercial |
$9,522.00
|
| Rate for Payer: Networks By Design Commercial |
$8,252.40
|
| Rate for Payer: Prime Health Services Commercial |
$10,791.60
|
|
|
HC AORTOGRAPH ABDOMINAL
|
Facility
|
OP
|
$12,696.00
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
909081602
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$197.77 |
| Max. Negotiated Rate |
$11,426.40 |
| Rate for Payer: Adventist Health Commercial |
$2,539.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,061.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,004.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,608.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,626.13
|
| Rate for Payer: Blue Shield of California Commercial |
$7,998.48
|
| Rate for Payer: Blue Shield of California EPN |
$5,040.31
|
| Rate for Payer: Cash Price |
$5,713.20
|
| Rate for Payer: Cash Price |
$5,713.20
|
| Rate for Payer: Central Health Plan Commercial |
$10,156.80
|
| Rate for Payer: Cigna of CA HMO |
$8,125.44
|
| Rate for Payer: Cigna of CA PPO |
$9,395.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,887.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$10,791.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,617.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,426.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$197.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,061.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$218.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,539.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$9,522.00
|
| Rate for Payer: Networks By Design Commercial |
$8,252.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Prime Health Services Commercial |
$10,791.60
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,617.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,617.60
|
| 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 |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC AORTOGRAPH ABDOMINAL AIF
|
Facility
|
IP
|
$14,013.00
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
909081603
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$2,802.60 |
| Max. Negotiated Rate |
$12,611.70 |
| Rate for Payer: Adventist Health Commercial |
$2,802.60
|
| Rate for Payer: Cash Price |
$6,305.85
|
| Rate for Payer: Central Health Plan Commercial |
$11,210.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,809.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,605.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,605.20
|
| Rate for Payer: Galaxy Health WC |
$11,911.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,407.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,611.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,898.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,267.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,802.60
|
| Rate for Payer: Multiplan Commercial |
$10,509.75
|
| Rate for Payer: Networks By Design Commercial |
$9,108.45
|
| Rate for Payer: Prime Health Services Commercial |
$11,911.05
|
|
|
HC AORTOGRAPH ABDOMINAL AIF
|
Facility
|
IP
|
$14,013.00
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
909081603
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,802.60 |
| Max. Negotiated Rate |
$12,611.70 |
| Rate for Payer: Adventist Health Commercial |
$2,802.60
|
| Rate for Payer: Cash Price |
$6,305.85
|
| Rate for Payer: Central Health Plan Commercial |
$11,210.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,809.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,605.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,605.20
|
| Rate for Payer: Galaxy Health WC |
$11,911.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,407.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,611.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,898.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,267.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,802.60
|
| Rate for Payer: Multiplan Commercial |
$10,509.75
|
| Rate for Payer: Networks By Design Commercial |
$9,108.45
|
| Rate for Payer: Prime Health Services Commercial |
$11,911.05
|
|
|
HC AORTOGRAPH ABDOMINAL AIF
|
Facility
|
OP
|
$14,013.00
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
909081603
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$244.62 |
| Max. Negotiated Rate |
$12,611.70 |
| Rate for Payer: Adventist Health Commercial |
$2,802.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,061.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,028.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,718.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,151.36
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$6,305.85
|
| Rate for Payer: Cash Price |
$6,305.85
|
| Rate for Payer: Cash Price |
$6,305.85
|
| Rate for Payer: Cash Price |
$6,305.85
|
| Rate for Payer: Central Health Plan Commercial |
$11,210.40
|
| Rate for Payer: Cigna of CA HMO |
$8,968.32
|
| Rate for Payer: Cigna of CA PPO |
$10,369.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,809.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$11,911.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,407.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,611.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$244.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,898.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$270.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,802.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$10,509.75
|
| Rate for Payer: Networks By Design Commercial |
$9,108.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Prime Health Services Commercial |
$11,911.05
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,407.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,407.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC AORTOGRAPH ABDOMINAL AIF
|
Facility
|
OP
|
$14,013.00
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
909081603
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$244.62 |
| Max. Negotiated Rate |
$12,611.70 |
| Rate for Payer: Adventist Health Commercial |
$2,802.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,061.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,028.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,718.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,779.20
|
| Rate for Payer: Blue Shield of California Commercial |
