|
HC CORD NEOX RT 2.0X2.0CM
|
Facility
|
OP
|
$775.00
|
|
|
Service Code
|
CPT Q4148
|
| Hospital Charge Code |
900102201
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$155.00 |
| Max. Negotiated Rate |
$795.92 |
| Rate for Payer: Adventist Health Commercial |
$155.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$160.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$795.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$240.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$176.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$160.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$375.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$450.82
|
| Rate for Payer: Blue Shield of California Commercial |
$491.35
|
| Rate for Payer: Blue Shield of California EPN |
$309.23
|
| Rate for Payer: Cash Price |
$348.75
|
| Rate for Payer: Cash Price |
$348.75
|
| Rate for Payer: Central Health Plan Commercial |
$620.00
|
| Rate for Payer: Cigna of CA HMO |
$542.50
|
| Rate for Payer: Cigna of CA PPO |
$542.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$240.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$176.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$160.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$542.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.10
|
| Rate for Payer: EPIC Health Plan Senior |
$176.07
|
| Rate for Payer: Galaxy Health WC |
$658.75
|
| Rate for Payer: Global Benefits Group Commercial |
$465.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$697.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$262.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$160.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$492.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$281.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$224.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$155.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$214.48
|
| Rate for Payer: Multiplan Commercial |
$581.25
|
| Rate for Payer: Networks By Design Commercial |
$387.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$160.06
|
| Rate for Payer: Prime Health Services Commercial |
$658.75
|
| Rate for Payer: Prime Health Services Medicare |
$169.66
|
| Rate for Payer: Riverside University Health System MISP |
$176.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$465.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$465.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.86
|
| Rate for Payer: United Healthcare All Other HMO |
$283.11
|
| Rate for Payer: United Healthcare HMO Rider |
$276.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$253.81
|
| Rate for Payer: Upland Medical Group Pediatric |
$160.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$240.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$176.07
|
| Rate for Payer: Vantage Medical Group Senior |
$160.06
|
|
|
HC CORD NEOX RT 3.0X2.0CM
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
CPT Q4148
|
| Hospital Charge Code |
900102202
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$795.92 |
| Rate for Payer: Adventist Health Commercial |
$130.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$160.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$795.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$240.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$176.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$160.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$314.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$378.11
|
| Rate for Payer: Blue Shield of California Commercial |
$412.10
|
| Rate for Payer: Blue Shield of California EPN |
$259.35
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Central Health Plan Commercial |
$520.00
|
| Rate for Payer: Cigna of CA HMO |
$455.00
|
| Rate for Payer: Cigna of CA PPO |
$455.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$240.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$176.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$160.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$455.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.10
|
| Rate for Payer: EPIC Health Plan Senior |
$176.07
|
| Rate for Payer: Galaxy Health WC |
$552.50
|
| Rate for Payer: Global Benefits Group Commercial |
$390.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$585.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$262.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$160.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$412.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$235.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$224.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$214.48
|
| Rate for Payer: Multiplan Commercial |
$487.50
|
| Rate for Payer: Networks By Design Commercial |
$325.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$160.06
|
| Rate for Payer: Prime Health Services Commercial |
$552.50
|
| Rate for Payer: Prime Health Services Medicare |
$169.66
|
| Rate for Payer: Riverside University Health System MISP |
$176.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$390.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$390.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$243.94
|
| Rate for Payer: United Healthcare All Other HMO |
$237.44
|
| Rate for Payer: United Healthcare HMO Rider |
$232.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$212.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$160.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$240.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$176.07
|
| Rate for Payer: Vantage Medical Group Senior |
$160.06
|
|
|
HC CORD NEOX RT 3.0X2.0CM
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
