|
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 |
$23,653.85
|
| Rate for Payer: Central Health Plan Commercial |
$34,405.60
|
| 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 Permanente of CA Commercial/Self Funded |
$28,685.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,385.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,621.33
|
| 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
|
IP
|
$33,373.00
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
906820259
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$6,674.60 |
| Max. Negotiated Rate |
$30,035.70 |
| Rate for Payer: Adventist Health Commercial |
$6,674.60
|
| Rate for Payer: Cash Price |
$18,355.15
|
| Rate for Payer: Central Health Plan Commercial |
$26,698.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,349.20
|
| Rate for Payer: EPIC Health Plan Senior |
$13,349.20
|
| Rate for Payer: Galaxy Health WC |
$28,367.05
|
| Rate for Payer: Global Benefits Group Commercial |
$20,023.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$30,035.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,259.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,715.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,657.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,674.60
|
| Rate for Payer: Multiplan Commercial |
$25,029.75
|
| Rate for Payer: Networks By Design Commercial |
$21,692.45
|
| Rate for Payer: Prime Health Services Commercial |
$28,367.05
|
|
|
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 |
$38,706.30 |
| Rate for Payer: Adventist Health Commercial |
$8,601.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$23,653.85
|
| Rate for Payer: Cash Price |
$23,653.85
|
| Rate for Payer: Cash Price |
$23,653.85
|
| 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 |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| 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 |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$929.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: InnovAge PACE Commercial |
$34,223.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28,685.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,026.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,601.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,573.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| 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 |
$22,815.81
|
| Rate for Payer: Prime Health Services Commercial |
$36,555.95
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| 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 |
$17,712.00
|
| 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: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
OP
|
$33,373.00
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
906820259
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$37,417.93 |
| Rate for Payer: Adventist Health Commercial |
$6,674.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$18,355.15
|
| Rate for Payer: Cash Price |
$18,355.15
|
| Rate for Payer: Cash Price |
$18,355.15
|
| Rate for Payer: Central Health Plan Commercial |
$26,698.40
|
| Rate for Payer: Cigna of CA HMO |
$21,358.72
|
| Rate for Payer: Cigna of CA PPO |
$24,696.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$28,367.05
|
| Rate for Payer: Global Benefits Group Commercial |
$20,023.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$30,035.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: InnovAge PACE Commercial |
$34,223.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22,259.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,715.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,674.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,573.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$25,029.75
|
| Rate for Payer: Networks By Design Commercial |
$21,692.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Prime Health Services Commercial |
$28,367.05
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20,023.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20,023.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
OP
|
$50,596.00
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
906820241
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$929.06 |
| Max. Negotiated Rate |
$45,536.40 |
| Rate for Payer: Adventist Health Commercial |
$10,119.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$27,827.80
|
| Rate for Payer: Cash Price |
$27,827.80
|
| Rate for Payer: Cash Price |
$27,827.80
|
| Rate for Payer: Central Health Plan Commercial |
$40,476.80
|
| Rate for Payer: Cigna of CA HMO |
$32,887.40
|
| Rate for Payer: Cigna of CA PPO |
$37,441.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$43,006.60
|
| Rate for Payer: Global Benefits Group Commercial |
$30,357.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$45,536.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$929.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: InnovAge PACE Commercial |
$34,223.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33,747.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,026.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,119.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,573.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$37,947.00
|
| Rate for Payer: Networks By Design Commercial |
$32,887.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Prime Health Services Commercial |
$43,006.60
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30,357.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30,357.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| 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: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
IP
|
$50,596.00
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
906820241
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,119.20 |
| Max. Negotiated Rate |
$45,536.40 |
| Rate for Payer: Adventist Health Commercial |
$10,119.20
|
| Rate for Payer: Cash Price |
$27,827.80
|
| Rate for Payer: Central Health Plan Commercial |
$40,476.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,238.40
|
| Rate for Payer: EPIC Health Plan Senior |
$20,238.40
|
| Rate for Payer: Galaxy Health WC |
$43,006.60
|
| Rate for Payer: Global Benefits Group Commercial |
$30,357.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$45,536.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33,747.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19,277.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,318.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,119.20
|
| Rate for Payer: Multiplan Commercial |
$37,947.00
|
| Rate for Payer: Networks By Design Commercial |
$32,887.40
|
| Rate for Payer: Prime Health Services Commercial |
$43,006.60
|
|
|
HC ATHERECTOMY W CORO STENT ADD
|
Facility
|
OP
|
$29,272.00
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
906820260
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$26,344.80 |
| Rate for Payer: Adventist Health Commercial |