$8,828.19
|
| Rate for Payer: Blue Shield of California EPN |
$5,563.16
|
| Rate for Payer: Cash Price |
$6,305.85
|
| Rate for Payer: Cash Price |
$6,305.85
|
| Rate for Payer: Central Health Plan Commercial |
$11,210.40
|
| Rate for Payer: Cigna of CA HMO |
$8,968.32
|
| Rate for Payer: Cigna of CA PPO |
$10,369.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,809.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$11,911.05
|
| Rate for Payer: Global Benefits Group Commercial |
$8,407.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,611.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$244.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,898.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$270.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,802.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$10,509.75
|
| Rate for Payer: Networks By Design Commercial |
$9,108.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Prime Health Services Commercial |
$11,911.05
|
| Rate for Payer: Prime Health Services Medicare |
$4,304.71
|
| Rate for Payer: Riverside University Health System MISP |
$4,467.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,407.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,407.80
|
| 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 |
$4,061.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC AORTOGRAPH THORACIC
|
Facility
|
OP
|
$11,450.00
|
|
|
Service Code
|
CPT 75605
|
| Hospital Charge Code |
909081600
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$190.15 |
| Max. Negotiated Rate |
$11,808.82 |
| Rate for Payer: Adventist Health Commercial |
$2,290.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,156.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,002.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,156.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,608.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,626.13
|
| Rate for Payer: Blue Shield of California Commercial |
$7,213.50
|
| Rate for Payer: Blue Shield of California EPN |
$4,545.65
|
| Rate for Payer: Cash Price |
$5,152.50
|
| Rate for Payer: Cash Price |
$5,152.50
|
| Rate for Payer: Central Health Plan Commercial |
$9,160.00
|
| Rate for Payer: Cigna of CA HMO |
$7,328.00
|
| Rate for Payer: Cigna of CA PPO |
$8,473.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,872.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,156.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,015.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,808.82
|
| Rate for Payer: EPIC Health Plan Senior |
$7,872.55
|
| Rate for Payer: Galaxy Health WC |
$9,732.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,870.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,305.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,737.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$190.15
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,270.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,019.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,290.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,590.19
|
| Rate for Payer: Multiplan Commercial |
$8,587.50
|
| Rate for Payer: Networks By Design Commercial |
$7,442.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Prime Health Services Commercial |
$9,732.50
|
| Rate for Payer: Prime Health Services Medicare |
$7,586.27
|
| Rate for Payer: Riverside University Health System MISP |
$7,872.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,870.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,870.00
|
| 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 |
$7,156.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,156.86
|
|
|
HC AORTOGRAPH THORACIC
|
Facility
|
IP
|
$11,450.00
|
|
|
Service Code
|
CPT 75605
|
| Hospital Charge Code |
909081600
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,290.00 |
| Max. Negotiated Rate |
$10,305.00 |
| Rate for Payer: Adventist Health Commercial |
$2,290.00
|
| Rate for Payer: Cash Price |
$5,152.50
|
| Rate for Payer: Central Health Plan Commercial |
$9,160.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,015.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,580.00
|
| Rate for Payer: EPIC Health Plan Senior |
$4,580.00
|
| Rate for Payer: Galaxy Health WC |
$9,732.50
|
| Rate for Payer: Global Benefits Group Commercial |
$6,870.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,305.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,270.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,755.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,290.00
|
| Rate for Payer: Multiplan Commercial |
$8,587.50
|
| Rate for Payer: Networks By Design Commercial |
$7,442.50
|
| Rate for Payer: Prime Health Services Commercial |
$9,732.50
|
|
|
HC AORTO TRNSLMBR NEEDL/CATH
|
Facility
|
IP
|
$687.00
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
909081317
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$137.40 |
| Max. Negotiated Rate |
$618.30 |
| Rate for Payer: Adventist Health Commercial |
$137.40
|
| Rate for Payer: Cash Price |
$309.15
|
| Rate for Payer: Central Health Plan Commercial |
$549.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$480.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$274.80
|
| Rate for Payer: EPIC Health Plan Senior |
$274.80
|
| Rate for Payer: Galaxy Health WC |
$583.95
|
| Rate for Payer: Global Benefits Group Commercial |
$412.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$618.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$436.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$405.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.40
|
| Rate for Payer: Multiplan Commercial |
$515.25
|
| Rate for Payer: Networks By Design Commercial |
$446.55
|
| Rate for Payer: Prime Health Services Commercial |
$583.95
|
|
|
HC AORTO TRNSLMBR NEEDL/CATH
|
Facility
|
OP
|
$687.00
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
909081317
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$137.40 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$137.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$583.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$377.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$515.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$309.15
|
| Rate for Payer: Cash Price |
$309.15
|
| Rate for Payer: Cash Price |
