|
HC ATHERECTOMY ILIAC
|
Facility
|
IP
|
$27,456.00
|
|
| Hospital Charge Code |
909080049
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,491.20 |
| Max. Negotiated Rate |
$24,710.40 |
| Rate for Payer: Adventist Health Commercial |
$5,491.20
|
| Rate for Payer: Cash Price |
$12,355.20
|
| Rate for Payer: Central Health Plan Commercial |
$21,964.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,219.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,982.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,982.40
|
| Rate for Payer: Galaxy Health WC |
$23,337.60
|
| Rate for Payer: Global Benefits Group Commercial |
$16,473.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,710.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,434.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16,199.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,491.20
|
| Rate for Payer: Multiplan Commercial |
$20,592.00
|
| Rate for Payer: Networks By Design Commercial |
$17,846.40
|
| Rate for Payer: Prime Health Services Commercial |
$23,337.60
|
|
|
HC ATHERECTOMY ILIAC
|
Facility
|
OP
|
$27,456.00
|
|
| Hospital Charge Code |
909080049
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,113.68 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$5,491.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23,337.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,100.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,592.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,294.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,971.16
|
| 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 |
$12,355.20
|
| Rate for Payer: Cash Price |
$12,355.20
|
| Rate for Payer: Central Health Plan Commercial |
$21,964.80
|
| Rate for Payer: Cigna of CA HMO |
$17,571.84
|
| Rate for Payer: Cigna of CA PPO |
$20,317.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,337.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,337.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,337.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,219.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,982.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,982.40
|
| Rate for Payer: Galaxy Health WC |
$23,337.60
|
| Rate for Payer: Global Benefits Group Commercial |
$16,473.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,710.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,434.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,966.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16,199.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,491.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,219.20
|
| Rate for Payer: Multiplan Commercial |
$20,592.00
|
| Rate for Payer: Networks By Design Commercial |
$17,846.40
|
| Rate for Payer: Prime Health Services Commercial |
$23,337.60
|
| Rate for Payer: Riverside University Health System MISP |
$10,982.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,473.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,728.00
|
| Rate for Payer: United Healthcare All Other HMO |
$13,728.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,728.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,728.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23,337.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,337.60
|
| Rate for Payer: Vantage Medical Group Senior |
$23,337.60
|
|
|
HC ATHERECTOMY RENAL OR VISCERAL
|
Facility
|
OP
|
$27,456.00
|
|
| Hospital Charge Code |
909080028
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,113.68 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$5,491.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23,337.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,100.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,592.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,294.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,971.16
|
| 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 |
$12,355.20
|
| Rate for Payer: Cash Price |
$12,355.20
|
| Rate for Payer: Central Health Plan Commercial |
$21,964.80
|
| Rate for Payer: Cigna of CA HMO |
$17,571.84
|
| Rate for Payer: Cigna of CA PPO |
$20,317.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,337.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,337.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,337.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,219.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,982.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,982.40
|
| Rate for Payer: Galaxy Health WC |
$23,337.60
|
| Rate for Payer: Global Benefits Group Commercial |
$16,473.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,710.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,434.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,966.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16,199.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,491.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,219.20
|
| Rate for Payer: Multiplan Commercial |
$20,592.00
|
| Rate for Payer: Networks By Design Commercial |
$17,846.40
|
| Rate for Payer: Prime Health Services Commercial |
$23,337.60
|
| Rate for Payer: Riverside University Health System MISP |
$10,982.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,473.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,728.00
|
| Rate for Payer: United Healthcare All Other HMO |
$13,728.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,728.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,728.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23,337.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,337.60
|
| Rate for Payer: Vantage Medical Group Senior |
$23,337.60
|
|
|
HC ATHERECTOMY RENAL OR VISCERAL
|
Facility
|
IP
|
$27,456.00
|
|
| Hospital Charge Code |
909080028
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,491.20 |
| Max. Negotiated Rate |
$24,710.40 |
| Rate for Payer: Adventist Health Commercial |
$5,491.20
|
| Rate for Payer: Cash Price |
$12,355.20
|
| Rate for Payer: Central Health Plan Commercial |
$21,964.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,219.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,982.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,982.40
|
| Rate for Payer: Galaxy Health WC |
$23,337.60
|
| Rate for Payer: Global Benefits Group Commercial |