$5,854.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17,776.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24,881.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,099.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,954.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$16,099.60
|
| Rate for Payer: Cash Price |
$16,099.60
|
| Rate for Payer: Central Health Plan Commercial |
$23,417.60
|
| Rate for Payer: Cigna of CA HMO |
$18,734.08
|
| Rate for Payer: Cigna of CA PPO |
$21,661.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24,881.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,881.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,881.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,708.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11,708.80
|
| Rate for Payer: Galaxy Health WC |
$24,881.20
|
| Rate for Payer: Global Benefits Group Commercial |
$17,563.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$26,344.80
|
| Rate for Payer: InnovAge PACE Commercial |
$14,636.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,524.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,152.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,119.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,854.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20,490.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20,490.40
|
| Rate for Payer: Multiplan Commercial |
$21,954.00
|
| Rate for Payer: Networks By Design Commercial |
$19,026.80
|
| Rate for Payer: Prime Health Services Commercial |
$24,881.20
|
| Rate for Payer: Riverside University Health System MISP |
$11,708.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,563.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17,563.20
|
| 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: Vantage Medical Group Commercial/Exchange |
$24,881.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,881.20
|
| Rate for Payer: Vantage Medical Group Senior |
$24,881.20
|
|
|
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 |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$13,684.55
|
| Rate for Payer: Cash Price |
$13,684.55
|
| 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: 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: InnovAge PACE Commercial |
$12,440.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,595.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,479.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,401.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,976.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,416.70
|
| Rate for Payer: Molina Healthcare of CA 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
|
$29,272.00
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
906820260
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5,854.40 |
| Max. Negotiated Rate |
$26,344.80 |
| Rate for Payer: Adventist Health Commercial |
$5,854.40
|
| Rate for Payer: Cash Price |
$16,099.60
|
| Rate for Payer: Central Health Plan Commercial |
$23,417.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,708.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11,708.80
|
| Rate for Payer: Galaxy Health WC |
$24,881.20
|
| Rate for Payer: Global Benefits Group Commercial |
$17,563.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$26,344.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,524.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,152.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18,119.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,854.40
|
| Rate for Payer: Multiplan Commercial |
$21,954.00
|
| Rate for Payer: Networks By Design Commercial |
$19,026.80
|
| Rate for Payer: Prime Health Services Commercial |
$24,881.20
|
|
|
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 |
$13,684.55
|
| Rate for Payer: Central Health Plan Commercial |
$19,904.80
|
| 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 Permanente of CA Commercial/Self Funded |
$16,595.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,479.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,401.34
|
| 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
|
$21,593.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
906820242
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,318.60 |
| Max. Negotiated Rate |
$19,433.70 |
| Rate for Payer: Adventist Health Commercial |
$4,318.60
|
| Rate for Payer: Cash Price |
$11,876.15
|
| Rate for Payer: Central Health Plan Commercial |
$17,274.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,637.20
|
| Rate for Payer: EPIC Health Plan Senior |
$8,637.20
|
| Rate for Payer: Galaxy Health WC |
$18,354.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12,955.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,433.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,402.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,226.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,366.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,318.60
|
| Rate for Payer: Multiplan Commercial |
$16,194.75
|
| Rate for Payer: Networks By Design Commercial |
$14,035.45
|
| Rate for Payer: Prime Health Services Commercial |
$18,354.05
|
|
|
HC ATHERECTOMY W CORO STENT ADD'L
|
Facility
|
OP
|
$21,593.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
906820242
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,901.00 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$4,318.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18,354.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,876.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16,194.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$11,876.15
|
| Rate for Payer: Cash Price |
$11,876.15
|
| Rate for Payer: Central Health Plan Commercial |
$17,274.40
|
| Rate for Payer: Cigna of CA HMO |
$14,035.45
|
| Rate for Payer: Cigna of CA PPO |
$15,978.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18,354.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$18,354.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18,354.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,637.20
|
| Rate for Payer: EPIC Health Plan Senior |
$8,637.20
|
| Rate for Payer: Galaxy Health WC |
$18,354.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12,955.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,433.70
|
| Rate for Payer: InnovAge PACE Commercial |
$10,796.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,402.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,366.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,318.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,115.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15,115.10
|
| Rate for Payer: Multiplan Commercial |
$16,194.75
|
| Rate for Payer: Networks By Design Commercial |
$14,035.45
|
| Rate for Payer: Prime Health Services Commercial |
$18,354.05
|
| Rate for Payer: Riverside University Health System MISP |