$309.15
|
| Rate for Payer: Central Health Plan Commercial |
$549.60
|
| Rate for Payer: Cigna of CA HMO |
$439.68
|
| Rate for Payer: Cigna of CA PPO |
$508.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$583.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$583.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$583.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$480.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$274.80
|
| Rate for Payer: EPIC Health Plan Senior |
$274.80
|
| Rate for Payer: Galaxy Health WC |
$583.95
|
| Rate for Payer: Global Benefits Group Commercial |
$412.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$618.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$192.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$436.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$212.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$405.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$137.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$480.90
|
| Rate for Payer: Multiplan Commercial |
$515.25
|
| Rate for Payer: Networks By Design Commercial |
$446.55
|
| Rate for Payer: Prime Health Services Commercial |
$583.95
|
| Rate for Payer: Riverside University Health System MISP |
$274.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$412.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$343.50
|
| 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 |
$583.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$583.95
|
| Rate for Payer: Vantage Medical Group Senior |
$583.95
|
|
|
HC APHERESIS PLASMA EXCHANGE
|
Facility
|
OP
|
$20,879.00
|
|
|
Service Code
|
CPT 36514
|
| Hospital Charge Code |
946100103
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$18,791.10 |
| Rate for Payer: Adventist Health Commercial |
$4,175.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,003.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$539.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$13,237.29
|
| Rate for Payer: Blue Shield of California EPN |
$8,330.72
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Central Health Plan Commercial |
$16,703.20
|
| Rate for Payer: Cigna of CA HMO |
$13,362.56
|
| Rate for Payer: Cigna of CA PPO |
$15,450.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,615.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$17,747.15
|
| Rate for Payer: Global Benefits Group Commercial |
$12,527.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,791.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,258.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,175.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$15,659.25
|
| Rate for Payer: Networks By Design Commercial |
$13,571.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Prime Health Services Commercial |
$17,747.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,123.30
|
| Rate for Payer: Riverside University Health System MISP |
$2,203.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,527.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,527.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC APHERESIS PLASMA EXCHANGE
|
Facility
|
IP
|
$20,879.00
|
|
|
Service Code
|
CPT 36514
|
| Hospital Charge Code |
946100103
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$4,175.80 |
| Max. Negotiated Rate |
$18,791.10 |
| Rate for Payer: Adventist Health Commercial |
$4,175.80
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Central Health Plan Commercial |
$16,703.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,615.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,351.60
|
| Rate for Payer: EPIC Health Plan Senior |
$8,351.60
|
| Rate for Payer: Galaxy Health WC |
$17,747.15
|
| Rate for Payer: Global Benefits Group Commercial |
$12,527.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,791.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,258.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,318.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,175.80
|
| Rate for Payer: Multiplan Commercial |
$15,659.25
|
| Rate for Payer: Networks By Design Commercial |
$13,571.35
|
| Rate for Payer: Prime Health Services Commercial |
$17,747.15
|
|
|
HC APHERESIS PLASMA EXCHANGE
|
Facility
|
OP
|
$20,879.00
|
|
|
Service Code
|
CPT 36514
|
| Hospital Charge Code |
945000103
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$18,791.10 |
| Rate for Payer: Adventist Health Commercial |
$4,175.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,003.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$539.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$13,237.29
|
| Rate for Payer: Blue Shield of California EPN |
$8,330.72
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Central Health Plan Commercial |
$16,703.20
|
| Rate for Payer: Cigna of CA HMO |
$13,362.56
|
| Rate for Payer: Cigna of CA PPO |
$15,450.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,615.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$17,747.15
|
| Rate for Payer: Global Benefits Group Commercial |
$12,527.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,791.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,258.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,175.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$15,659.25
|
| Rate for Payer: Networks By Design Commercial |
$13,571.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Prime Health Services Commercial |
$17,747.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,123.30
|
| Rate for Payer: Riverside University Health System MISP |
$2,203.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,527.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,527.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC APHERESIS PLASMA EXCHANGE
|
Facility
|
OP
|
$20,879.00
|
|
|
Service Code
|
CPT 36514
|
| Hospital Charge Code |
945100103
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$18,791.10 |
| Rate for Payer: Adventist Health Commercial |
$4,175.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,003.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$539.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$13,237.29
|
| Rate for Payer: Blue Shield of California EPN |
$8,330.72
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Central Health Plan Commercial |
$16,703.20
|
| Rate for Payer: Cigna of CA HMO |
$13,362.56
