|
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
|
|
|
HC ATHRECTOMY & STENT FEM/POP
|
Facility
|
IP
|
$40,001.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
909020068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,000.20 |
| Max. Negotiated Rate |
$36,000.90 |
| Rate for Payer: Adventist Health Commercial |
$8,000.20
|
| Rate for Payer: Cash Price |
$18,000.45
|
| Rate for Payer: Central Health Plan Commercial |
$32,000.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28,000.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,000.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16,000.40
|
| Rate for Payer: Galaxy Health WC |
$34,000.85
|
| Rate for Payer: Global Benefits Group Commercial |
$24,000.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36,000.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25,400.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23,600.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,000.20
|
| Rate for Payer: Multiplan Commercial |
$30,000.75
|
| Rate for Payer: Networks By Design Commercial |
$26,000.65
|
| Rate for Payer: Prime Health Services Commercial |
$34,000.85
|
|
|
HC ATHRECTOMY & STENT FEM/POP
|
Facility
|
OP
|
$40,001.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
909020068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,914.40 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$8,000.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,000.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22,000.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30,000.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,138.00
|
| 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 |
$18,000.45
|
| Rate for Payer: Cash Price |
$18,000.45
|
| Rate for Payer: Cash Price |
$18,000.45
|
| Rate for Payer: Central Health Plan Commercial |
$32,000.80
|
| Rate for Payer: Cigna of CA HMO |
$25,600.64
|
| Rate for Payer: Cigna of CA PPO |
$29,600.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,000.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$34,000.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34,000.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28,000.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,000.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16,000.40
|
| Rate for Payer: Galaxy Health WC |
$34,000.85
|
| Rate for Payer: Global Benefits Group Commercial |
$24,000.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36,000.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25,400.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14,520.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23,600.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,000.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$28,000.70
|
| Rate for Payer: Multiplan Commercial |
$30,000.75
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$26,000.65
|
| Rate for Payer: Preferred Health Network WC |
$37,094.82
|
| Rate for Payer: Prime Health Services Commercial |
$34,000.85
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Riverside University Health System MISP |
$16,000.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24,000.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$20,000.50
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,000.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34,000.85
|
| Rate for Payer: Vantage Medical Group Senior |
$34,000.85
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
|
IP
|
$13,017.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
909020076
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,603.40 |
| Max. Negotiated Rate |
$11,715.30 |
| Rate for Payer: Adventist Health Commercial |
$2,603.40
|
| Rate for Payer: Cash Price |
$5,857.65
|
| Rate for Payer: Central Health Plan Commercial |
$10,413.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,111.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,206.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,206.80
|
| Rate for Payer: Galaxy Health WC |
$11,064.45
|
| Rate for Payer: Global Benefits Group Commercial |
$7,810.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,715.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,265.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,680.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,603.40
|
| Rate for Payer: Multiplan Commercial |
$9,762.75
|
| Rate for Payer: Networks By Design Commercial |
$8,461.05
|
| Rate for Payer: Prime Health Services Commercial |
$11,064.45
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
|
OP
|
$13,017.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
909020076
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,603.40 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,603.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,064.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,159.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,762.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| 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 |
$5,857.65
|
| Rate for Payer: Cash Price |
$5,857.65
|
| Rate for Payer: Central Health Plan Commercial |
$10,413.60
|
| Rate for Payer: Cigna of CA HMO |
$8,330.88
|
| Rate for Payer: Cigna of CA PPO |
$9,632.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,064.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$11,064.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11,064.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,111.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,206.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,206.80
|
| Rate for Payer: Galaxy Health WC |
$11,064.45
|
| Rate for Payer: Global Benefits Group Commercial |
$7,810.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,715.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,265.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,725.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,680.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,603.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,111.90
|
| Rate for Payer: Multiplan Commercial |
$9,762.75
|
| Rate for Payer: Networks By Design Commercial |
$8,461.05
|
| Rate for Payer: Prime Health Services Commercial |
$11,064.45
|
| Rate for Payer: Riverside University Health System MISP |
$5,206.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,810.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,508.50
|
| 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: Vantage Medical Group Commercial/Exchange |
$11,064.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,064.45
|
| Rate for Payer: Vantage Medical Group Senior |
$11,064.45
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
|
IP
|
$40,001.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
909020072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,000.20 |
| Max. Negotiated Rate |
$36,000.90 |
| Rate for Payer: Adventist Health Commercial |
$8,000.20
|
| Rate for Payer: Cash Price |
$18,000.45
|
| Rate for Payer: Central Health Plan Commercial |
$32,000.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28,000.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,000.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16,000.40
|
| Rate for Payer: Galaxy Health WC |
$34,000.85
|
| Rate for Payer: Global Benefits Group Commercial |
$24,000.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36,000.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25,400.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23,600.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,000.20
|
| Rate for Payer: Multiplan Commercial |
$30,000.75
|
| Rate for Payer: Networks By Design Commercial |
$26,000.65
|
| Rate for Payer: Prime Health Services Commercial |
$34,000.85
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
|
OP
|
$40,001.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
909020072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,914.40 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$8,000.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,000.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22,000.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30,000.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,138.00
|
| 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 |
$18,000.45
|
| Rate for Payer: Cash Price |
$18,000.45
|
| Rate for Payer: Cash Price |
$18,000.45
|
| Rate for Payer: Central Health Plan Commercial |
$32,000.80
|
| Rate for Payer: Cigna of CA HMO |
$25,600.64
|
| Rate for Payer: Cigna of CA PPO |
$29,600.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,000.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$34,000.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34,000.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28,000.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,000.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16,000.40
|
| Rate for Payer: Galaxy Health WC |
$34,000.85
|
| Rate for Payer: Global Benefits Group Commercial |