CPT Q4148
|
| Hospital Charge Code |
900102202
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$585.00 |
| Rate for Payer: Adventist Health Commercial |
$130.00
|
| Rate for Payer: Blue Shield of California Commercial |
$521.30
|
| Rate for Payer: Blue Shield of California EPN |
$327.60
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Central Health Plan Commercial |
$520.00
|
| Rate for Payer: Cigna of CA HMO |
$455.00
|
| Rate for Payer: Cigna of CA PPO |
$455.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$455.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$260.00
|
| Rate for Payer: EPIC Health Plan Senior |
$260.00
|
| Rate for Payer: Galaxy Health WC |
$552.50
|
| Rate for Payer: Global Benefits Group Commercial |
$390.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$585.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$412.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$383.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.00
|
| Rate for Payer: Multiplan Commercial |
$487.50
|
| Rate for Payer: Networks By Design Commercial |
$325.00
|
| Rate for Payer: Prime Health Services Commercial |
$552.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$243.94
|
| Rate for Payer: United Healthcare All Other HMO |
$237.44
|
| Rate for Payer: United Healthcare HMO Rider |
$232.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$212.88
|
|
|
HC CORD NEOX RT 3.0X3.0CM
|
Facility
|
IP
|
$433.00
|
|
|
Service Code
|
CPT Q4148
|
| Hospital Charge Code |
900102203
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$86.60 |
| Max. Negotiated Rate |
$389.70 |
| Rate for Payer: Adventist Health Commercial |
$86.60
|
| Rate for Payer: Blue Shield of California Commercial |
$347.27
|
| Rate for Payer: Blue Shield of California EPN |
$218.23
|
| Rate for Payer: Cash Price |
$194.85
|
| Rate for Payer: Central Health Plan Commercial |
$346.40
|
| Rate for Payer: Cigna of CA HMO |
$303.10
|
| Rate for Payer: Cigna of CA PPO |
$303.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$303.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$173.20
|
| Rate for Payer: EPIC Health Plan Senior |
$173.20
|
| Rate for Payer: Galaxy Health WC |
$368.05
|
| Rate for Payer: Global Benefits Group Commercial |
$259.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$389.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$274.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$255.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.60
|
| Rate for Payer: Multiplan Commercial |
$324.75
|
| Rate for Payer: Networks By Design Commercial |
$216.50
|
| Rate for Payer: Prime Health Services Commercial |
$368.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$162.50
|
| Rate for Payer: United Healthcare All Other HMO |
$158.17
|
| Rate for Payer: United Healthcare HMO Rider |
$154.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$141.81
|
|
|
HC CORD NEOX RT 3.0X3.0CM
|
Facility
|
OP
|
$433.00
|
|
|
Service Code
|
CPT Q4148
|
| Hospital Charge Code |
900102203
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$86.60 |
| Max. Negotiated Rate |
$795.92 |
| Rate for Payer: Adventist Health Commercial |
$86.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$160.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$795.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$240.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$176.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$160.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$209.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$251.88
|
| Rate for Payer: Blue Shield of California Commercial |
$274.52
|
| Rate for Payer: Blue Shield of California EPN |
$172.77
|
| Rate for Payer: Cash Price |
$194.85
|
| Rate for Payer: Cash Price |
$194.85
|
| Rate for Payer: Central Health Plan Commercial |
$346.40
|
| Rate for Payer: Cigna of CA HMO |
$303.10
|
| Rate for Payer: Cigna of CA PPO |
$303.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$240.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$176.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$160.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$303.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.10
|
| Rate for Payer: EPIC Health Plan Senior |
$176.07
|
| Rate for Payer: Galaxy Health WC |
$368.05
|
| Rate for Payer: Global Benefits Group Commercial |
$259.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$389.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$262.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$160.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$274.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$157.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$224.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$86.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$214.48
|
| Rate for Payer: Multiplan Commercial |
$324.75
|
| Rate for Payer: Networks By Design Commercial |
$216.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$160.06
|
| Rate for Payer: Prime Health Services Commercial |
$368.05
|
| Rate for Payer: Prime Health Services Medicare |
$169.66
|
| Rate for Payer: Riverside University Health System MISP |
$176.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$259.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$259.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$162.50
|
| Rate for Payer: United Healthcare All Other HMO |
$158.17
|
| Rate for Payer: United Healthcare HMO Rider |
$154.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$141.81
|
| Rate for Payer: Upland Medical Group Pediatric |
$160.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$240.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$176.07