$8,637.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,955.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12,955.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| 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 |
$18,354.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18,354.05
|
| Rate for Payer: Vantage Medical Group Senior |
$18,354.05
|
|
|
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 |
$2,901.00 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,670.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$10,094.70
|
| Rate for Payer: Cash Price |
$10,094.70
|
| 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: 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: InnovAge PACE Commercial |
$9,177.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,242.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,361.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,670.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,847.80
|
| Rate for Payer: Molina Healthcare of CA 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 |
$17,712.00
|
| 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 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 |
$10,094.70
|
| Rate for Payer: Central Health Plan Commercial |
$14,683.20
|
| 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 Permanente of CA Commercial/Self Funded |
$12,242.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,992.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,361.13
|
| 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 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 |
$11,877.80
|
| Rate for Payer: Central Health Plan Commercial |
$17,276.80
|
| 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 Permanente of CA Commercial/Self Funded |
$14,404.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,228.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,367.92
|
| 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
|
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 |
$14,409.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$11,877.80
|
| Rate for Payer: Cash Price |
$11,877.80
|
| Rate for Payer: Cash Price |
$11,877.80
|
| 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 |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| 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 |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$889.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: InnovAge PACE Commercial |
$21,613.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,404.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$982.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,319.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,308.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| 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 |
$14,409.33
|
| Rate for Payer: Prime Health Services Commercial |
$18,356.60
|
| Rate for Payer: Prime Health Services Medicare |
$15,273.89
|
| Rate for Payer: Riverside University Health System MISP |
$15,850.26
|
| 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 |
$31,261.00
|
| 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 |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
|
OP
|
$25,407.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906820237
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$889.69 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,081.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,409.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$13,973.85
|
| Rate for Payer: Cash Price |
$13,973.85
|
| Rate for Payer: Cash Price |
$13,973.85
|
| Rate for Payer: Central Health Plan Commercial |
$20,325.60
|
| Rate for Payer: Cigna of CA HMO |
$16,514.55
|
| Rate for Payer: Cigna of CA PPO |
$18,801.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$21,595.95
|
| Rate for Payer: Global Benefits Group Commercial |
$15,244.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,866.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$889.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: InnovAge PACE Commercial |
$21,613.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,946.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$982.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,081.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,308.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$19,055.25
|
| Rate for Payer: Networks By Design Commercial |
$16,514.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Prime Health Services Commercial |
$21,595.95
|
| Rate for Payer: Prime Health Services Medicare |
$15,273.89
|
| Rate for Payer: Riverside University Health System MISP |
$15,850.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,244.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15,244.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| 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 |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
|
IP
|
$25,407.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906820237
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,081.40 |
| Max. Negotiated Rate |
$22,866.30 |
| Rate for Payer: Adventist Health Commercial |
$5,081.40
|
| Rate for Payer: Cash Price |
$13,973.85
|
| Rate for Payer: Central Health Plan Commercial |
$20,325.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,162.80
|
| Rate for Payer: EPIC Health Plan Senior |
$10,162.80
|
| Rate for Payer: Galaxy Health WC |
$21,595.95
|
| Rate for Payer: Global Benefits Group Commercial |
$15,244.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,866.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,946.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,680.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,726.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,081.40
|
| Rate for Payer: Multiplan Commercial |
$19,055.25
|
| Rate for Payer: Networks By Design Commercial |
$16,514.55
|
| Rate for Payer: Prime Health Services Commercial |
$21,595.95
|
|
|
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 |
$4,751.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,911.20
|
| 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 Permanente of CA Commercial/Self Funded |
$5,762.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,291.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,347.54
|
| 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 ATHERECTOMY W PTCA ADD'L VESSEL
|
Facility
|
IP
|
$10,164.00
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
906820238
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,032.80 |
| Max. Negotiated Rate |
$9,147.60 |
| Rate for Payer: Adventist Health Commercial |
$2,032.80
|
| Rate for Payer: Cash Price |
$5,590.20
|
| Rate for Payer: Central Health Plan Commercial |
$8,131.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,065.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,065.60
|
| Rate for Payer: Galaxy Health WC |
