|
HC ANGIO ADD'L VESSEL
|
Facility
|
OP
|
$4,464.00
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
906820168
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$143.49 |
| Max. Negotiated Rate |
$4,017.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$793.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,794.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,455.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,455.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,608.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,181.33
|
| Rate for Payer: Blue Distinction Transplant |
$2,678.40
|
| Rate for Payer: Blue Shield of California Commercial |
$2,758.75
|
| Rate for Payer: Blue Shield of California EPN |
$2,169.50
|
| Rate for Payer: Cash Price |
$2,008.80
|
| Rate for Payer: Cash Price |
$2,008.80
|
| Rate for Payer: Central Health Plan Commercial |
$3,571.20
|
| Rate for Payer: Cigna of CA HMO |
$2,856.96
|
| Rate for Payer: Cigna of CA PPO |
$3,303.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,794.40
|
| Rate for Payer: Dignity Health Media |
$3,794.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,794.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,785.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,785.60
|
| Rate for Payer: Galaxy Health WC |
$3,794.40
|
| Rate for Payer: Global Benefits Group Commercial |
$2,678.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,017.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,348.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,562.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,977.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$892.80
|
| Rate for Payer: Multiplan Commercial |
$3,348.00
|
| Rate for Payer: Networks By Design Commercial |
$2,901.60
|
| Rate for Payer: Prime Health Services Commercial |
$3,794.40
|
| Rate for Payer: Riverside University Health System MISP |
$1,785.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,678.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,678.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,232.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,232.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,232.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,232.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,794.40
|
| Rate for Payer: Vantage Medical Group Senior |
$3,794.40
|
|
|
HC ANGIO CORONARY
|
Facility
|
OP
|
$3,188.00
|
|
|
Service Code
|
CPT 93563
|
| Hospital Charge Code |
906811412
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$89.11 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,033.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,709.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,753.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,753.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,912.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$1,434.60
|
| Rate for Payer: Cash Price |
$1,434.60
|
| Rate for Payer: Cash Price |
$1,434.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,550.40
|
| Rate for Payer: Cigna of CA PPO |
$2,359.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,709.80
|
| Rate for Payer: Dignity Health Media |
$2,709.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,709.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,275.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,275.20
|
| Rate for Payer: Galaxy Health WC |
$2,709.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,912.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,869.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,391.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,115.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,126.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$637.60
|
| Rate for Payer: Multiplan Commercial |
$2,391.00
|
| Rate for Payer: Networks By Design Commercial |
$2,072.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,709.80
|
| Rate for Payer: Riverside University Health System MISP |
$1,275.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,912.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,912.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,709.80
|
| Rate for Payer: Vantage Medical Group Senior |
$2,709.80
|
|
|
HC ANGIO CORONARY
|
Facility
|
IP
|
$3,188.00
|
|
|
Service Code
|
CPT 93563
|
| Hospital Charge Code |
906820069
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$637.60 |
| Max. Negotiated Rate |
$2,869.20 |
| Rate for Payer: Cash Price |
$1,434.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,550.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,275.20
|
| Rate for Payer: Galaxy Health WC |
$2,709.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,912.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,869.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,126.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,214.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$637.60
|
| Rate for Payer: Multiplan Commercial |
$2,391.00
|
| Rate for Payer: Networks By Design Commercial |
$2,072.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,709.80
|
|
|
HC ANGIO CORONARY
|
Facility
|
OP
|
$3,188.00
|
|
|
Service Code
|
CPT 93563
|
| Hospital Charge Code |
906820069
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$89.11 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,033.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,709.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,753.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,753.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,912.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$1,434.60
|
| Rate for Payer: Cash Price |
$1,434.60
|
| Rate for Payer: Cash Price |
$1,434.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,550.40
|
| Rate for Payer: Cigna of CA PPO |
$2,359.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,709.80
|
| Rate for Payer: Dignity Health Media |
$2,709.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,709.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,275.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,275.20
|
| Rate for Payer: Galaxy Health WC |
$2,709.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,912.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,869.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,391.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,115.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,126.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$637.60
|
| Rate for Payer: Multiplan Commercial |
$2,391.00
|
| Rate for Payer: Networks By Design Commercial |
$2,072.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,709.80