|
| Rate for Payer: Vantage Medical Group Senior |
$160.06
|
|
|
HC CORD NEOX RT 4.0X3.0CM
|
Facility
|
IP
|
$325.00
|
|
|
Service Code
|
CPT Q4148
|
| Hospital Charge Code |
900102204
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$65.00
|
| Rate for Payer: Blue Shield of California Commercial |
$260.65
|
| Rate for Payer: Blue Shield of California EPN |
$163.80
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Central Health Plan Commercial |
$260.00
|
| Rate for Payer: Cigna of CA HMO |
$227.50
|
| Rate for Payer: Cigna of CA PPO |
$227.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.00
|
| Rate for Payer: EPIC Health Plan Senior |
$130.00
|
| Rate for Payer: Galaxy Health WC |
$276.25
|
| Rate for Payer: Global Benefits Group Commercial |
$195.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$292.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$206.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$191.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.00
|
| Rate for Payer: Multiplan Commercial |
$243.75
|
| Rate for Payer: Networks By Design Commercial |
$162.50
|
| Rate for Payer: Prime Health Services Commercial |
$276.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.97
|
| Rate for Payer: United Healthcare All Other HMO |
$118.72
|
| Rate for Payer: United Healthcare HMO Rider |
$116.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.44
|
|
|
HC CORD NEOX RT 4.0X3.0CM
|
Facility
|
OP
|
$325.00
|
|
|
Service Code
|
CPT Q4148
|
| Hospital Charge Code |
900102204
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$795.92 |
| Rate for Payer: Adventist Health Commercial |
$65.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$160.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$795.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$240.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$176.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$160.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$157.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$189.05
|
| Rate for Payer: Blue Shield of California Commercial |
$206.05
|
| Rate for Payer: Blue Shield of California EPN |
$129.68
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Cash Price |
$146.25
|
| Rate for Payer: Central Health Plan Commercial |
$260.00
|
| Rate for Payer: Cigna of CA HMO |
$227.50
|
| Rate for Payer: Cigna of CA PPO |
$227.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$240.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$176.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$160.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.10
|
| Rate for Payer: EPIC Health Plan Senior |
$176.07
|
| Rate for Payer: Galaxy Health WC |
$276.25
|
| Rate for Payer: Global Benefits Group Commercial |
$195.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$292.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$262.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$160.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$206.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$117.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$224.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$214.48
|
| Rate for Payer: Multiplan Commercial |
$243.75
|
| Rate for Payer: Networks By Design Commercial |
$162.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$160.06
|
| Rate for Payer: Prime Health Services Commercial |
$276.25
|
| Rate for Payer: Prime Health Services Medicare |
$169.66
|
| Rate for Payer: Riverside University Health System MISP |
$176.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$195.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.97
|
| Rate for Payer: United Healthcare All Other HMO |
$118.72
|
| Rate for Payer: United Healthcare HMO Rider |
$116.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.44
|
| Rate for Payer: Upland Medical Group Pediatric |
$160.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$240.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$176.07
|
| Rate for Payer: Vantage Medical Group Senior |
$160.06
|
|
|
HC CORDOCENTESIS INTRAUTERINE PUBS
|
Facility
|
OP
|
$1,250.00
|
|
|
Service Code
|
CPT 59012
|
| Hospital Charge Code |
910400084
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$250.00 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$250.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$391.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,231.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$391.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$792.50
|
| Rate for Payer: Blue Shield of California EPN |
$498.75
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,000.00
|
| Rate for Payer: Cigna of CA HMO |
$800.00
|
| Rate for Payer: Cigna of CA PPO |
$925.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$587.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$431.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$391.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$875.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$646.68
|
| Rate for Payer: EPIC Health Plan Senior |
$431.12
|
| Rate for Payer: Galaxy Health WC |
$1,062.50
|
| Rate for Payer: Global Benefits Group Commercial |
$750.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,125.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$642.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$294.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$391.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$793.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$325.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$548.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$250.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$525.19