$16,473.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,710.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17,434.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16,199.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,491.20
|
| Rate for Payer: Multiplan Commercial |
$20,592.00
|
| Rate for Payer: Networks By Design Commercial |
$17,846.40
|
| Rate for Payer: Prime Health Services Commercial |
$23,337.60
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
IP
|
$28,367.00
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
906811461
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5,673.40 |
| Max. Negotiated Rate |
$25,530.30 |
| Rate for Payer: Adventist Health Commercial |
$5,673.40
|
| Rate for Payer: Cash Price |
$12,765.15
|
| Rate for Payer: Central Health Plan Commercial |
$22,693.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,856.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,346.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11,346.80
|
| Rate for Payer: Galaxy Health WC |
$24,111.95
|
| Rate for Payer: Global Benefits Group Commercial |
$17,020.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,530.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18,013.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16,736.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,673.40
|
| Rate for Payer: Multiplan Commercial |
$21,275.25
|
| Rate for Payer: Networks By Design Commercial |
$18,438.55
|
| Rate for Payer: Prime Health Services Commercial |
$24,111.95
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
OP
|
$43,007.00
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
906811438
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$929.06 |
| Max. Negotiated Rate |
$38,902.96 |
| Rate for Payer: Adventist Health Commercial |
$8,601.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$23,577.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,577.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$19,353.15
|
| Rate for Payer: Cash Price |
$19,353.15
|
| Rate for Payer: Cash Price |
$19,353.15
|
| Rate for Payer: Central Health Plan Commercial |
$34,405.60
|
| Rate for Payer: Cigna of CA HMO |
$27,954.55
|
| Rate for Payer: Cigna of CA PPO |
$31,825.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,935.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,577.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,104.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,902.96
|
| Rate for Payer: EPIC Health Plan Senior |
$25,935.31
|
| Rate for Payer: Galaxy Health WC |
$36,555.95
|
| Rate for Payer: Global Benefits Group Commercial |
$25,804.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$38,706.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$38,667.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$929.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,309.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,026.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33,008.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,601.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$31,593.92
|
| Rate for Payer: Multiplan Commercial |
$32,255.25
|
| Rate for Payer: Networks By Design Commercial |
$27,954.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Prime Health Services Commercial |
$36,555.95
|
| Rate for Payer: Prime Health Services Medicare |
$24,992.20
|
| Rate for Payer: Riverside University Health System MISP |
$25,935.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25,804.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25,804.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,503.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$23,577.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Vantage Medical Group Senior |
$23,577.55
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
IP
|
$43,007.00
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
906811438
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,601.40 |
| Max. Negotiated Rate |
$38,706.30 |
| Rate for Payer: Adventist Health Commercial |
$8,601.40
|
| Rate for Payer: Cash Price |
$19,353.15
|
| Rate for Payer: Central Health Plan Commercial |
$34,405.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30,104.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,202.80
|
| Rate for Payer: EPIC Health Plan Senior |
$17,202.80
|
| Rate for Payer: Galaxy Health WC |
$36,555.95
|
| Rate for Payer: Global Benefits Group Commercial |
$25,804.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$38,706.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,309.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25,374.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,601.40
|
| Rate for Payer: Multiplan Commercial |
$32,255.25
|
| Rate for Payer: Networks By Design Commercial |
$27,954.55
|
| Rate for Payer: Prime Health Services Commercial |
$36,555.95
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
OP
|
$28,367.00
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
906811461
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$38,902.96 |
| Rate for Payer: Adventist Health Commercial |
$5,673.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$23,577.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,729.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,577.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$12,765.15
|
| Rate for Payer: Cash Price |
$12,765.15
|
| Rate for Payer: Cash Price |
$12,765.15
|
| Rate for Payer: Cash Price |
$12,765.15
|
| Rate for Payer: Central Health Plan Commercial |
$22,693.60
|
| Rate for Payer: Cigna of CA HMO |
$18,154.88
|
| Rate for Payer: Cigna of CA PPO |
$20,991.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,935.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,577.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,856.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,902.96
|
| Rate for Payer: EPIC Health Plan Senior |
$25,935.31
|
| Rate for Payer: Galaxy Health WC |
$24,111.95
|
| Rate for Payer: Global Benefits Group Commercial |
$17,020.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,530.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$38,667.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18,013.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10,297.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33,008.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,673.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$31,593.92