|
| Rate for Payer: Riverside University Health System MISP |
$1,275.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,912.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,912.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,709.80
|
| Rate for Payer: Vantage Medical Group Senior |
$2,709.80
|
|
|
HC ANGIO CORONARY
|
Facility
|
IP
|
$3,188.00
|
|
|
Service Code
|
CPT 93563
|
| Hospital Charge Code |
906811412
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$637.60 |
| Max. Negotiated Rate |
$2,869.20 |
| Rate for Payer: Cash Price |
$1,434.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,550.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,275.20
|
| Rate for Payer: Galaxy Health WC |
$2,709.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,912.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,869.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,126.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,214.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$637.60
|
| Rate for Payer: Multiplan Commercial |
$2,391.00
|
| Rate for Payer: Networks By Design Commercial |
$2,072.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,709.80
|
|
|
HC ANGIOGRAPH ADRENAL BILAT
|
Facility
|
IP
|
$12,419.00
|
|
|
Service Code
|
CPT 75733
|
| Hospital Charge Code |
909081624
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,483.80 |
| Max. Negotiated Rate |
$11,177.10 |
| Rate for Payer: Cash Price |
$5,588.55
|
| Rate for Payer: Central Health Plan Commercial |
$9,935.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,967.60
|
| Rate for Payer: Galaxy Health WC |
$10,556.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,451.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,177.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,283.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,731.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,483.80
|
| Rate for Payer: Multiplan Commercial |
$9,314.25
|
| Rate for Payer: Networks By Design Commercial |
$8,072.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,556.15
|
|
|
HC ANGIOGRAPH ADRENAL BILAT
|
Facility
|
OP
|
$12,419.00
|
|
|
Service Code
|
CPT 75733
|
| Hospital Charge Code |
909081624
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$294.10 |
| Max. Negotiated Rate |
$11,177.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,143.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,622.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,198.96
|
| Rate for Payer: Blue Distinction Transplant |
$7,451.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,674.94
|
| Rate for Payer: Blue Shield of California EPN |
$6,035.63
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$5,588.55
|
| Rate for Payer: Cash Price |
$5,588.55
|
| Rate for Payer: Central Health Plan Commercial |
$9,935.20
|
| Rate for Payer: Cigna of CA HMO |
$7,948.16
|
| Rate for Payer: Cigna of CA PPO |
$9,190.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$10,556.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7,451.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,177.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,314.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,283.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,483.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$9,314.25
|
| Rate for Payer: Networks By Design Commercial |
$8,072.35
|
| Rate for Payer: Prime Health Services Commercial |
$10,556.15
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,451.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,451.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC ANGIOGRAPH ADRENAL UNILAT
|
Facility
|
IP
|
$8,135.00
|
|
|
Service Code
|
CPT 75731
|
| Hospital Charge Code |
909081574
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,627.00 |
| Max. Negotiated Rate |
$7,321.50 |
| Rate for Payer: Cash Price |
$3,660.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,508.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,254.00
|
| Rate for Payer: Galaxy Health WC |
$6,914.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,881.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,321.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,426.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,099.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,627.00
|
| Rate for Payer: Multiplan Commercial |
$6,101.25
|
| Rate for Payer: Networks By Design Commercial |
$5,287.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,914.75
|
|
|
HC ANGIOGRAPH ADRENAL UNILAT
|
Facility
|
OP
|
$8,135.00
|
|
|
Service Code
|
CPT 75731
|
| Hospital Charge Code |
909081574
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$264.99 |
| Max. Negotiated Rate |
$7,321.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$998.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,608.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,181.45
|
| Rate for Payer: Blue Distinction Transplant |
$4,881.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,027.43
|
| Rate for Payer: Blue Shield of California EPN |
$3,953.61
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$3,660.75
|
| Rate for Payer: Cash Price |
$3,660.75
|
| Rate for Payer: Central Health Plan Commercial |
$6,508.00
|
| Rate for Payer: Cigna of CA HMO |
$5,206.40
|
| Rate for Payer: Cigna of CA PPO |
$6,019.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$6,914.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4,881.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,321.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,101.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,426.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$264.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,627.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$6,101.25
|
| Rate for Payer: Networks By Design Commercial |
$5,287.75
|
| Rate for Payer: Prime Health Services Commercial |
$6,914.75
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,881.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,881.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC ANGIOGRAPH EXT CAROTID UNILAT
|
Facility
|
IP
|
$21,162.00
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
909081608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,232.40 |
| Max. Negotiated Rate |
$19,045.80 |
| Rate for Payer: Cash Price |
$9,522.90
|
| Rate for Payer: Central Health Plan Commercial |
$16,929.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,464.80
|
| Rate for Payer: Galaxy Health WC |
$17,987.70
|
| Rate for Payer: Global Benefits Group Commercial |
