|
HC ATHERECTOMY ILIAC
|
Facility
|
IP
|
$25,902.00
|
|
| Hospital Charge Code |
909080049
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,180.40 |
| Max. Negotiated Rate |
$23,311.80 |
| Rate for Payer: Cash Price |
$11,655.90
|
| Rate for Payer: Central Health Plan Commercial |
$20,721.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,360.80
|
| Rate for Payer: Galaxy Health WC |
$22,016.70
|
| Rate for Payer: Global Benefits Group Commercial |
$15,541.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,311.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,276.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,868.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,180.40
|
| Rate for Payer: Multiplan Commercial |
$19,426.50
|
| Rate for Payer: Networks By Design Commercial |
$16,836.30
|
| Rate for Payer: Prime Health Services Commercial |
$22,016.70
|
|
|
HC ATHERECTOMY ILIAC
|
Facility
|
OP
|
$25,902.00
|
|
| Hospital Charge Code |
909080049
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,180.40 |
| Max. Negotiated Rate |
$23,311.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15,730.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,016.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,246.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,246.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,541.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,302.90
|
| Rate for Payer: Blue Distinction Transplant |
$15,541.20
|
| 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 |
$11,655.90
|
| Rate for Payer: Cash Price |
$11,655.90
|
| Rate for Payer: Central Health Plan Commercial |
$20,721.60
|
| Rate for Payer: Cigna of CA PPO |
$19,167.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,016.70
|
| Rate for Payer: Dignity Health Media |
$22,016.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,016.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,360.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,360.80
|
| Rate for Payer: Galaxy Health WC |
$22,016.70
|
| Rate for Payer: Global Benefits Group Commercial |
$15,541.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,311.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19,426.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,065.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,276.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,868.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,180.40
|
| Rate for Payer: Multiplan Commercial |
$19,426.50
|
| Rate for Payer: Networks By Design Commercial |
$16,836.30
|
| Rate for Payer: Prime Health Services Commercial |
$22,016.70
|
| Rate for Payer: Riverside University Health System MISP |
$10,360.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,541.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,951.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,951.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,951.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22,016.70
|
| Rate for Payer: Vantage Medical Group Senior |
$22,016.70
|
|
|
HC ATHERECTOMY, RENAL
|
Facility
|
OP
|
$2,515.00
|
|
|
Service Code
|
CPT 75994
|
| Hospital Charge Code |
909080033
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$503.00 |
| Max. Negotiated Rate |
$2,263.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,527.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,137.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,383.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,383.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,217.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,485.86
|
| Rate for Payer: Blue Distinction Transplant |
$1,509.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,554.27
|
| Rate for Payer: Blue Shield of California EPN |
$1,222.29
|
| Rate for Payer: Cash Price |
$1,131.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,012.00
|
| Rate for Payer: Cigna of CA HMO |
$1,609.60
|
| Rate for Payer: Cigna of CA PPO |
$1,861.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,137.75
|
| Rate for Payer: Dignity Health Media |
$2,137.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,137.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,006.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,006.00
|
| Rate for Payer: Galaxy Health WC |
$2,137.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,509.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,263.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,886.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$880.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,677.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$958.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$503.00
|
| Rate for Payer: Multiplan Commercial |
$1,886.25
|
| Rate for Payer: Networks By Design Commercial |
$1,634.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,137.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,006.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,509.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,509.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,257.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,257.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,257.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,257.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,137.75
|
| Rate for Payer: Vantage Medical Group Senior |
$2,137.75
|
|
|
HC ATHERECTOMY, RENAL
|
Facility
|
IP
|
$2,515.00
|
|
|
Service Code
|
CPT 75994
|
| Hospital Charge Code |
909080033
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$503.00 |
| Max. Negotiated Rate |
$2,263.50 |
| Rate for Payer: Cash Price |
$1,131.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,012.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,006.00
|
| Rate for Payer: Galaxy Health WC |
$2,137.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,509.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,263.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,677.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$958.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$503.00
|
| Rate for Payer: Multiplan Commercial |
$1,886.25
|
| Rate for Payer: Networks By Design Commercial |
$1,634.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,137.75
|
|
|
HC ATHERECTOMY RENAL OR VISCERAL
