|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
|
IP
|
$47,060.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
906820155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,412.00 |
| Max. Negotiated Rate |
$42,354.00 |
| Rate for Payer: Adventist Health Commercial |
$9,412.00
|
| Rate for Payer: Cash Price |
$25,883.00
|
| Rate for Payer: Central Health Plan Commercial |
$37,648.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,824.00
|
| Rate for Payer: EPIC Health Plan Senior |
$18,824.00
|
| Rate for Payer: Galaxy Health WC |
$40,001.00
|
| Rate for Payer: Global Benefits Group Commercial |
$28,236.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,354.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,389.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,929.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,130.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,412.00
|
| Rate for Payer: Multiplan Commercial |
$35,295.00
|
| Rate for Payer: Networks By Design Commercial |
$30,589.00
|
| Rate for Payer: Prime Health Services Commercial |
$40,001.00
|
|
|
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 |
$22,000.55
|
| Rate for Payer: Central Health Plan Commercial |
$32,000.80
|
| 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 Permanente of CA Commercial/Self Funded |
$26,680.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15,240.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,760.62
|
| 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 |
$222.21 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$8,000.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| 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 |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,581.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,352.92
|
| Rate for Payer: Blue Shield of California Commercial |
$5,999.40
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$22,000.55
|
| Rate for Payer: Cash Price |
$22,000.55
|
| Rate for Payer: Cash Price |
$22,000.55
|
| 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 |
$34,223.71
|
| 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 |
$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: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$222.21
|
| 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 |
$26,680.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$245.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,000.20
|
| 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 |
$30,000.75
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$26,000.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| 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 Medicare |
$24,184.76
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24,000.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,866.00
|
| 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: 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 ATHRECTOMY & STENT TIBIOPERONE
|
Facility
|
OP
|
$47,060.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
906820155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$222.21 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$9,412.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| 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 |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,581.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,352.92
|
| Rate for Payer: Blue Shield of California Commercial |
$5,999.40
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$25,883.00
|
| Rate for Payer: Cash Price |
$25,883.00
|
| Rate for Payer: Cash Price |
$25,883.00
|
| Rate for Payer: Central Health Plan Commercial |
$37,648.00
|
| Rate for Payer: Cigna of CA HMO |
$30,118.40
|
| Rate for Payer: Cigna of CA PPO |
$34,824.40
|
| 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 |
$40,001.00
|
| Rate for Payer: Global Benefits Group Commercial |
$28,236.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,354.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$222.21
|
| 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 |
$31,389.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$245.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,412.00
|
| 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 |
$35,295.00
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$30,589.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Preferred Health Network WC |
$37,094.82
|
| Rate for Payer: Prime Health Services Commercial |
$40,001.00
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28,236.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,866.00
|
| 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: 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 ATHRECTOMY TIBIOPERONEAL
|
Facility
|
IP
|
$26,601.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
906820153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,320.20 |
| Max. Negotiated Rate |
$23,940.90 |
| Rate for Payer: Adventist Health Commercial |
$5,320.20
|
| Rate for Payer: Cash Price |
$14,630.55
|
| Rate for Payer: Central Health Plan Commercial |
$21,280.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,640.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,640.40
|
| Rate for Payer: Galaxy Health WC |
$22,610.85
|
| Rate for Payer: Global Benefits Group Commercial |
$15,960.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,940.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,742.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,134.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,466.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,320.20
|
| Rate for Payer: Multiplan Commercial |
$19,950.75
|
| Rate for Payer: Networks By Design Commercial |
$17,290.65
|
| Rate for Payer: Prime Health Services Commercial |
$22,610.85
|
|
|
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 |
$12,436.05
|
| Rate for Payer: Central Health Plan Commercial |
$18,088.80
|
| 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 Permanente of CA Commercial/Self Funded |
$15,081.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,614.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,996.21
|
| 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
|
Facility
|
OP
|
$26,601.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
906820153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$210.68 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,320.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| 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 |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,581.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,352.92
|
| Rate for Payer: Blue Shield of California Commercial |
$5,999.40
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$14,630.55
|
| Rate for Payer: Cash Price |
$14,630.55
|
| Rate for Payer: Cash Price |
$14,630.55
|
| Rate for Payer: Central Health Plan Commercial |
$21,280.80
|
| Rate for Payer: Cigna of CA HMO |
$17,024.64
|
| Rate for Payer: Cigna of CA PPO |
$19,684.74
|
| 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 |
$22,610.85
|
| Rate for Payer: Global Benefits Group Commercial |
$15,960.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,940.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$210.68
|
| 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 |
$17,742.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,320.20
|
| 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 |
$19,950.75
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$17,290.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Preferred Health Network WC |
$37,094.82
|
| Rate for Payer: Prime Health Services Commercial |