$12,697.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,045.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,115.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,062.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,232.40
|
| Rate for Payer: Multiplan Commercial |
$15,871.50
|
| Rate for Payer: Networks By Design Commercial |
$13,755.30
|
| Rate for Payer: Prime Health Services Commercial |
$17,987.70
|
|
|
HC ANGIOGRAPH EXT CAROTID UNILAT
|
Facility
|
OP
|
$21,162.00
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
909081608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$168.36 |
| Max. Negotiated Rate |
$19,045.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17,987.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,639.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,639.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$12,697.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Cash Price |
$9,522.90
|
| Rate for Payer: Cash Price |
$9,522.90
|
| Rate for Payer: Central Health Plan Commercial |
$16,929.60
|
| Rate for Payer: Cigna of CA PPO |
$15,659.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,987.70
|
| Rate for Payer: Dignity Health Media |
$17,987.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$17,987.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,464.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,464.80
|
| Rate for Payer: Galaxy Health WC |
$17,987.70
|
| Rate for Payer: Global Benefits Group Commercial |
$12,697.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$19,045.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$15,871.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,406.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14,115.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$168.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,232.40
|
| Rate for Payer: Multiplan Commercial |
$15,871.50
|
| Rate for Payer: Networks By Design Commercial |
$13,755.30
|
| Rate for Payer: Prime Health Services Commercial |
$17,987.70
|
| Rate for Payer: Riverside University Health System MISP |
$8,464.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,697.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,987.70
|
| Rate for Payer: Vantage Medical Group Senior |
$17,987.70
|
|
|
HC ANGIOGRAPH EXTREMITY BILAT
|
Facility
|
IP
|
$13,136.00
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
909081619
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,627.20 |
| Max. Negotiated Rate |
$11,822.40 |
| Rate for Payer: Cash Price |
$5,911.20
|
| Rate for Payer: Central Health Plan Commercial |
$10,508.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,254.40
|
| Rate for Payer: Galaxy Health WC |
$11,165.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,881.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,822.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,761.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,004.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,627.20
|
| Rate for Payer: Multiplan Commercial |
$9,852.00
|
| Rate for Payer: Networks By Design Commercial |
$8,538.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,165.60
|
|
|
HC ANGIOGRAPH EXTREMITY BILAT
|
Facility
|
OP
|
$13,136.00
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
906820191
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$279.28 |
| Max. Negotiated Rate |
$11,822.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,147.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,622.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,198.96
|
| Rate for Payer: Blue Distinction Transplant |
$7,881.60
|
| Rate for Payer: Blue Shield of California Commercial |
$8,118.05
|
| Rate for Payer: Blue Shield of California EPN |
$6,384.10
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$5,911.20
|
| Rate for Payer: Cash Price |
$5,911.20
|
| Rate for Payer: Central Health Plan Commercial |
$10,508.80
|
| Rate for Payer: Cigna of CA HMO |
$8,407.04
|
| Rate for Payer: Cigna of CA PPO |
$9,720.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$11,165.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,881.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,822.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,852.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,761.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$279.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,627.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$9,852.00
|
| Rate for Payer: Networks By Design Commercial |
$8,538.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,165.60
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,881.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,881.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC ANGIOGRAPH EXTREMITY BILAT
|
Facility
|
OP
|
$13,136.00
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
909081619
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$279.28 |
| Max. Negotiated Rate |
$11,822.40 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,147.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,622.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,198.96
|
| Rate for Payer: Blue Distinction Transplant |
$7,881.60
|
| Rate for Payer: Blue Shield of California Commercial |
$8,118.05
|
| Rate for Payer: Blue Shield of California EPN |
$6,384.10
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$5,911.20
|
| Rate for Payer: Cash Price |
$5,911.20
|
| Rate for Payer: Central Health Plan Commercial |
$10,508.80
|
| Rate for Payer: Cigna of CA HMO |
$8,407.04
|
| Rate for Payer: Cigna of CA PPO |
$9,720.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$11,165.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,881.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,822.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,852.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,761.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$279.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,627.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$9,852.00
|
| Rate for Payer: Networks By Design Commercial |
$8,538.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,165.60
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,881.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,881.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC ANGIOGRAPH EXTREMITY BILAT
|
Facility
|
IP
|
$13,136.00
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
906820191
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,627.20 |
| Max. Negotiated Rate |
$11,822.40 |
| Rate for Payer: Cash Price |
$5,911.20
|
| Rate for Payer: Central Health Plan Commercial |
$10,508.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,254.40