|
| Rate for Payer: Multiplan Commercial |
$937.50
|
| Rate for Payer: Networks By Design Commercial |
$812.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$391.93
|
| Rate for Payer: Prime Health Services Commercial |
$1,062.50
|
| Rate for Payer: Prime Health Services Medicare |
$415.45
|
| Rate for Payer: Riverside University Health System MISP |
$431.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$750.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$750.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$635.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$581.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$391.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$587.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$431.12
|
| Rate for Payer: Vantage Medical Group Senior |
$391.93
|
|
|
HC CORDOCENTESIS INTRAUTERINE PUBS
|
Facility
|
IP
|
$1,250.00
|
|
|
Service Code
|
CPT 59012
|
| Hospital Charge Code |
910400084
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$250.00 |
| Max. Negotiated Rate |
$1,125.00 |
| Rate for Payer: Adventist Health Commercial |
$250.00
|
| Rate for Payer: Cash Price |
$562.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,000.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$875.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$500.00
|
| Rate for Payer: EPIC Health Plan Senior |
$500.00
|
| Rate for Payer: Galaxy Health WC |
$1,062.50
|
| Rate for Payer: Global Benefits Group Commercial |
$750.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,125.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$793.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$737.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$250.00
|
| Rate for Payer: Multiplan Commercial |
$937.50
|
| Rate for Payer: Networks By Design Commercial |
$812.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,062.50
|
|
|
HC CORE NDL BX PERC INCL IMG GDNC
|
Facility
|
OP
|
$6,946.00
|
|
|
Service Code
|
CPT 32408
|
| Hospital Charge Code |
909000408
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$639.21 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,389.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,124.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,124.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,280.13
|
| Rate for Payer: Blue Shield of California Commercial |
$1,017.03
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$3,125.70
|
| Rate for Payer: Cash Price |
$3,125.70
|
| Rate for Payer: Cash Price |
$3,125.70
|
| Rate for Payer: Central Health Plan Commercial |
$5,556.80
|
| Rate for Payer: Cigna of CA HMO |
$4,445.44
|
| Rate for Payer: Cigna of CA PPO |
$5,140.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,336.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,124.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,862.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,504.98
|
| Rate for Payer: EPIC Health Plan Senior |
$2,336.65
|
| Rate for Payer: Galaxy Health WC |
$5,904.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,167.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,251.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,483.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,511.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,410.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,669.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,973.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,389.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,846.47
|
| Rate for Payer: Multiplan Commercial |
$5,209.50
|
| Rate for Payer: Multiplan WC |
$3,280.13
|
| Rate for Payer: Networks By Design Commercial |
$4,514.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,124.23
|
| Rate for Payer: Preferred Health Network WC |
$3,347.07
|
| Rate for Payer: Prime Health Services Commercial |
$5,904.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,251.68
|
| Rate for Payer: Prime Health Services WC |
$3,246.66
|
| Rate for Payer: Riverside University Health System MISP |
$2,336.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,167.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,473.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,124.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,186.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,336.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2,124.23
|
|
|
HC CORE NDL BX PERC INCL IMG GDNC
|
Facility
|
IP
|
$6,946.00
|
|
|
Service Code
|
CPT 32408
|
| Hospital Charge Code |
909000408
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,389.20 |
| Max. Negotiated Rate |
$6,251.40 |
| Rate for Payer: Adventist Health Commercial |
$1,389.20
|
| Rate for Payer: Cash Price |
$3,125.70
|
| Rate for Payer: Central Health Plan Commercial |
$5,556.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,862.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,778.40
|
| Rate for Payer: EPIC Health Plan Senior |
$2,778.40
|
| Rate for Payer: Galaxy Health WC |
$5,904.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4,167.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,251.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,410.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,098.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,389.20
|
| Rate for Payer: Multiplan Commercial |
$5,209.50
|
| Rate for Payer: Networks By Design Commercial |
$4,514.90
|
| Rate for Payer: Prime Health Services Commercial |
$5,904.10
|
|
|
HC CORO CATH, CORO ANGIO
|
Facility
|
OP
|
$13,983.00
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
906811401