$24,000.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36,000.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25,400.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14,520.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23,600.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,000.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$28,000.70
|
| Rate for Payer: Multiplan Commercial |
$30,000.75
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$26,000.65
|
| Rate for Payer: Preferred Health Network WC |
$37,094.82
|
| Rate for Payer: Prime Health Services Commercial |
$34,000.85
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Riverside University Health System MISP |
$16,000.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24,000.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$20,000.50
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,000.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34,000.85
|
| Rate for Payer: Vantage Medical Group Senior |
$34,000.85
|
|
|
HC ATHRECTOMY TIBIOPERONEAL
|
Facility
|
OP
|
$22,611.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
909020070
|
|
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 |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,138.00
|
| 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 TIBIOPERONEAL
|
Facility
|
IP
|
$22,611.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
909020070
|
|
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 TIBIOPERONEAL EA AD
|
Facility
|
OP
|
$22,611.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
909020074
|
|
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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| 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: 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: Networks By Design Commercial |
$14,697.15
|
| Rate for Payer: Prime Health Services Commercial |
$19,219.35
|
| 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 TIBIOPERONEAL EA AD
|
Facility
|
IP
|
$22,611.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
909020074
|
|
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 VISCERAL
|
Facility
|
OP
|
$42,804.00
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
909020078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,374.00 |
| Max. Negotiated Rate |
$38,523.60 |
| Rate for Payer: Adventist Health Commercial |
$8,560.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36,383.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23,542.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$32,103.00
|
| 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: 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: 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 |
$36,383.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$36,383.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$36,383.40
|
| 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 Medi-Cal |
$15,537.85
|
| 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: Molina Healthcare of CA Medi-Cal/Medicare |
$29,962.80
|
| 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
|
| Rate for Payer: Riverside University Health System MISP |
$17,121.60
|
| 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 |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,383.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36,383.40
|
| Rate for Payer: Vantage Medical Group Senior |
$36,383.40
|
|
|
HC ATHRECTOMY VISCERAL
|
Facility
|
IP
|
$42,804.00
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
909020078
|
|
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 ATRIAL BALLOON SEPTOSTOMY
|
Facility
|
OP
|
$8,448.00
|
|
|
Service Code
|
CPT 33741
|
| Hospital Charge Code |
906811741
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,079.01 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,689.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,180.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,646.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,336.00
|
| 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 |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$3,801.60
|
| Rate for Payer: Cash Price |
$3,801.60
|
| Rate for Payer: Cash Price |
$3,801.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,758.40
|
| Rate for Payer: Cigna of CA HMO |
$5,406.72
|
| Rate for Payer: Cigna of CA PPO |
$6,251.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,180.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,180.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,180.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,913.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,379.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,379.20
|
| Rate for Payer: Galaxy Health WC |
$7,180.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,068.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,603.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,079.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,364.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,191.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,984.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,689.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,913.60
|
| Rate for Payer: Multiplan Commercial |
$6,336.00
|
| Rate for Payer: Networks By Design Commercial |
$5,491.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,180.80
|
| Rate for Payer: Riverside University Health System MISP |
$3,379.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,068.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,224.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,180.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,180.80
|
| Rate for Payer: Vantage Medical Group Senior |
$7,180.80
|
|
|
HC ATRIAL BALLOON SEPTOSTOMY
|
Facility
|
IP
|
$8,448.00
|
|
|
Service Code
|
CPT 33741
|
| Hospital Charge Code |
906811741
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,689.60 |
| Max. Negotiated Rate |
$7,603.20 |
| Rate for Payer: Adventist Health Commercial |
$1,689.60
|
| Rate for Payer: Cash Price |
$3,801.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,758.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,913.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,379.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,379.20
|
| Rate for Payer: Galaxy Health WC |
$7,180.80
|
| Rate for Payer: Global Benefits Group Commercial |
$5,068.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,603.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,364.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,984.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,689.60
|
| Rate for Payer: Multiplan Commercial |
$6,336.00
|
| Rate for Payer: Networks By Design Commercial |
$5,491.20
|
| Rate for Payer: Prime Health Services Commercial |
$7,180.80
|
|
|
HC ATTEN CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9165
|
| Hospital Charge Code |
900018130
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC ATTEN CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9165
|
| Hospital Charge Code |
900018230
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC ATTEN CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9165
|
| Hospital Charge Code |
900018430
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC ATTEN CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9165
|
| Hospital Charge Code |
900018430
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC ATTEN CURRENT STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9165
|
| Hospital Charge Code |
900018230
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC ATTEN CURRENT STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9165
|
| Hospital Charge Code |
900018130
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC ATTEN D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9167
|
| Hospital Charge Code |
900018432
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC ATTEN D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9167
|
| Hospital Charge Code |
900018132
|
|
Hospital Revenue Code
|
420
|
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
HC ATTEN D/C STATUS
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
CPT G9167
|
| Hospital Charge Code |
900018232
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
|
HC ATTEN D/C STATUS
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
CPT G9167
|
| Hospital Charge Code |
900018232
|
|
Hospital Revenue Code
|
430
|
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Central Health Plan Commercial |
$0.01
|
| Rate for Payer: Cigna of CA HMO |
$0.01
|
| Rate for Payer: Cigna of CA PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
| Rate for Payer: EPIC Health Plan Senior |
$0.00
|
| Rate for Payer: Galaxy Health WC |
$0.01
|
| Rate for Payer: Global Benefits Group Commercial |
$0.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: Networks By Design Commercial |
$0.01
|
| Rate for Payer: Prime Health Services Commercial |
$0.01
|
| Rate for Payer: Riverside University Health System MISP |
$0.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