|
| Rate for Payer: Galaxy Health WC |
$11,165.60
|
| Rate for Payer: Global Benefits Group Commercial |
$7,881.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,822.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,761.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,004.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,627.20
|
| Rate for Payer: Multiplan Commercial |
$9,852.00
|
| Rate for Payer: Networks By Design Commercial |
$8,538.40
|
| Rate for Payer: Prime Health Services Commercial |
$11,165.60
|
|
|
HC ANGIOGRAPH EXTREMITY UNILAT
|
Facility
|
IP
|
$11,282.00
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
909081572
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,256.40 |
| Max. Negotiated Rate |
$10,153.80 |
| Rate for Payer: Cash Price |
$5,076.90
|
| Rate for Payer: Central Health Plan Commercial |
$9,025.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,512.80
|
| Rate for Payer: Galaxy Health WC |
$9,589.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,769.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,153.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,525.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,298.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,256.40
|
| Rate for Payer: Multiplan Commercial |
$8,461.50
|
| Rate for Payer: Networks By Design Commercial |
$7,333.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,589.70
|
|
|
HC ANGIOGRAPH EXTREMITY UNILAT
|
Facility
|
OP
|
$11,282.00
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
909081572
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$258.67 |
| Max. Negotiated Rate |
$10,153.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$998.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,608.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,181.45
|
| Rate for Payer: Blue Distinction Transplant |
$6,769.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,972.28
|
| Rate for Payer: Blue Shield of California EPN |
$5,483.05
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$5,076.90
|
| Rate for Payer: Cash Price |
$5,076.90
|
| Rate for Payer: Central Health Plan Commercial |
$9,025.60
|
| Rate for Payer: Cigna of CA HMO |
$7,220.48
|
| Rate for Payer: Cigna of CA PPO |
$8,348.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$9,589.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,769.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,153.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,461.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,525.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,256.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$8,461.50
|
| Rate for Payer: Networks By Design Commercial |
$7,333.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,589.70
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,769.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,769.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC ANGIOGRAPH EXTREMITY UNILAT
|
Facility
|
IP
|
$11,282.00
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
906820184
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,256.40 |
| Max. Negotiated Rate |
$10,153.80 |
| Rate for Payer: Cash Price |
$5,076.90
|
| Rate for Payer: Central Health Plan Commercial |
$9,025.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,512.80
|
| Rate for Payer: Galaxy Health WC |
$9,589.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,769.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,153.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,525.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,298.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,256.40
|
| Rate for Payer: Multiplan Commercial |
$8,461.50
|
| Rate for Payer: Networks By Design Commercial |
$7,333.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,589.70
|
|
|
HC ANGIOGRAPH EXTREMITY UNILAT
|
Facility
|
OP
|
$11,282.00
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
906820184
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$258.67 |
| Max. Negotiated Rate |
$10,153.80 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$998.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,608.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,181.45
|
| Rate for Payer: Blue Distinction Transplant |
$6,769.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,972.28
|
| Rate for Payer: Blue Shield of California EPN |
$5,483.05
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$5,076.90
|
| Rate for Payer: Cash Price |
$5,076.90
|
| Rate for Payer: Central Health Plan Commercial |
$9,025.60
|
| Rate for Payer: Cigna of CA HMO |
$7,220.48
|
| Rate for Payer: Cigna of CA PPO |
$8,348.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$9,589.70
|
| Rate for Payer: Global Benefits Group Commercial |
$6,769.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,153.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,461.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,525.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,256.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$8,461.50
|
| Rate for Payer: Networks By Design Commercial |
$7,333.30
|
| Rate for Payer: Prime Health Services Commercial |
$9,589.70
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,769.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,769.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC ANGIOGRAPH INTERNAL MAMMARY
|
Facility
|
OP
|
$11,948.00
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
906820186
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$276.24 |
| Max. Negotiated Rate |
$10,753.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,000.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,608.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,181.45
|
| Rate for Payer: Blue Distinction Transplant |
$7,168.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,383.86
|
| Rate for Payer: Blue Shield of California EPN |
$5,806.73
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$5,376.60
|
| Rate for Payer: Cash Price |
$5,376.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,558.40
|
| Rate for Payer: Cigna of CA HMO |
$7,646.72
|
| Rate for Payer: Cigna of CA PPO |
$8,841.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$10,155.80
|
| Rate for Payer: Global Benefits Group Commercial |
$7,168.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,753.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,961.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,969.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$276.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,389.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$8,961.00