$8,639.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,098.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,147.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,779.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,872.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,291.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,032.80
|
| Rate for Payer: Multiplan Commercial |
$7,623.00
|
| Rate for Payer: Networks By Design Commercial |
$6,606.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,639.40
|
|
|
HC ATHERECTOMY W PTCA ADD'L VESSEL
|
Facility
|
OP
|
$10,164.00
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
906820238
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,032.80 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$2,032.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,639.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,590.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,623.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$5,590.20
|
| Rate for Payer: Cash Price |
$5,590.20
|
| Rate for Payer: Central Health Plan Commercial |
$8,131.20
|
| Rate for Payer: Cigna of CA HMO |
$6,606.60
|
| Rate for Payer: Cigna of CA PPO |
$7,521.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,639.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,639.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,639.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,065.60
|
| Rate for Payer: EPIC Health Plan Senior |
$4,065.60
|
| Rate for Payer: Galaxy Health WC |
$8,639.40
|
| Rate for Payer: Global Benefits Group Commercial |
$6,098.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,147.60
|
| Rate for Payer: InnovAge PACE Commercial |
$5,082.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,779.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,291.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,032.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7,114.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7,114.80
|
| Rate for Payer: Multiplan Commercial |
$7,623.00
|
| Rate for Payer: Networks By Design Commercial |
$6,606.60
|
| Rate for Payer: Prime Health Services Commercial |
$8,639.40
|
| Rate for Payer: Riverside University Health System MISP |
$4,065.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,098.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,098.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| 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: Vantage Medical Group Commercial/Exchange |
$8,639.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,639.40
|
| Rate for Payer: Vantage Medical Group Senior |
$8,639.40
|
|
|
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 |
$2,901.00
|
| 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 |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$4,751.45
|
| Rate for Payer: Cash Price |
$4,751.45
|
| 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: 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: InnovAge PACE Commercial |
$4,319.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,762.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,347.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,727.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,047.30
|
| Rate for Payer: Molina Healthcare of CA 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 |
$31,261.00
|
| 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: 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 ATHRECTOMY AORTA
|
Facility
|
OP
|
$37,221.00
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
906820163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,179.04 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$7,444.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,409.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,958.69
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$20,471.55
|
| Rate for Payer: Cash Price |
$20,471.55
|
| Rate for Payer: Cash Price |
$20,471.55
|
| Rate for Payer: Central Health Plan Commercial |
$29,776.80
|
| Rate for Payer: Cigna of CA HMO |
$23,821.44
|
| Rate for Payer: Cigna of CA PPO |
$27,543.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$31,637.85
|
| Rate for Payer: Global Benefits Group Commercial |
$22,332.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$33,498.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: InnovAge PACE Commercial |
$21,613.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,826.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,181.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,444.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,308.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$27,915.75
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: Networks By Design Commercial |
$24,193.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Preferred Health Network WC |
$23,427.23
|
| Rate for Payer: Prime Health Services Commercial |
$31,637.85
|
| Rate for Payer: Prime Health Services Medicare |
$15,273.89
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Riverside University Health System MISP |
$15,850.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22,332.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| 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 |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
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 |
$14,409.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$22,958.69
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$23,542.20
|
| Rate for Payer: Cash Price |
$23,542.20
|
| Rate for Payer: Cash Price |
$23,542.20
|
| 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 |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| 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 |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: InnovAge PACE Commercial |
$21,613.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28,550.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,308.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,560.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,308.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| 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 |
$14,409.33
|
| 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 |
$15,273.89
|
| Rate for Payer: Prime Health Services WC |
$22,724.41
|
| Rate for Payer: Riverside University Health System MISP |
$15,850.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25,682.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| 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 |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
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 |
$23,542.20
|
| Rate for Payer: Central Health Plan Commercial |
$34,243.20
|
| 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 Permanente of CA Commercial/Self Funded |
$28,550.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,308.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,495.68
|
| 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
|
|