|
| Rate for Payer: Multiplan Commercial |
$21,275.25
|
| Rate for Payer: Networks By Design Commercial |
$18,438.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Prime Health Services Commercial |
$24,111.95
|
| Rate for Payer: Prime Health Services Medicare |
$24,992.20
|
| Rate for Payer: Riverside University Health System MISP |
$25,935.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,020.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17,020.20
|
| 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 |
$23,577.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Vantage Medical Group Senior |
$23,577.55
|
|
|
HC ATHERECTOMY W CORO STENT ADD
|
Facility
|
OP
|
$24,881.00
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
906811462
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$22,392.90 |
| Rate for Payer: Adventist Health Commercial |
$4,976.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15,110.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,148.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13,684.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18,660.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$11,196.45
|
| Rate for Payer: Cash Price |
$11,196.45
|
| Rate for Payer: Cash Price |
$11,196.45
|
| Rate for Payer: Central Health Plan Commercial |
$19,904.80
|
| Rate for Payer: Cigna of CA HMO |
$15,923.84
|
| Rate for Payer: Cigna of CA PPO |
$18,411.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,148.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,148.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21,148.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,416.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,952.40
|
| Rate for Payer: EPIC Health Plan Senior |
$9,952.40
|
| Rate for Payer: Galaxy Health WC |
$21,148.85
|
| Rate for Payer: Global Benefits Group Commercial |
$14,928.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,392.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,799.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,031.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,679.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,976.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17,416.70
|
| Rate for Payer: Multiplan Commercial |
$18,660.75
|
| Rate for Payer: Networks By Design Commercial |
$16,172.65
|
| Rate for Payer: Prime Health Services Commercial |
$21,148.85
|
| Rate for Payer: Riverside University Health System MISP |
$9,952.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,928.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14,928.60
|
| 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: Vantage Medical Group Commercial/Exchange |
$21,148.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,148.85
|
| Rate for Payer: Vantage Medical Group Senior |
$21,148.85
|
|
|
HC ATHERECTOMY W CORO STENT ADD
|
Facility
|
IP
|
$24,881.00
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
906811462
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,976.20 |
| Max. Negotiated Rate |
$22,392.90 |
| Rate for Payer: Adventist Health Commercial |
$4,976.20
|
| Rate for Payer: Cash Price |
$11,196.45
|
| Rate for Payer: Central Health Plan Commercial |
$19,904.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17,416.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,952.40
|
| Rate for Payer: EPIC Health Plan Senior |
$9,952.40
|
| Rate for Payer: Galaxy Health WC |
$21,148.85
|
| Rate for Payer: Global Benefits Group Commercial |
$14,928.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,392.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,799.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,679.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,976.20
|
| Rate for Payer: Multiplan Commercial |
$18,660.75
|
| Rate for Payer: Networks By Design Commercial |
$16,172.65
|
| Rate for Payer: Prime Health Services Commercial |
$21,148.85
|
|
|
HC ATHERECTOMY W CORO STENT ADD'L
|
Facility
|
IP
|
$18,354.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
906811439
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,670.80 |
| Max. Negotiated Rate |
$16,518.60 |
| Rate for Payer: Adventist Health Commercial |
$3,670.80
|
| Rate for Payer: Cash Price |
$8,259.30
|
| Rate for Payer: Central Health Plan Commercial |
$14,683.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,847.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,341.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,341.60
|
| Rate for Payer: Galaxy Health WC |
$15,600.90
|
| Rate for Payer: Global Benefits Group Commercial |
$11,012.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,518.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,654.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,828.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,670.80
|
| Rate for Payer: Multiplan Commercial |
$13,765.50
|
| Rate for Payer: Networks By Design Commercial |
$11,930.10
|
| Rate for Payer: Prime Health Services Commercial |
$15,600.90
|
|
|
HC ATHERECTOMY W CORO STENT ADD'L
|
Facility
|
OP
|
$18,354.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
906811439
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,670.80 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,670.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15,600.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,094.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,765.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$8,259.30
|
| Rate for Payer: Cash Price |
$8,259.30
|
| Rate for Payer: Central Health Plan Commercial |
$14,683.20
|
| Rate for Payer: Cigna of CA HMO |
$11,930.10
|
| Rate for Payer: Cigna of CA PPO |
$13,581.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15,600.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,600.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15,600.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12,847.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,341.60
|
| Rate for Payer: EPIC Health Plan Senior |
$7,341.60
|
| Rate for Payer: Galaxy Health WC |
$15,600.90
|
| Rate for Payer: Global Benefits Group Commercial |