|
| Rate for Payer: Cigna of CA PPO |
$15,450.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,615.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$17,747.15
|
| Rate for Payer: Global Benefits Group Commercial |
$12,527.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,791.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,258.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,175.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$15,659.25
|
| Rate for Payer: Networks By Design Commercial |
$13,571.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Prime Health Services Commercial |
$17,747.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,123.30
|
| Rate for Payer: Riverside University Health System MISP |
$2,203.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,527.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,527.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC APHERESIS PLASMA EXCHANGE
|
Facility
|
IP
|
$20,879.00
|
|
|
Service Code
|
CPT 36514
|
| Hospital Charge Code |
945100103
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$4,175.80 |
| Max. Negotiated Rate |
$18,791.10 |
| Rate for Payer: EPIC Health Plan Senior |
$8,351.60
|
| Rate for Payer: Galaxy Health WC |
$17,747.15
|
| Rate for Payer: Adventist Health Commercial |
$4,175.80
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Central Health Plan Commercial |
$16,703.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,615.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,351.60
|
| Rate for Payer: Global Benefits Group Commercial |
$12,527.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,791.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,258.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,318.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,175.80
|
| Rate for Payer: Multiplan Commercial |
$15,659.25
|
| Rate for Payer: Networks By Design Commercial |
$13,571.35
|
| Rate for Payer: Prime Health Services Commercial |
$17,747.15
|
|
|
HC APHERESIS PLASMA EXCHANGE
|
Facility
|
IP
|
$20,879.00
|
|
|
Service Code
|
CPT 36514
|
| Hospital Charge Code |
907201026
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$4,175.80 |
| Max. Negotiated Rate |
$18,791.10 |
| Rate for Payer: Adventist Health Commercial |
$4,175.80
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Central Health Plan Commercial |
$16,703.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,615.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,351.60
|
| Rate for Payer: EPIC Health Plan Senior |
$8,351.60
|
| Rate for Payer: Galaxy Health WC |
$17,747.15
|
| Rate for Payer: Global Benefits Group Commercial |
$12,527.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,791.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,258.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,318.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,175.80
|
| Rate for Payer: Multiplan Commercial |
$15,659.25
|
| Rate for Payer: Networks By Design Commercial |
$13,571.35
|
| Rate for Payer: Prime Health Services Commercial |
$17,747.15
|
|
|
HC APHERESIS PLASMA EXCHANGE
|
Facility
|
IP
|
$20,879.00
|
|
|
Service Code
|
CPT 36514
|
| Hospital Charge Code |
945000103
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$4,175.80 |
| Max. Negotiated Rate |
$18,791.10 |
| Rate for Payer: Adventist Health Commercial |
$4,175.80
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Central Health Plan Commercial |
$16,703.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,615.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,351.60
|
| Rate for Payer: EPIC Health Plan Senior |
$8,351.60
|
| Rate for Payer: Galaxy Health WC |
$17,747.15
|
| Rate for Payer: Global Benefits Group Commercial |
$12,527.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,791.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,258.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,318.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,175.80
|
| Rate for Payer: Multiplan Commercial |
$15,659.25
|
| Rate for Payer: Networks By Design Commercial |
$13,571.35
|
| Rate for Payer: Prime Health Services Commercial |
$17,747.15
|
|
|
HC APHERESIS PLASMA EXCHANGE
|
Facility
|
OP
|
$20,879.00
|
|
|
Service Code
|
CPT 36514
|
| Hospital Charge Code |
946000103
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$18,791.10 |
| Rate for Payer: Adventist Health Commercial |
$4,175.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,003.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$539.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$13,237.29
|
| Rate for Payer: Blue Shield of California EPN |
$8,330.72
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Central Health Plan Commercial |
$16,703.20
|
| Rate for Payer: Cigna of CA HMO |
$13,362.56
|
| Rate for Payer: Cigna of CA PPO |
$15,450.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,615.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$17,747.15
|
| Rate for Payer: Global Benefits Group Commercial |
$12,527.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,791.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,258.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,175.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$15,659.25
|
| Rate for Payer: Networks By Design Commercial |
$13,571.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Prime Health Services Commercial |
$17,747.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,123.30
|
| Rate for Payer: Riverside University Health System MISP |
$2,203.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,527.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,527.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC APHERESIS PLASMA EXCHANGE
|
Facility
|
IP
|
$20,879.00
|
|
|
Service Code
|
CPT 36514
|
| Hospital Charge Code |
946000103
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$4,175.80 |
| Max. Negotiated Rate |
$18,791.10 |
| Rate for Payer: Adventist Health Commercial |
$4,175.80
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Central Health Plan Commercial |
$16,703.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,615.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,351.60
|
| Rate for Payer: EPIC Health Plan Senior |
$8,351.60
|
| Rate for Payer: Galaxy Health WC |
$17,747.15
|
| Rate for Payer: Global Benefits Group Commercial |