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,354.76 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$2,796.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,169.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,169.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$6,292.35
|
| Rate for Payer: Cash Price |
$6,292.35
|
| Rate for Payer: Cash Price |
$6,292.35
|
| Rate for Payer: Central Health Plan Commercial |
$11,186.40
|
| Rate for Payer: Cigna of CA HMO |
$9,088.95
|
| Rate for Payer: Cigna of CA PPO |
$10,347.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,586.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,169.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,788.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,879.96
|
| Rate for Payer: EPIC Health Plan Senior |
$4,586.64
|
| Rate for Payer: Galaxy Health WC |
$11,885.55
|
| Rate for Payer: Global Benefits Group Commercial |
$8,389.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,584.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,838.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,354.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,879.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,496.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,837.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,796.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,587.36
|
| Rate for Payer: Multiplan Commercial |
$10,487.25
|
| Rate for Payer: Networks By Design Commercial |
$9,088.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Prime Health Services Commercial |
$11,885.55
|
| Rate for Payer: Prime Health Services Medicare |
$4,419.85
|
| Rate for Payer: Riverside University Health System MISP |
$4,586.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,389.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,991.50
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,169.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Vantage Medical Group Senior |
$4,169.67
|
|
|
HC CORO CATH, CORO ANGIO
|
Facility
|
IP
|
$13,983.00
|
|
|
Service Code
|
CPT 93454
|
| Hospital Charge Code |
906811401
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,796.60 |
| Max. Negotiated Rate |
$12,584.70 |
| Rate for Payer: Adventist Health Commercial |
$2,796.60
|
| Rate for Payer: Cash Price |
$6,292.35
|
| Rate for Payer: Central Health Plan Commercial |
$11,186.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9,788.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,593.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5,593.20
|
| Rate for Payer: Galaxy Health WC |
$11,885.55
|
| Rate for Payer: Global Benefits Group Commercial |
$8,389.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,584.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,879.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,249.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,796.60
|
| Rate for Payer: Multiplan Commercial |
$10,487.25
|
| Rate for Payer: Networks By Design Commercial |
$9,088.95
|
| Rate for Payer: Prime Health Services Commercial |
$11,885.55
|
|
|
HC CORO CATH, CORO ANGIO,GRAFT,IM
|
Facility
|
OP
|
$11,967.00
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
906811402
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,581.52 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$2,393.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,169.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,169.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$5,385.15
|
| Rate for Payer: Cash Price |
$5,385.15
|
| Rate for Payer: Cash Price |
$5,385.15
|
| Rate for Payer: Central Health Plan Commercial |
$9,573.60
|
| Rate for Payer: Cigna of CA HMO |
$7,778.55
|
| Rate for Payer: Cigna of CA PPO |
$8,855.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,586.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,169.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,376.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,879.96
|
| Rate for Payer: EPIC Health Plan Senior |
$4,586.64
|
| Rate for Payer: Galaxy Health WC |
$10,171.95
|
| Rate for Payer: Global Benefits Group Commercial |
$7,180.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,770.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,838.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,581.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,599.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,747.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,837.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,393.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,587.36
|
| Rate for Payer: Multiplan Commercial |
$8,975.25
|
| Rate for Payer: Networks By Design Commercial |
$7,778.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,169.67
|
| Rate for Payer: Prime Health Services Commercial |
$10,171.95
|
| Rate for Payer: Prime Health Services Medicare |
$4,419.85
|
| Rate for Payer: Riverside University Health System MISP |
$4,586.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,180.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,983.50
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,169.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,254.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,586.64
|
| Rate for Payer: Vantage Medical Group Senior |
$4,169.67
|
|
|
HC CORO CATH, CORO ANGIO,GRAFT,IM
|
Facility
|
IP
|
$11,967.00
|
|
|
Service Code
|
CPT 93455
|
| Hospital Charge Code |
906811402
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,393.40 |
| Max. Negotiated Rate |
$10,770.30 |
| Rate for Payer: Adventist Health Commercial |
$2,393.40
|
| Rate for Payer: Cash Price |
$5,385.15
|
| Rate for Payer: Central Health Plan Commercial |