$11,012.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,518.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11,654.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,662.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,828.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,670.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12,847.80
|
| Rate for Payer: Multiplan Commercial |
$13,765.50
|
| Rate for Payer: Networks By Design Commercial |
$11,930.10
|
| Rate for Payer: Prime Health Services Commercial |
$15,600.90
|
| Rate for Payer: Riverside University Health System MISP |
$7,341.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,012.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,012.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,177.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15,600.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,600.90
|
| Rate for Payer: Vantage Medical Group Senior |
$15,600.90
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
|
OP
|
$21,596.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906811434
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$889.69 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,319.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$9,718.20
|
| Rate for Payer: Cash Price |
$9,718.20
|
| Rate for Payer: Cash Price |
$9,718.20
|
| Rate for Payer: Central Health Plan Commercial |
$17,276.80
|
| Rate for Payer: Cigna of CA HMO |
$14,037.40
|
| Rate for Payer: Cigna of CA PPO |
$15,981.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,117.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$18,356.60
|
| Rate for Payer: Global Benefits Group Commercial |
$12,957.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,436.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$889.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,713.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$982.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,319.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$16,197.00
|
| Rate for Payer: Networks By Design Commercial |
$14,037.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Prime Health Services Commercial |
$18,356.60
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,957.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,957.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,798.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
|
IP
|
$21,596.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906811434
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,319.20 |
| Max. Negotiated Rate |
$19,436.40 |
| Rate for Payer: Adventist Health Commercial |
$4,319.20
|
| Rate for Payer: Cash Price |
$9,718.20
|
| Rate for Payer: Central Health Plan Commercial |
$17,276.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,117.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,638.40
|
| Rate for Payer: EPIC Health Plan Senior |
$8,638.40
|
| Rate for Payer: Galaxy Health WC |
$18,356.60
|
| Rate for Payer: Global Benefits Group Commercial |
$12,957.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,436.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,713.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,741.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,319.20
|
| Rate for Payer: Multiplan Commercial |
$16,197.00
|
| Rate for Payer: Networks By Design Commercial |
$14,037.40
|
| Rate for Payer: Prime Health Services Commercial |
$18,356.60
|
|
|
HC ATHERECTOMY W PTCA ADD'L VESSEL
|
Facility
|
OP
|
$8,639.00
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
906811435
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,727.80 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$1,727.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,343.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,751.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,479.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$3,887.55
|
| Rate for Payer: Cash Price |
$3,887.55
|
| Rate for Payer: Central Health Plan Commercial |
$6,911.20
|
| Rate for Payer: Cigna of CA HMO |
$5,615.35
|
| Rate for Payer: Cigna of CA PPO |
$6,392.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,343.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,343.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,343.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,047.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,455.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,455.60
|
| Rate for Payer: Galaxy Health WC |
$7,343.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,183.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,775.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,485.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,135.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,097.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,727.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,047.30
|
| Rate for Payer: Multiplan Commercial |
$6,479.25
|
| Rate for Payer: Networks By Design Commercial |
$5,615.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,343.15
|
| Rate for Payer: Riverside University Health System MISP |
$3,455.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,183.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,183.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,319.50
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,343.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,343.15
|
| Rate for Payer: Vantage Medical Group Senior |
$7,343.15
|
|
|
HC ATHERECTOMY W PTCA ADD'L VESSEL
|
Facility
|
IP
|
$8,639.00
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
906811435
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,727.80 |
| Max. Negotiated Rate |
$7,775.10 |
| Rate for Payer: Adventist Health Commercial |
$1,727.80
|
| Rate for Payer: Cash Price |
$3,887.55
|
| Rate for Payer: Central Health Plan Commercial |
$6,911.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,047.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,455.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,455.60
|
| Rate for Payer: Galaxy Health WC |
$7,343.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,183.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,775.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,485.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,097.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,727.80
|
| Rate for Payer: Multiplan Commercial |
$6,479.25
|