$22,610.85
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,960.60
|
| 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 |
$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 ATHRECTOMY TIBIOPERONEAL
|
Facility
|
OP
|
$22,611.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
909020070
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$210.68 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,522.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| 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 |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,581.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,352.92
|
| Rate for Payer: Blue Shield of California Commercial |
$5,999.40
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$12,436.05
|
| Rate for Payer: Cash Price |
$12,436.05
|
| Rate for Payer: Cash Price |
$12,436.05
|
| 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 |
$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 |
$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: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$210.68
|
| 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 |
$15,081.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,522.20
|
| 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 |
$16,958.25
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$14,697.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| 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 Medicare |
$24,184.76
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,566.60
|
| 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 |
$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 ATHRECTOMY TIBIOPERONEAL EA AD
|
Facility
|
OP
|
$26,601.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
906820157
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$97.33 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$5,320.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,610.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,630.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19,950.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,581.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,999.40
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$14,630.55
|
| Rate for Payer: Cash Price |
$14,630.55
|
| Rate for Payer: Cash Price |
$14,630.55
|
| Rate for Payer: Central Health Plan Commercial |
$21,280.80
|
| Rate for Payer: Cigna of CA HMO |
$17,024.64
|
| Rate for Payer: Cigna of CA PPO |
$19,684.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,610.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,610.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,610.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,640.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,640.40
|
| Rate for Payer: Galaxy Health WC |
$22,610.85
|
| Rate for Payer: Global Benefits Group Commercial |
$15,960.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,940.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$97.33
|
| Rate for Payer: InnovAge PACE Commercial |
$13,300.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,742.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,466.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,320.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,620.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,620.70
|
| Rate for Payer: Multiplan Commercial |
$19,950.75
|
| Rate for Payer: Networks By Design Commercial |
$17,290.65
|
| Rate for Payer: Prime Health Services Commercial |
$22,610.85
|
| Rate for Payer: Riverside University Health System MISP |
$10,640.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,960.60
|
| 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: Vantage Medical Group Commercial/Exchange |
$22,610.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22,610.85
|
| Rate for Payer: Vantage Medical Group Senior |
$22,610.85
|
|
|
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 |
$12,436.05
|
| Rate for Payer: Central Health Plan Commercial |
$18,088.80
|
| 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 Permanente of CA Commercial/Self Funded |
$15,081.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,614.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,996.21
|
| 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
|
IP
|
$26,601.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
906820157
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,320.20 |
| Max. Negotiated Rate |
$23,940.90 |
| Rate for Payer: Adventist Health Commercial |
$5,320.20
|
| Rate for Payer: Cash Price |
$14,630.55
|
| Rate for Payer: Central Health Plan Commercial |
$21,280.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,640.40
|
| Rate for Payer: EPIC Health Plan Senior |
$10,640.40
|
| Rate for Payer: Galaxy Health WC |
$22,610.85
|
| Rate for Payer: Global Benefits Group Commercial |
$15,960.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,940.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,742.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,134.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,466.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,320.20
|
| Rate for Payer: Multiplan Commercial |
$19,950.75
|
| Rate for Payer: Networks By Design Commercial |
$17,290.65
|
| Rate for Payer: Prime Health Services Commercial |
$22,610.85
|
|
|
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 |
$97.33 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$4,522.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,219.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12,436.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16,958.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,581.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,999.40
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$12,436.05
|
| Rate for Payer: Cash Price |
$12,436.05
|
| Rate for Payer: Cash Price |
$12,436.05
|
| 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: 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: Inland Empire Health Plan (IEHP) medi-cal |
$97.33
|
| Rate for Payer: InnovAge PACE Commercial |
$11,305.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,081.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$107.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,996.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,522.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,827.70
|
| Rate for Payer: Molina Healthcare of CA 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 |
$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 |
$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 VISCERAL
|
Facility
|
OP
|
$37,221.00
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
906820161
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,374.00 |
| Max. Negotiated Rate |
$33,498.90 |
| Rate for Payer: Adventist Health Commercial |
$7,444.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31,637.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20,471.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27,915.75
|
| 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: 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: 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 |
$31,637.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,637.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31,637.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,888.40
|
| Rate for Payer: EPIC Health Plan Senior |
$14,888.40
|
| 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: InnovAge PACE Commercial |
$18,610.50
|
| 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 |