$9,573.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,376.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,786.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4,786.80
|
| Rate for Payer: Galaxy Health WC |
$10,171.95
|
| Rate for Payer: Global Benefits Group Commercial |
$7,180.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,770.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7,599.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,060.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,393.40
|
| Rate for Payer: Multiplan Commercial |
$8,975.25
|
| Rate for Payer: Networks By Design Commercial |
$7,778.55
|
| Rate for Payer: Prime Health Services Commercial |
$10,171.95
|
|
|
HC CORONARY CTA W/MORPH W/O CCS
|
Facility
|
OP
|
$4,587.00
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
909201402
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$255.00 |
| Max. Negotiated Rate |
$4,128.30 |
| Rate for Payer: Adventist Health Commercial |
$917.40
|
| Rate for Payer: Adventist Health Commercial |
$643.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Adventist Health Medi-Cal |
$448.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,364.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,507.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,507.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,668.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,871.91
|
| Rate for Payer: Blue Shield of California Commercial |
$2,027.34
|
| Rate for Payer: Blue Shield of California Commercial |
$2,889.81
|
| Rate for Payer: Blue Shield of California EPN |
$1,821.04
|
| Rate for Payer: Blue Shield of California EPN |
$1,277.55
|
| Rate for Payer: Cash Price |
$1,448.10
|
| Rate for Payer: Cash Price |
$2,064.15
|
| Rate for Payer: Cash Price |
$2,064.15
|
| Rate for Payer: Cash Price |
$1,448.10
|
| Rate for Payer: Cash Price |
$1,448.10
|
| Rate for Payer: Cash Price |
$2,064.15
|
| Rate for Payer: Center for Health Promotion Commercial |
$255.00
|
| Rate for Payer: Center for Health Promotion Commercial |
$255.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,574.40
|
| Rate for Payer: Central Health Plan Commercial |
$3,669.60
|
| Rate for Payer: Cigna of CA HMO |
$2,935.68
|
| Rate for Payer: Cigna of CA HMO |
$2,059.52
|
| Rate for Payer: Cigna of CA PPO |
$3,394.38
|
| Rate for Payer: Cigna of CA PPO |
$2,381.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,210.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,252.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$2,735.30
|
| Rate for Payer: Galaxy Health WC |
$3,898.95
|
| Rate for Payer: Global Benefits Group Commercial |
$1,930.80
|
| Rate for Payer: Global Benefits Group Commercial |
$2,752.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,896.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,128.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$536.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$536.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,043.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,912.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$593.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$593.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$643.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$917.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$3,440.25
|
| Rate for Payer: Multiplan Commercial |
$2,413.50
|
| Rate for Payer: Networks By Design Commercial |
$2,091.70
|
| Rate for Payer: Networks By Design Commercial |
$2,981.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$448.71
|
| Rate for Payer: Prime Health Services Commercial |
$2,735.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,898.95
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Prime Health Services Medicare |
$475.63
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Riverside University Health System MISP |
$493.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,930.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,752.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,930.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,752.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$669.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$669.92
|
| Rate for Payer: United Healthcare All Other HMO |
$669.92
|
| Rate for Payer: United Healthcare All Other HMO |
$669.92
|
| Rate for Payer: United Healthcare HMO Rider |
$669.92
|
| Rate for Payer: United Healthcare HMO Rider |
$669.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$669.92
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
|
HC CORONARY CTA W/MORPH W/O CCS
|
Facility
|
IP
|
$4,587.00
|
|
|
Service Code
|
CPT 75574
|
| Hospital Charge Code |
909201402
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$917.40 |
| Max. Negotiated Rate |
$4,128.30 |
| Rate for Payer: Adventist Health Commercial |
$917.40
|
| Rate for Payer: Cash Price |
$2,064.15
|
| Rate for Payer: Central Health Plan Commercial |
$3,669.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,210.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,834.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,834.80
|
| Rate for Payer: Galaxy Health WC |
$3,898.95
|
| Rate for Payer: Global Benefits Group Commercial |
$2,752.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,128.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,912.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,706.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$917.40
|
| Rate for Payer: Multiplan Commercial |
$3,440.25
|
| Rate for Payer: Networks By Design Commercial |
$2,981.55
|
| Rate for Payer: Prime Health Services Commercial |
$3,898.95
|
|
|
HC CORONARY STENT ADD'L VESSEL
|
Facility
|