|
Facility
|
OP
|
$25,902.00
|
|
| Hospital Charge Code |
909080028
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,180.40 |
| Max. Negotiated Rate |
$23,311.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15,730.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,016.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,246.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,246.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,541.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,302.90
|
| Rate for Payer: Blue Distinction Transplant |
$15,541.20
|
| 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 |
$11,655.90
|
| Rate for Payer: Cash Price |
$11,655.90
|
| Rate for Payer: Central Health Plan Commercial |
$20,721.60
|
| Rate for Payer: Cigna of CA PPO |
$19,167.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,016.70
|
| Rate for Payer: Dignity Health Media |
$22,016.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,016.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,360.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$10,360.80
|
| Rate for Payer: Galaxy Health WC |
$22,016.70
|
| Rate for Payer: Global Benefits Group Commercial |
$15,541.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,311.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$19,426.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,065.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,276.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,868.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,180.40
|
| Rate for Payer: Multiplan Commercial |
$19,426.50
|
| Rate for Payer: Networks By Design Commercial |
$16,836.30
|
| Rate for Payer: Prime Health Services Commercial |
$22,016.70
|
| Rate for Payer: Riverside University Health System MISP |
$10,360.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15,541.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,951.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,951.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,951.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12,951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22,016.70
|
| Rate for Payer: Vantage Medical Group Senior |
$22,016.70
|
|
|
HC ATHERECTOMY RENAL OR VISCERAL
|
Facility
|
IP
|
$25,902.00
|
|
| Hospital Charge Code |
909080028
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,180.40 |
| Max. Negotiated Rate |
$23,311.80 |
| Rate for Payer: Cash Price |
$11,655.90
|
| Rate for Payer: Central Health Plan Commercial |
$20,721.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,360.80
|
| Rate for Payer: Galaxy Health WC |
$22,016.70
|
| Rate for Payer: Global Benefits Group Commercial |
$15,541.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$23,311.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,276.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,868.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,180.40
|
| Rate for Payer: Multiplan Commercial |
$19,426.50
|
| Rate for Payer: Networks By Design Commercial |
$16,836.30
|
| Rate for Payer: Prime Health Services Commercial |
$22,016.70
|
|
|
HC ATHERECTOMY, VISCERAL
|
Facility
|
OP
|
$2,515.00
|
|
|
Service Code
|
CPT 75995
|
| Hospital Charge Code |
909080034
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$503.00 |
| Max. Negotiated Rate |
$2,263.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,527.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,137.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,383.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,383.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,217.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,485.86
|
| Rate for Payer: Blue Distinction Transplant |
$1,509.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,554.27
|
| Rate for Payer: Blue Shield of California EPN |
$1,222.29
|
| Rate for Payer: Cash Price |
$1,131.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,012.00
|
| Rate for Payer: Cigna of CA HMO |
$1,609.60
|
| Rate for Payer: Cigna of CA PPO |
$1,861.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,137.75
|
| Rate for Payer: Dignity Health Media |
$2,137.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,137.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,006.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,006.00
|
| Rate for Payer: Galaxy Health WC |
$2,137.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,509.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,263.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,886.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$880.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,677.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$958.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$503.00
|
| Rate for Payer: Multiplan Commercial |
$1,886.25
|
| Rate for Payer: Networks By Design Commercial |
$1,634.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,137.75
|
| Rate for Payer: Riverside University Health System MISP |
$1,006.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,509.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,509.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,257.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,257.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,257.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,257.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,137.75
|
| Rate for Payer: Vantage Medical Group Senior |
$2,137.75
|
|
|
HC ATHERECTOMY, VISCERAL
|
Facility
|
IP
|
$2,515.00
|
|
|
Service Code
|
CPT 75995
|
| Hospital Charge Code |
909080034
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$503.00 |
| Max. Negotiated Rate |
$2,263.50 |
| Rate for Payer: Cash Price |
$1,131.75
|
| Rate for Payer: Central Health Plan Commercial |
$2,012.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,006.00
|
| Rate for Payer: Galaxy Health WC |
$2,137.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1,509.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,263.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,677.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$958.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$503.00
|
| Rate for Payer: Multiplan Commercial |
$1,886.25
|
| Rate for Payer: Networks By Design Commercial |