$23,039.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,444.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26,054.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26,054.70
|
| Rate for Payer: Multiplan Commercial |
$27,915.75
|
| Rate for Payer: Networks By Design Commercial |
$24,193.65
|
| Rate for Payer: Prime Health Services Commercial |
$31,637.85
|
| Rate for Payer: Riverside University Health System MISP |
$14,888.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22,332.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$31,637.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,637.85
|
| Rate for Payer: Vantage Medical Group Senior |
$31,637.85
|
|
|
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 |
$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
|
|
|
HC ATHRECTOMY VISCERAL
|
Facility
|
IP
|
$37,221.00
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
906820161
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,444.20 |
| Max. Negotiated Rate |
$33,498.90 |
| Rate for Payer: Adventist Health Commercial |
$7,444.20
|
| Rate for Payer: Cash Price |
$20,471.55
|
| Rate for Payer: Central Health Plan Commercial |
$29,776.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,888.40
|
| Rate for Payer: EPIC Health Plan Senior |
$14,888.40
|
| 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: 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 |
$23,039.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,444.20
|
| Rate for Payer: Multiplan Commercial |
$27,915.75
|
| Rate for Payer: Networks By Design Commercial |
$24,193.65
|
| Rate for Payer: Prime Health Services Commercial |
$31,637.85
|
|
|
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 |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| 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: 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: 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: InnovAge PACE Commercial |
$21,402.00
|
| 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: Molina Healthcare of CA Medi-Cal |
$29,962.80
|
| Rate for Payer: Molina Healthcare of CA 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 |
$4,341.00
|
| 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 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$4,646.40
|
| Rate for Payer: Cash Price |
$4,646.40
|
| Rate for Payer: Cash Price |
$4,646.40
|
| 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: 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: InnovAge PACE Commercial |
$4,224.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,634.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,191.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,229.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,689.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,913.60
|
| Rate for Payer: Molina Healthcare of CA 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 |
$4,341.00
|
| 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
|
$9,939.00
|
|
|
Service Code
|
CPT 33741
|
| Hospital Charge Code |
906820317
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,987.80 |
| Max. Negotiated Rate |
$8,945.10 |
| Rate for Payer: Adventist Health Commercial |
$1,987.80
|
| Rate for Payer: Cash Price |
$5,466.45
|
| Rate for Payer: Central Health Plan Commercial |
$7,951.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,975.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,975.60
|
| Rate for Payer: Galaxy Health WC |
$8,448.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,963.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,945.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,629.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,786.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,152.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,987.80
|
| Rate for Payer: Multiplan Commercial |
$7,454.25
|
| Rate for Payer: Networks By Design Commercial |
$6,460.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,448.15
|
|
|
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 |
$4,646.40
|
| Rate for Payer: Central Health Plan Commercial |
$6,758.40
|
| 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 Permanente of CA Commercial/Self Funded |
$5,634.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,218.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,229.31
|
| 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 ATRIAL BALLOON SEPTOSTOMY
|
Facility
|
OP
|
$9,939.00
|
|
|
Service Code
|
CPT 33741
|
| Hospital Charge Code |
906820317
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,079.01 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,987.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,448.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,466.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,454.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$5,466.45
|
| Rate for Payer: Cash Price |
$5,466.45
|
| Rate for Payer: Cash Price |
$5,466.45
|
| Rate for Payer: Central Health Plan Commercial |
$7,951.20
|
| Rate for Payer: Cigna of CA HMO |
$6,360.96
|
| Rate for Payer: Cigna of CA PPO |
$7,354.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,448.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,448.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,448.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,975.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,975.60
|
| Rate for Payer: Galaxy Health WC |
$8,448.15
|
| Rate for Payer: Global Benefits Group Commercial |
$5,963.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,945.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,079.01
|
| Rate for Payer: InnovAge PACE Commercial |
$4,969.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,629.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,191.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,152.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,987.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,957.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,957.30
|
| Rate for Payer: Multiplan Commercial |
$7,454.25
|
| Rate for Payer: Networks By Design Commercial |
$6,460.35
|
| Rate for Payer: Prime Health Services Commercial |
$8,448.15
|
| Rate for Payer: Riverside University Health System MISP |
$3,975.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,963.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| 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 |
$8,448.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,448.15
|
| Rate for Payer: Vantage Medical Group Senior |
$8,448.15
|
|
|
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: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA 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
|
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: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA 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 |
$447.00 |
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| 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: 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: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA 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: Cash Price |
$0.01
|
| Rate for Payer: Central Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA 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 |
$447.00 |
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| 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: 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: InnovAge PACE Commercial |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.01
|
| Rate for Payer: Molina Healthcare of CA 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
|
|