OP
|
$7,987.00
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
906811437
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,597.40 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$1,597.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,788.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,392.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,990.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$3,594.15
|
| Rate for Payer: Cash Price |
$3,594.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,389.60
|
| Rate for Payer: Cigna of CA HMO |
$5,191.55
|
| Rate for Payer: Cigna of CA PPO |
$5,910.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,788.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,788.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,788.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,590.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,194.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,194.80
|
| Rate for Payer: Galaxy Health WC |
$6,788.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,792.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,188.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,071.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,899.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,712.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,597.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,590.90
|
| Rate for Payer: Multiplan Commercial |
$5,990.25
|
| Rate for Payer: Networks By Design Commercial |
$5,191.55
|
| Rate for Payer: Prime Health Services Commercial |
$6,788.95
|
| Rate for Payer: Riverside University Health System MISP |
$3,194.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,792.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,792.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,993.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,788.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,788.95
|
| Rate for Payer: Vantage Medical Group Senior |
$6,788.95
|
|
|
HC CORONARY STENT ADD'L VESSEL
|
Facility
|
IP
|
$7,987.00
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
906811437
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,597.40 |
| Max. Negotiated Rate |
$7,188.30 |
| Rate for Payer: Adventist Health Commercial |
$1,597.40
|
| Rate for Payer: Cash Price |
$3,594.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,389.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,590.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,194.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,194.80
|
| Rate for Payer: Galaxy Health WC |
$6,788.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,792.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,188.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,071.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,712.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,597.40
|
| Rate for Payer: Multiplan Commercial |
$5,990.25
|
| Rate for Payer: Networks By Design Commercial |
$5,191.55
|
| Rate for Payer: Prime Health Services Commercial |
$6,788.95
|
|
|
HC CORONARY STENT ADD VESSEL
|
Facility
|
OP
|
$22,694.00
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
906811460
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$20,424.60 |
| Rate for Payer: Adventist Health Commercial |
$4,538.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,566.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,289.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12,481.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17,020.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$10,212.30
|
| Rate for Payer: Cash Price |
$10,212.30
|
| Rate for Payer: Cash Price |
$10,212.30
|
| Rate for Payer: Cash Price |
$10,212.30
|
| Rate for Payer: Central Health Plan Commercial |
$18,155.20
|
| Rate for Payer: Cigna of CA HMO |
$14,524.16
|
| Rate for Payer: Cigna of CA PPO |
$16,793.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,289.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$19,289.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19,289.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,885.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,077.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9,077.60
|
| Rate for Payer: Galaxy Health WC |
$19,289.90
|
| Rate for Payer: Global Benefits Group Commercial |
$13,616.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,424.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,410.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8,237.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,389.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,538.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15,885.80
|
| Rate for Payer: Multiplan Commercial |
$17,020.50
|
| Rate for Payer: Networks By Design Commercial |
$14,751.10
|
| Rate for Payer: Prime Health Services Commercial |
$19,289.90
|
| Rate for Payer: Riverside University Health System MISP |
$9,077.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,616.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13,616.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,289.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19,289.90
|
| Rate for Payer: Vantage Medical Group Senior |
$19,289.90
|
|
|
HC CORONARY STENT ADD VESSEL
|
Facility
|
IP
|
$22,694.00
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
906811460
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,538.80 |
| Max. Negotiated Rate |
$20,424.60 |
| Rate for Payer: Adventist Health Commercial |
$4,538.80
|
| Rate for Payer: Cash Price |
$10,212.30
|
| Rate for Payer: Central Health Plan Commercial |