$1,634.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,137.75
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
IP
|
$35,129.00
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
906811461
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7,025.80 |
| Max. Negotiated Rate |
$31,616.10 |
| Rate for Payer: Cash Price |
$15,808.05
|
| Rate for Payer: Central Health Plan Commercial |
$28,103.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,051.60
|
| Rate for Payer: Galaxy Health WC |
$29,859.65
|
| Rate for Payer: Global Benefits Group Commercial |
$21,077.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$31,616.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23,431.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,384.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,025.80
|
| Rate for Payer: Multiplan Commercial |
$26,346.75
|
| Rate for Payer: Networks By Design Commercial |
$22,833.85
|
| Rate for Payer: Prime Health Services Commercial |
$29,859.65
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
IP
|
$35,129.00
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
906820259
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7,025.80 |
| Max. Negotiated Rate |
$31,616.10 |
| Rate for Payer: Cash Price |
$15,808.05
|
| Rate for Payer: Central Health Plan Commercial |
$28,103.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,051.60
|
| Rate for Payer: Galaxy Health WC |
$29,859.65
|
| Rate for Payer: Global Benefits Group Commercial |
$21,077.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$31,616.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23,431.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,384.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,025.80
|
| Rate for Payer: Multiplan Commercial |
$26,346.75
|
| Rate for Payer: Networks By Design Commercial |
$22,833.85
|
| Rate for Payer: Prime Health Services Commercial |
$29,859.65
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
IP
|
$53,259.00
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
906811438
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,651.80 |
| Max. Negotiated Rate |
$47,933.10 |
| Rate for Payer: Cash Price |
$23,966.55
|
| Rate for Payer: Central Health Plan Commercial |
$42,607.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,303.60
|
| Rate for Payer: Galaxy Health WC |
$45,270.15
|
| Rate for Payer: Global Benefits Group Commercial |
$31,955.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$47,933.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35,523.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20,291.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,651.80
|
| Rate for Payer: Multiplan Commercial |
$39,944.25
|
| Rate for Payer: Networks By Design Commercial |
$34,618.35
|
| Rate for Payer: Prime Health Services Commercial |
$45,270.15
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
OP
|
$53,259.00
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
906811438
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,026.28 |
| Max. Negotiated Rate |
$47,933.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,708.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$31,955.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$23,966.55
|
| Rate for Payer: Cash Price |
$23,966.55
|
| Rate for Payer: Central Health Plan Commercial |
$42,607.20
|
| Rate for Payer: Cigna of CA PPO |
$39,411.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Dignity Health Media |
$21,908.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,099.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,577.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,908.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$21,908.96
|
| Rate for Payer: Galaxy Health WC |
$45,270.15
|
| Rate for Payer: Global Benefits Group Commercial |
$31,955.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$47,933.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$39,944.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35,930.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36,149.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,908.96
|
| Rate for Payer: InnovAge PACE Commercial |
$32,863.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35,523.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,026.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,651.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,358.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,358.01
|
| Rate for Payer: Multiplan Commercial |
$39,944.25
|
| Rate for Payer: Networks By Design Commercial |
$34,618.35
|
| Rate for Payer: Prime Health Services Commercial |
$45,270.15
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Riverside University Health System MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31,955.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31,955.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Vantage Medical Group Senior |
$21,908.96
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
OP
|
$35,129.00
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
906820259
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$36,149.78 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,729.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$21,077.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$15,808.05
|
| Rate for Payer: Cash Price |
$15,808.05
|
| Rate for Payer: Cash Price |
$15,808.05
|
| Rate for Payer: Central Health Plan Commercial |
$28,103.20
|
| Rate for Payer: Cigna of CA HMO |
$22,482.56
|
| Rate for Payer: Cigna of CA PPO |
$25,995.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Dignity Health Media |
$21,908.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,099.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,577.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,908.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$21,908.96
|
| Rate for Payer: Galaxy Health WC |
$29,859.65
|
| Rate for Payer: Global Benefits Group Commercial |
$21,077.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$31,616.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$26,346.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35,930.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36,149.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,908.96
|