$12,527.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,791.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,258.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,318.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,175.80
|
| Rate for Payer: Multiplan Commercial |
$15,659.25
|
| Rate for Payer: Networks By Design Commercial |
$13,571.35
|
| Rate for Payer: Prime Health Services Commercial |
$17,747.15
|
|
|
HC APHERESIS PLASMA EXCHANGE
|
Facility
|
OP
|
$20,879.00
|
|
|
Service Code
|
CPT 36514
|
| Hospital Charge Code |
907201026
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$18,791.10 |
| Rate for Payer: Adventist Health Commercial |
$4,175.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,003.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$539.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,003.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$13,237.29
|
| Rate for Payer: Blue Shield of California EPN |
$8,330.72
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Cash Price |
$9,395.55
|
| Rate for Payer: Central Health Plan Commercial |
$16,703.20
|
| Rate for Payer: Cigna of CA HMO |
$13,362.56
|
| Rate for Payer: Cigna of CA PPO |
$15,450.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,203.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,003.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,615.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,305.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2,203.42
|
| Rate for Payer: Galaxy Health WC |
$17,747.15
|
| Rate for Payer: Global Benefits Group Commercial |
$12,527.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,791.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,285.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,680.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,258.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,856.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,804.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,175.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,684.17
|
| Rate for Payer: Multiplan Commercial |
$15,659.25
|
| Rate for Payer: Networks By Design Commercial |
$13,571.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,003.11
|
| Rate for Payer: Prime Health Services Commercial |
$17,747.15
|
| Rate for Payer: Prime Health Services Medicare |
$2,123.30
|
| Rate for Payer: Riverside University Health System MISP |
$2,203.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,527.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,527.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,003.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,004.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,203.42
|
| Rate for Payer: Vantage Medical Group Senior |
$2,003.11
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
OP
|
$12,454.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
945000102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$515.48 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Preferred Health Network WC |
$903.12
|
| Rate for Payer: Adventist Health Commercial |
$2,490.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$567.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$851.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$624.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$567.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$885.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Central Health Plan Commercial |
$9,963.20
|
| Rate for Payer: Cigna of CA HMO |
$7,970.56
|
| Rate for Payer: Cigna of CA PPO |
$9,215.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$851.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$624.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$567.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,717.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.24
|
| Rate for Payer: EPIC Health Plan Senior |
$624.16
|
| Rate for Payer: Galaxy Health WC |
$10,585.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,472.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,208.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$930.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$515.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$567.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,908.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$569.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$794.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,490.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$760.34
|
| Rate for Payer: Multiplan Commercial |
$9,340.50
|
| Rate for Payer: Multiplan WC |
$885.06
|
| Rate for Payer: Networks By Design Commercial |
$8,095.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$567.42
|
| Rate for Payer: Prime Health Services Commercial |
$10,585.90
|
| Rate for Payer: Prime Health Services Medicare |
$601.47
|
| Rate for Payer: Prime Health Services WC |
$876.03
|
| Rate for Payer: Riverside University Health System MISP |
$624.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,472.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,227.00
|
| 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: Upland Medical Group Pediatric |
$567.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$851.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$624.16
|
| Rate for Payer: Vantage Medical Group Senior |
$567.42
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
OP
|
$12,454.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
945100102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$515.48 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,490.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$567.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$851.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$624.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$567.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$885.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Central Health Plan Commercial |
$9,963.20
|
| Rate for Payer: Cigna of CA HMO |
$7,970.56
|
| Rate for Payer: Cigna of CA PPO |
$9,215.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$851.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$624.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$567.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,717.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.24