| Rate for Payer: Networks By Design Commercial |
$5,615.35
|
| Rate for Payer: Prime Health Services Commercial |
$7,343.15
|
|
|
HC ATHRECTOMY AORTA
|
Facility
|
OP
|
$42,804.00
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
909020080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,179.04 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$8,560.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,958.69
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,243.20
|
| Rate for Payer: Cigna of CA HMO |
$27,394.56
|
| Rate for Payer: Cigna of CA PPO |
$31,674.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29,962.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$36,383.40
|
| Rate for Payer: Global Benefits Group Commercial |
$25,682.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$38,523.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,180.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15,537.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,560.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$32,103.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$27,822.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Preferred Health Network WC |
$23,427.23
|
| Rate for Payer: Prime Health Services Commercial |
$36,383.40
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25,682.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,402.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC ATHRECTOMY AORTA
|
Facility
|
IP
|
$42,804.00
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
909020080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,560.80 |
| Max. Negotiated Rate |
$38,523.60 |
| Rate for Payer: Adventist Health Commercial |
$8,560.80
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,243.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29,962.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,121.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,121.60
|
| Rate for Payer: Galaxy Health WC |
$36,383.40
|
| Rate for Payer: Global Benefits Group Commercial |
$25,682.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$38,523.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,180.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25,254.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,560.80
|
| Rate for Payer: Multiplan Commercial |
$32,103.00
|
| Rate for Payer: Networks By Design Commercial |
$27,822.60
|
| Rate for Payer: Prime Health Services Commercial |
$36,383.40
|
|
|
HC ATHRECTOMY BRACHIOCEPHALIC
|
Facility
|
IP
|
$42,804.00
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
909020079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,560.80 |
| Max. Negotiated Rate |
$38,523.60 |
| Rate for Payer: Adventist Health Commercial |
$8,560.80
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,243.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29,962.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,121.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,121.60
|
| Rate for Payer: Galaxy Health WC |
$36,383.40
|
| Rate for Payer: Global Benefits Group Commercial |
$25,682.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$38,523.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,180.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25,254.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,560.80
|
| Rate for Payer: Multiplan Commercial |
$32,103.00
|
| Rate for Payer: Networks By Design Commercial |
$27,822.60
|
| Rate for Payer: Prime Health Services Commercial |
$36,383.40
|
|
|
HC ATHRECTOMY BRACHIOCEPHALIC
|
Facility
|
OP
|
$42,804.00
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
909020079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,179.04 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$8,560.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,958.69
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,243.20
|
| Rate for Payer: Cigna of CA HMO |
$27,394.56
|
| Rate for Payer: Cigna of CA PPO |
$31,674.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29,962.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$36,383.40
|
| Rate for Payer: Global Benefits Group Commercial |
$25,682.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$38,523.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,180.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15,537.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,560.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$32,103.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$27,822.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Preferred Health Network WC |
$23,427.23
|
| Rate for Payer: Prime Health Services Commercial |
$36,383.40
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25,682.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,402.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC ATHRECTOMY FEM/POP
|
Facility
|
OP
|
$22,611.00
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
909020066
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,914.40 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,522.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,219.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12,436.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16,958.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,352.92
|
| Rate for Payer: Blue Shield of California Commercial |
$6,228.07
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$10,174.95
|
| Rate for Payer: Cash Price |
$10,174.95
|
| Rate for Payer: Cash Price |
$10,174.95
|
| Rate for Payer: Central Health Plan Commercial |
$18,088.80
|
| Rate for Payer: Cigna of CA HMO |
$14,471.04
|
| Rate for Payer: Cigna of CA PPO |
$16,732.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,219.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$19,219.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19,219.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,827.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,044.40
|
| Rate for Payer: EPIC Health Plan Senior |
$9,044.40
|
| Rate for Payer: Galaxy Health WC |
$19,219.35
|
| Rate for Payer: Global Benefits Group Commercial |
$13,566.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,349.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,357.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8,207.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,340.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,522.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15,827.70