| Rate for Payer: InnovAge PACE Commercial |
$32,863.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23,431.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,384.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,025.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,358.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,358.01
|
| Rate for Payer: Multiplan Commercial |
$26,346.75
|
| Rate for Payer: Networks By Design Commercial |
$22,833.85
|
| Rate for Payer: Prime Health Services Commercial |
$29,859.65
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Riverside University Health System MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21,077.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21,077.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Vantage Medical Group Senior |
$21,908.96
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
OP
|
$53,259.00
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
906820241
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,026.28 |
| Max. Negotiated Rate |
$47,933.10 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,708.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$31,955.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$23,966.55
|
| Rate for Payer: Cash Price |
$23,966.55
|
| Rate for Payer: Central Health Plan Commercial |
$42,607.20
|
| Rate for Payer: Cigna of CA PPO |
$39,411.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Dignity Health Media |
$21,908.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,099.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,577.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,908.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$21,908.96
|
| Rate for Payer: Galaxy Health WC |
$45,270.15
|
| Rate for Payer: Global Benefits Group Commercial |
$31,955.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$47,933.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$39,944.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35,930.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36,149.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,908.96
|
| Rate for Payer: InnovAge PACE Commercial |
$32,863.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35,523.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,026.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,651.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,358.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,358.01
|
| Rate for Payer: Multiplan Commercial |
$39,944.25
|
| Rate for Payer: Networks By Design Commercial |
$34,618.35
|
| Rate for Payer: Prime Health Services Commercial |
$45,270.15
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Riverside University Health System MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31,955.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31,955.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Vantage Medical Group Senior |
$21,908.96
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
OP
|
$35,129.00
|
|
|
Service Code
|
CPT C9602
|
| Hospital Charge Code |
906811461
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$36,149.78 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,729.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$21,077.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$15,808.05
|
| Rate for Payer: Cash Price |
$15,808.05
|
| Rate for Payer: Cash Price |
$15,808.05
|
| Rate for Payer: Central Health Plan Commercial |
$28,103.20
|
| Rate for Payer: Cigna of CA HMO |
$22,482.56
|
| Rate for Payer: Cigna of CA PPO |
$25,995.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Dignity Health Media |
$21,908.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,099.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,577.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,908.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$21,908.96
|
| Rate for Payer: Galaxy Health WC |
$29,859.65
|
| Rate for Payer: Global Benefits Group Commercial |
$21,077.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$31,616.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$26,346.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35,930.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36,149.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,908.96
|
| Rate for Payer: InnovAge PACE Commercial |
$32,863.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23,431.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,384.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,025.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,358.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,358.01
|
| Rate for Payer: Multiplan Commercial |
$26,346.75
|
| Rate for Payer: Networks By Design Commercial |
$22,833.85
|
| Rate for Payer: Prime Health Services Commercial |
$29,859.65
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Riverside University Health System MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21,077.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21,077.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Vantage Medical Group Senior |
$21,908.96
|
|
|
HC ATHERECTOMY W CORONARY STENT
|
Facility
|
IP
|
$53,259.00
|
|
|
Service Code
|
CPT 92933
|
| Hospital Charge Code |
906820241
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,651.80 |
| Max. Negotiated Rate |
$47,933.10 |
| Rate for Payer: Cash Price |
$23,966.55
|
| Rate for Payer: Central Health Plan Commercial |
$42,607.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,303.60
|
| Rate for Payer: Galaxy Health WC |
$45,270.15
|
| Rate for Payer: Global Benefits Group Commercial |
$31,955.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$47,933.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35,523.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20,291.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,651.80
|
| Rate for Payer: Multiplan Commercial |
$39,944.25
|
| Rate for Payer: Networks By Design Commercial |
$34,618.35
|
| Rate for Payer: Prime Health Services Commercial |
$45,270.15
|
|
|
HC ATHERECTOMY W CORO STENT ADD
|
Facility
|
IP
|
$30,813.00
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
906820260
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$6,162.60 |
| Max. Negotiated Rate |
$27,731.70 |
| Rate for Payer: Cash Price |
$13,865.85
|