$18,155.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,885.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,077.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9,077.60
|
| Rate for Payer: Galaxy Health WC |
$19,289.90
|
| Rate for Payer: Global Benefits Group Commercial |
$13,616.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,424.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,410.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,389.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,538.80
|
| Rate for Payer: Multiplan Commercial |
$17,020.50
|
| Rate for Payer: Networks By Design Commercial |
$14,751.10
|
| Rate for Payer: Prime Health Services Commercial |
$19,289.90
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
IP
|
$37,324.00
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
906811459
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7,464.80 |
| Max. Negotiated Rate |
$33,591.60 |
| Rate for Payer: Adventist Health Commercial |
$7,464.80
|
| Rate for Payer: Cash Price |
$16,795.80
|
| Rate for Payer: Central Health Plan Commercial |
$29,859.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26,126.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,929.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,929.60
|
| Rate for Payer: Galaxy Health WC |
$31,725.40
|
| Rate for Payer: Global Benefits Group Commercial |
$22,394.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$33,591.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23,700.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22,021.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,464.80
|
| Rate for Payer: Multiplan Commercial |
$27,993.00
|
| Rate for Payer: Networks By Design Commercial |
$24,260.60
|
| Rate for Payer: Prime Health Services Commercial |
$31,725.40
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
IP
|
$19,968.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
906811436
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,993.60 |
| Max. Negotiated Rate |
$17,971.20 |
| Rate for Payer: Adventist Health Commercial |
$3,993.60
|
| Rate for Payer: Cash Price |
$8,985.60
|
| Rate for Payer: Central Health Plan Commercial |
$15,974.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13,977.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,987.20
|
| Rate for Payer: EPIC Health Plan Senior |
$7,987.20
|
| Rate for Payer: Galaxy Health WC |
$16,972.80
|
| Rate for Payer: Global Benefits Group Commercial |
$11,980.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,971.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,679.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,781.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,993.60
|
| Rate for Payer: Multiplan Commercial |
$14,976.00
|
| Rate for Payer: Networks By Design Commercial |
$12,979.20
|
| Rate for Payer: Prime Health Services Commercial |
$16,972.80
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
OP
|
$37,324.00
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
906811459
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$33,591.60 |
| Rate for Payer: Adventist Health Commercial |
$7,464.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,785.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$16,795.80
|
| Rate for Payer: Cash Price |
$16,795.80
|
| Rate for Payer: Cash Price |
$16,795.80
|
| Rate for Payer: Cash Price |
$16,795.80
|
| Rate for Payer: Central Health Plan Commercial |
$29,859.20
|
| Rate for Payer: Cigna of CA HMO |
$23,887.36
|
| Rate for Payer: Cigna of CA PPO |
$27,619.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26,126.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$31,725.40
|
| Rate for Payer: Global Benefits Group Commercial |
$22,394.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$33,591.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23,700.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13,548.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,464.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$27,993.00
|
| Rate for Payer: Networks By Design Commercial |
$24,260.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Prime Health Services Commercial |
$31,725.40
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22,394.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22,394.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
OP
|
$19,968.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
906811436
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$830.85 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,993.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$8,985.60
|
| Rate for Payer: Cash Price |
$8,985.60
|
| Rate for Payer: Cash Price |
$8,985.60
|
| Rate for Payer: Central Health Plan Commercial |
$15,974.40
|
| Rate for Payer: Cigna of CA HMO |
$12,979.20
|
| Rate for Payer: Cigna of CA PPO |
$14,776.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13,977.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$16,972.80
|
| Rate for Payer: Global Benefits Group Commercial |
$11,980.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,971.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$830.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,679.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$917.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,993.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$14,976.00
|
| Rate for Payer: Networks By Design Commercial |
$12,979.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Prime Health Services Commercial |
$16,972.80
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,980.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,980.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