|
| Rate for Payer: EPIC Health Plan Senior |
$624.16
|
| Rate for Payer: Galaxy Health WC |
$10,585.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,472.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,208.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$930.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$515.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$567.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,908.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$569.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$794.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,490.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$760.34
|
| Rate for Payer: Multiplan Commercial |
$9,340.50
|
| Rate for Payer: Multiplan WC |
$885.06
|
| Rate for Payer: Networks By Design Commercial |
$8,095.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$567.42
|
| Rate for Payer: Preferred Health Network WC |
$903.12
|
| Rate for Payer: Prime Health Services Commercial |
$10,585.90
|
| Rate for Payer: Prime Health Services Medicare |
$601.47
|
| Rate for Payer: Prime Health Services WC |
$876.03
|
| Rate for Payer: Riverside University Health System MISP |
$624.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,472.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,227.00
|
| 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: Upland Medical Group Pediatric |
$567.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$851.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$624.16
|
| Rate for Payer: Vantage Medical Group Senior |
$567.42
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
OP
|
$12,454.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
945000102
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$300.00 |
| Max. Negotiated Rate |
$11,208.60 |
| Rate for Payer: Vantage Medical Group Senior |
$567.42
|
| Rate for Payer: Adventist Health Commercial |
$2,490.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$567.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$580.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$851.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$624.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$567.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,895.84
|
| Rate for Payer: Blue Shield of California EPN |
$4,969.15
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Central Health Plan Commercial |
$9,963.20
|
| Rate for Payer: Cigna of CA HMO |
$7,970.56
|
| Rate for Payer: Cigna of CA PPO |
$9,215.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$851.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$624.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$567.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,717.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.24
|
| Rate for Payer: EPIC Health Plan Senior |
$624.16
|
| Rate for Payer: Galaxy Health WC |
$10,585.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,472.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,208.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$930.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$515.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$567.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,908.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$569.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$794.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,490.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$760.34
|
| Rate for Payer: Multiplan Commercial |
$9,340.50
|
| Rate for Payer: Networks By Design Commercial |
$8,095.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$567.42
|
| Rate for Payer: Prime Health Services Commercial |
$10,585.90
|
| Rate for Payer: Prime Health Services Medicare |
$601.47
|
| Rate for Payer: Riverside University Health System MISP |
$624.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,472.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,472.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$567.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$851.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$624.16
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
IP
|
$12,454.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
945000102
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$2,490.80 |
| Max. Negotiated Rate |
$11,208.60 |
| Rate for Payer: Adventist Health Commercial |
$2,490.80
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Central Health Plan Commercial |
$9,963.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,717.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,981.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,981.60
|
| Rate for Payer: Galaxy Health WC |
$10,585.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,472.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,208.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,908.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,347.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,490.80
|
| Rate for Payer: Multiplan Commercial |
$9,340.50
|
| Rate for Payer: Networks By Design Commercial |
$8,095.10
|
| Rate for Payer: Prime Health Services Commercial |
$10,585.90
|
|
|
HC APHERESIS PLATELETS
|
Facility
|
IP
|
$12,454.00
|
|
|
Service Code
|
CPT 36513
|
| Hospital Charge Code |
945100102
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,490.80 |
| Max. Negotiated Rate |
$11,208.60 |
| Rate for Payer: Adventist Health Commercial |
$2,490.80
|
| Rate for Payer: Cash Price |
$5,604.30
|
| Rate for Payer: Central Health Plan Commercial |
$9,963.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,717.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,981.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,981.60
|
| Rate for Payer: Galaxy Health WC |
$10,585.90
|
| Rate for Payer: Global Benefits Group Commercial |
$7,472.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,208.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,908.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,347.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,490.80
|
| Rate for Payer: Multiplan Commercial |
$9,340.50
|
| Rate for Payer: Networks By Design Commercial |
$8,095.10
|
| Rate for Payer: Prime Health Services Commercial |
$10,585.90
|
|