| Rate for Payer: Central Health Plan Commercial |
$24,650.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,325.20
|
| Rate for Payer: Galaxy Health WC |
$26,191.05
|
| Rate for Payer: Global Benefits Group Commercial |
$18,487.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,731.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,552.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,739.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,162.60
|
| Rate for Payer: Multiplan Commercial |
$23,109.75
|
| Rate for Payer: Networks By Design Commercial |
$20,028.45
|
| Rate for Payer: Prime Health Services Commercial |
$26,191.05
|
|
|
HC ATHERECTOMY W CORO STENT ADD
|
Facility
|
IP
|
$30,813.00
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
906811462
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$6,162.60 |
| Max. Negotiated Rate |
$27,731.70 |
| Rate for Payer: Cash Price |
$13,865.85
|
| Rate for Payer: Central Health Plan Commercial |
$24,650.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,325.20
|
| Rate for Payer: Galaxy Health WC |
$26,191.05
|
| Rate for Payer: Global Benefits Group Commercial |
$18,487.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,731.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,552.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,739.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,162.60
|
| Rate for Payer: Multiplan Commercial |
$23,109.75
|
| Rate for Payer: Networks By Design Commercial |
$20,028.45
|
| Rate for Payer: Prime Health Services Commercial |
$26,191.05
|
|
|
HC ATHERECTOMY W CORO STENT ADD
|
Facility
|
OP
|
$30,813.00
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
906820260
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$27,731.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,712.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26,191.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,947.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16,947.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$18,487.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$13,865.85
|
| Rate for Payer: Cash Price |
$13,865.85
|
| Rate for Payer: Cash Price |
$13,865.85
|
| Rate for Payer: Central Health Plan Commercial |
$24,650.40
|
| Rate for Payer: Cigna of CA HMO |
$19,720.32
|
| Rate for Payer: Cigna of CA PPO |
$22,801.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26,191.05
|
| Rate for Payer: Dignity Health Media |
$26,191.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,191.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,325.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,325.20
|
| Rate for Payer: Galaxy Health WC |
$26,191.05
|
| Rate for Payer: Global Benefits Group Commercial |
$18,487.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,731.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$23,109.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10,784.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,552.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,739.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,162.60
|
| Rate for Payer: Multiplan Commercial |
$23,109.75
|
| Rate for Payer: Networks By Design Commercial |
$20,028.45
|
| Rate for Payer: Prime Health Services Commercial |
$26,191.05
|
| Rate for Payer: Riverside University Health System MISP |
$12,325.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,487.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18,487.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,191.05
|
| Rate for Payer: Vantage Medical Group Senior |
$26,191.05
|
|
|
HC ATHERECTOMY W CORO STENT ADD
|
Facility
|
OP
|
$30,813.00
|
|
|
Service Code
|
CPT C9603
|
| Hospital Charge Code |
906811462
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$27,731.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,712.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26,191.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,947.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16,947.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$18,487.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$13,865.85
|
| Rate for Payer: Cash Price |
$13,865.85
|
| Rate for Payer: Cash Price |
$13,865.85
|
| Rate for Payer: Central Health Plan Commercial |
$24,650.40
|
| Rate for Payer: Cigna of CA HMO |
$19,720.32
|
| Rate for Payer: Cigna of CA PPO |
$22,801.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26,191.05
|
| Rate for Payer: Dignity Health Media |
$26,191.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,191.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,325.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,325.20
|
| Rate for Payer: Galaxy Health WC |
$26,191.05
|
| Rate for Payer: Global Benefits Group Commercial |
$18,487.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,731.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$23,109.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10,784.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,552.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,739.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,162.60
|
| Rate for Payer: Multiplan Commercial |
$23,109.75
|
| Rate for Payer: Networks By Design Commercial |
$20,028.45
|
| Rate for Payer: Prime Health Services Commercial |
$26,191.05
|
| Rate for Payer: Riverside University Health System MISP |
$12,325.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,487.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18,487.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,191.05
|
| Rate for Payer: Vantage Medical Group Senior |
$26,191.05
|
|
|
HC ATHERECTOMY W CORO STENT ADD'L
|
Facility
|
IP
|
$22,729.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
906811439
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,545.80 |
| Max. Negotiated Rate |
$20,456.10 |
| Rate for Payer: Cash Price |
$10,228.05
|
| Rate for Payer: Central Health Plan Commercial |
$18,183.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,091.60
|
| Rate for Payer: Galaxy Health WC |
$19,319.65
|
| Rate for Payer: Global Benefits Group Commercial |
$13,637.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,456.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,160.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,659.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,545.80