|
| Rate for Payer: Networks By Design Commercial |
$7,766.20
|
| Rate for Payer: Prime Health Services Commercial |
$10,155.80
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,168.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,168.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,688.24
|
| Rate for Payer: United Healthcare All Other HMO |
$1,688.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,688.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,688.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC ANGIOGRAPH INTERNAL MAMMARY
|
Facility
|
OP
|
$11,948.00
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
909081576
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$276.24 |
| Max. Negotiated Rate |
$10,753.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,000.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,608.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,181.45
|
| Rate for Payer: Blue Distinction Transplant |
$7,168.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,383.86
|
| Rate for Payer: Blue Shield of California EPN |
$5,806.73
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$5,376.60
|
| Rate for Payer: Cash Price |
$5,376.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,558.40
|
| Rate for Payer: Cigna of CA HMO |
$7,646.72
|
| Rate for Payer: Cigna of CA PPO |
$8,841.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$10,155.80
|
| Rate for Payer: Global Benefits Group Commercial |
$7,168.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,753.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,961.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,969.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$276.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,389.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$8,961.00
|
| Rate for Payer: Networks By Design Commercial |
$7,766.20
|
| Rate for Payer: Prime Health Services Commercial |
$10,155.80
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,168.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,168.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,688.24
|
| Rate for Payer: United Healthcare All Other HMO |
$1,688.24
|
| Rate for Payer: United Healthcare HMO Rider |
$1,688.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,688.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC ANGIOGRAPH INTERNAL MAMMARY
|
Facility
|
IP
|
$11,948.00
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
906820186
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,389.60 |
| Max. Negotiated Rate |
$10,753.20 |
| Rate for Payer: Cash Price |
$5,376.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,558.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,779.20
|
| Rate for Payer: Galaxy Health WC |
$10,155.80
|
| Rate for Payer: Global Benefits Group Commercial |
$7,168.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,753.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,969.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,552.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,389.60
|
| Rate for Payer: Multiplan Commercial |
$8,961.00
|
| Rate for Payer: Networks By Design Commercial |
$7,766.20
|
| Rate for Payer: Prime Health Services Commercial |
$10,155.80
|
|
|
HC ANGIOGRAPH INTERNAL MAMMARY
|
Facility
|
IP
|
$11,948.00
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
909081576
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,389.60 |
| Max. Negotiated Rate |
$10,753.20 |
| Rate for Payer: Cash Price |
$5,376.60
|
| Rate for Payer: Central Health Plan Commercial |
$9,558.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,779.20
|
| Rate for Payer: Galaxy Health WC |
$10,155.80
|
| Rate for Payer: Global Benefits Group Commercial |
$7,168.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,753.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,969.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,552.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,389.60
|
| Rate for Payer: Multiplan Commercial |
$8,961.00
|
| Rate for Payer: Networks By Design Commercial |
$7,766.20
|
| Rate for Payer: Prime Health Services Commercial |
$10,155.80
|
|
|
HC ANGIOGRAPH PULMONARY BILAT
|
Facility
|
OP
|
$11,597.00
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
909081627
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$255.63 |
| Max. Negotiated Rate |
$10,437.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$912.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,622.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,198.96
|
| Rate for Payer: Blue Distinction Transplant |
$6,958.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,166.95
|
| Rate for Payer: Blue Shield of California EPN |
$5,636.14
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$5,218.65
|
| Rate for Payer: Cash Price |
$5,218.65
|
| Rate for Payer: Central Health Plan Commercial |
$9,277.60
|
| Rate for Payer: Cigna of CA HMO |
$7,422.08
|
| Rate for Payer: Cigna of CA PPO |
$8,581.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$9,857.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,958.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,437.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,697.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,735.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$255.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,319.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$8,697.75
|
| Rate for Payer: Networks By Design Commercial |
$7,538.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,857.45
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,958.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,958.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC ANGIOGRAPH PULMONARY BILAT
|
Facility
|
IP
|
$11,597.00
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
909081627
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,319.40 |
| Max. Negotiated Rate |
$10,437.30 |
| Rate for Payer: Cash Price |
$5,218.65
|
| Rate for Payer: Central Health Plan Commercial |
$9,277.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,638.80
|
| Rate for Payer: Galaxy Health WC |
$9,857.45
|
| Rate for Payer: Global Benefits Group Commercial |
$6,958.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,437.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,735.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,418.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,319.40
|
| Rate for Payer: Multiplan Commercial |
$8,697.75
|
| Rate for Payer: Networks By Design Commercial |
$7,538.05
|
| Rate for Payer: Prime Health Services Commercial |
$9,857.45
|
|