|
| Rate for Payer: Multiplan Commercial |
$16,958.25
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$14,697.15
|
| Rate for Payer: Preferred Health Network WC |
$37,094.82
|
| Rate for Payer: Prime Health Services Commercial |
$19,219.35
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Riverside University Health System MISP |
$9,044.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,566.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,305.50
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,219.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19,219.35
|
| Rate for Payer: Vantage Medical Group Senior |
$19,219.35
|
|
|
HC ATHRECTOMY FEM/POP
|
Facility
|
IP
|
$22,611.00
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
909020066
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,522.20 |
| Max. Negotiated Rate |
$20,349.90 |
| Rate for Payer: Adventist Health Commercial |
$4,522.20
|
| Rate for Payer: Cash Price |
$10,174.95
|
| Rate for Payer: Central Health Plan Commercial |
$18,088.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,827.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,044.40
|
| Rate for Payer: EPIC Health Plan Senior |
$9,044.40
|
| Rate for Payer: Galaxy Health WC |
$19,219.35
|
| Rate for Payer: Global Benefits Group Commercial |
$13,566.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,349.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,357.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,340.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,522.20
|
| Rate for Payer: Multiplan Commercial |
$16,958.25
|
| Rate for Payer: Networks By Design Commercial |
$14,697.15
|
| Rate for Payer: Prime Health Services Commercial |
$19,219.35
|
|
|
HC ATHRECTOMY ILIAC
|
Facility
|
IP
|
$42,804.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
909020081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,560.80 |
| Max. Negotiated Rate |
$38,523.60 |
| Rate for Payer: Adventist Health Commercial |
$8,560.80
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,243.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29,962.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,121.60
|
| Rate for Payer: EPIC Health Plan Senior |
$17,121.60
|
| Rate for Payer: Galaxy Health WC |
$36,383.40
|
| Rate for Payer: Global Benefits Group Commercial |
$25,682.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$38,523.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,180.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25,254.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,560.80
|
| Rate for Payer: Multiplan Commercial |
$32,103.00
|
| Rate for Payer: Networks By Design Commercial |
$27,822.60
|
| Rate for Payer: Prime Health Services Commercial |
$36,383.40
|
|
|
HC ATHRECTOMY ILIAC
|
Facility
|
OP
|
$42,804.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
909020081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,179.04 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$8,560.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$23,577.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,577.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,352.92
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,243.20
|
| Rate for Payer: Cigna of CA HMO |
$27,394.56
|
| Rate for Payer: Cigna of CA PPO |
$31,674.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,935.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,577.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29,962.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,902.96
|
| Rate for Payer: EPIC Health Plan Senior |
$25,935.31
|
| Rate for Payer: Galaxy Health WC |
$36,383.40
|
| Rate for Payer: Global Benefits Group Commercial |
$25,682.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$38,523.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$38,667.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,180.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15,537.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33,008.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,560.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$31,593.92
|
| Rate for Payer: Multiplan Commercial |
$32,103.00
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$27,822.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Preferred Health Network WC |
$37,094.82
|
| Rate for Payer: Prime Health Services Commercial |
$36,383.40
|
| Rate for Payer: Prime Health Services Medicare |
$24,992.20
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Riverside University Health System MISP |
$25,935.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25,682.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,402.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$23,577.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Vantage Medical Group Senior |
$23,577.55
|
|
|
HC ATHRECTOMY RENAL
|
Facility
|
OP
|
$42,804.00
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
909020077
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,179.04 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$8,560.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,958.69
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Cash Price |
$19,261.80
|
| Rate for Payer: Central Health Plan Commercial |
$34,243.20
|
| Rate for Payer: Cigna of CA HMO |
$27,394.56
|
| Rate for Payer: Cigna of CA PPO |
$31,674.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29,962.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$36,383.40
|
| Rate for Payer: Global Benefits Group Commercial |
$25,682.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$38,523.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27,180.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15,537.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,560.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$32,103.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$27,822.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Preferred Health Network WC |
$23,427.23
|
| Rate for Payer: Prime Health Services Commercial |
$36,383.40
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25,682.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$21,402.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