|
| Rate for Payer: Multiplan Commercial |
$17,046.75
|
| Rate for Payer: Networks By Design Commercial |
$14,773.85
|
| Rate for Payer: Prime Health Services Commercial |
$19,319.65
|
|
|
HC ATHERECTOMY W CORO STENT ADD'L
|
Facility
|
IP
|
$22,729.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
906820242
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,545.80 |
| Max. Negotiated Rate |
$20,456.10 |
| Rate for Payer: Cash Price |
$10,228.05
|
| Rate for Payer: Central Health Plan Commercial |
$18,183.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,091.60
|
| Rate for Payer: Galaxy Health WC |
$19,319.65
|
| Rate for Payer: Global Benefits Group Commercial |
$13,637.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,456.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,160.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,659.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,545.80
|
| Rate for Payer: Multiplan Commercial |
$17,046.75
|
| Rate for Payer: Networks By Design Commercial |
$14,773.85
|
| Rate for Payer: Prime Health Services Commercial |
$19,319.65
|
|
|
HC ATHERECTOMY W CORO STENT ADD'L
|
Facility
|
OP
|
$22,729.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
906811439
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,147.50 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,147.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,319.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12,500.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12,500.95
|
| 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 |
$13,637.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$10,228.05
|
| Rate for Payer: Cash Price |
$10,228.05
|
| Rate for Payer: Central Health Plan Commercial |
$18,183.20
|
| Rate for Payer: Cigna of CA PPO |
$16,819.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,319.65
|
| Rate for Payer: Dignity Health Media |
$19,319.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$19,319.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,091.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,091.60
|
| Rate for Payer: Galaxy Health WC |
$19,319.65
|
| Rate for Payer: Global Benefits Group Commercial |
$13,637.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,456.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$17,046.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,955.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,160.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,545.80
|
| Rate for Payer: Multiplan Commercial |
$17,046.75
|
| Rate for Payer: Networks By Design Commercial |
$14,773.85
|
| Rate for Payer: Prime Health Services Commercial |
$19,319.65
|
| Rate for Payer: Riverside University Health System MISP |
$9,091.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,637.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13,637.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19,319.65
|
| Rate for Payer: Vantage Medical Group Senior |
$19,319.65
|
|
|
HC ATHERECTOMY W CORO STENT ADD'L
|
Facility
|
OP
|
$22,729.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
906820242
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,147.50 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,147.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,319.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12,500.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12,500.95
|
| 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 |
$13,637.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$10,228.05
|
| Rate for Payer: Cash Price |
$10,228.05
|
| Rate for Payer: Central Health Plan Commercial |
$18,183.20
|
| Rate for Payer: Cigna of CA PPO |
$16,819.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,319.65
|
| Rate for Payer: Dignity Health Media |
$19,319.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$19,319.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,091.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,091.60
|
| Rate for Payer: Galaxy Health WC |
$19,319.65
|
| Rate for Payer: Global Benefits Group Commercial |
$13,637.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,456.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$17,046.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,955.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,160.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,545.80
|
| Rate for Payer: Multiplan Commercial |
$17,046.75
|
| Rate for Payer: Networks By Design Commercial |
$14,773.85
|
| Rate for Payer: Prime Health Services Commercial |
$19,319.65
|
| Rate for Payer: Riverside University Health System MISP |
$9,091.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,637.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13,637.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19,319.65
|
| Rate for Payer: Vantage Medical Group Senior |
$19,319.65
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
|
OP
|
$26,744.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906820237
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$982.79 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,551.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$16,046.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$12,034.80
|
| Rate for Payer: Cash Price |
$12,034.80
|
| Rate for Payer: Central Health Plan Commercial |
$21,395.20
|
| Rate for Payer: Cigna of CA PPO |
$19,790.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$22,732.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,046.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,069.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$20,058.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,679.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: InnovAge PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,838.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$982.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,348.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$20,058.00
|
| Rate for Payer: Networks By Design Commercial |
$17,383.60
|
| Rate for Payer: Prime Health Services Commercial |
$22,732.40
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,046.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,046.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
