|
HC ATHERECTOMY W PTCA
|
Facility
IP
|
$26,744.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906811434
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,348.80 |
| Max. Negotiated Rate |
$24,069.60 |
| Rate for Payer: Cash Price |
$12,034.80
|
| Rate for Payer: Central Health Plan Commercial |
$21,395.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,697.60
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$17,838.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,348.80
|
| 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
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
OP
|
$26,744.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906811434
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,551.10 |
| 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: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare 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: BCBS Transplant 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: 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 Transplant Other |
$20,058.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: IEHP medi-cal |
$22,679.61
|
| Rate for Payer: 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 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: Redlands Yucaipa Medical Group Commercial/Senior |
$16,046.40
|
| Rate for Payer: Riverside University Health 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
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
IP
|
$26,744.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906820237
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,348.80 |
| Max. Negotiated Rate |
$24,069.60 |
| Rate for Payer: Cash Price |
$12,034.80
|
| Rate for Payer: Central Health Plan Commercial |
$21,395.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,697.60
|
| 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: Kaiser Permanente of CA Commercial/Self Funded |
$17,838.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,348.80
|
| 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
|
|
|
HC ATHERECTOMY W PTCA ADD'L VESSEL
|
Facility
OP
|
$10,699.00
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
906811435
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,840.71 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,840.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9,094.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,884.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5,884.45
|
| 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: BCBS Transplant Transplant |
$6,419.40
|
| 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 |
$4,814.55
|
| Rate for Payer: Cash Price |
$4,814.55
|
| Rate for Payer: Central Health Plan Commercial |
$8,559.20
|
| Rate for Payer: Cigna of CA PPO |
$7,917.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,094.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,279.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,279.60
|
| Rate for Payer: Galaxy Health WC |
$9,094.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,419.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,629.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,024.25
|
| Rate for Payer: IEHP medi-cal |
$3,744.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,136.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,139.80
|
| Rate for Payer: Multiplan Commercial |
$8,024.25
|
| Rate for Payer: Networks By Design Commercial |
$6,954.35
|
| Rate for Payer: Prime Health Services Commercial |
$9,094.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,419.40
|
| Rate for Payer: Riverside University Health MISP |
$4,279.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,419.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,419.40
|
| 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 Medi-Cal |
$9,094.15
|
| Rate for Payer: Vantage Medical Group Senior |
$9,094.15
|
|
|
HC ATHERECTOMY W PTCA ADD'L VESSEL
|
Facility
IP
|
$10,699.00
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
906811435
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,139.80 |
| Max. Negotiated Rate |
$9,629.10 |
| Rate for Payer: Cash Price |
$4,814.55
|
| Rate for Payer: Central Health Plan Commercial |
$8,559.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,279.60
|
| Rate for Payer: Galaxy Health WC |
$9,094.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,419.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,629.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,136.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,139.80
|
| Rate for Payer: Multiplan Commercial |
$8,024.25
|
| Rate for Payer: Networks By Design Commercial |
$6,954.35
|
| Rate for Payer: Prime Health Services Commercial |
$9,094.15
|
|
|
HC ATHERECTOMY W PTCA ADD'L VESSEL
|
Facility
IP
|
$10,699.00
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
906820238
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,139.80 |
| Max. Negotiated Rate |
$9,629.10 |
| Rate for Payer: Cash Price |
$4,814.55
|
| Rate for Payer: Central Health Plan Commercial |
$8,559.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,279.60
|
| Rate for Payer: Galaxy Health WC |
$9,094.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,419.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,629.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,136.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,139.80
|
| Rate for Payer: Multiplan Commercial |
$8,024.25
|
| Rate for Payer: Networks By Design Commercial |
$6,954.35
|
| Rate for Payer: Prime Health Services Commercial |
$9,094.15
|
|
|
HC ATHERECTOMY W PTCA ADD'L VESSEL
|
Facility
OP
|
$10,699.00
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
906820238
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,840.71 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,840.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9,094.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,884.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5,884.45
|
| 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: BCBS Transplant Transplant |
$6,419.40
|
| 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 |
$4,814.55
|
| Rate for Payer: Cash Price |
$4,814.55
|
| Rate for Payer: Central Health Plan Commercial |
$8,559.20
|
| Rate for Payer: Cigna of CA PPO |
$7,917.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,094.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,279.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,279.60
|
| Rate for Payer: Galaxy Health WC |
$9,094.15
|
| Rate for Payer: Global Benefits Group Commercial |
$6,419.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,629.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,024.25
|
| Rate for Payer: IEHP medi-cal |
$3,744.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,136.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,139.80
|
| Rate for Payer: Multiplan Commercial |
$8,024.25
|
| Rate for Payer: Networks By Design Commercial |
$6,954.35
|
| Rate for Payer: Prime Health Services Commercial |
$9,094.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6,419.40
|
| Rate for Payer: Riverside University Health MISP |
$4,279.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,419.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,419.40
|
| 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 Medi-Cal |
$9,094.15
|
| Rate for Payer: Vantage Medical Group Senior |
$9,094.15
|
|
|
HC ATHRECTOMY AORTA
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
909020080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,473.20 |
| Max. Negotiated Rate |
$29,129.40 |
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,946.40
|
| Rate for Payer: Galaxy Health WC |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,588.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| Rate for Payer: Multiplan Commercial |
$24,274.50
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
|
|
HC ATHRECTOMY AORTA
|
Facility
OP
|
$32,366.00
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
909020080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,419.00 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: BCBS Transplant Transplant |
$19,419.60
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: Cigna of CA PPO |
$23,950.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| 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 |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24,274.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: IEHP medi-cal |
$22,679.61
|
| Rate for Payer: 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 |
$21,588.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| 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 |
$24,274.50
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19,419.60
|
| Rate for Payer: Riverside University Health MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,419.60
|
| 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
|
|
|
HC ATHRECTOMY AORTA
|
Facility
OP
|
$32,366.00
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
906820163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,419.00 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: BCBS Transplant Transplant |
$19,419.60
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: Cigna of CA PPO |
$23,950.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| 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 |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24,274.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: IEHP medi-cal |
$22,679.61
|
| Rate for Payer: 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 |
$21,588.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| 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 |
$24,274.50
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19,419.60
|
| Rate for Payer: Riverside University Health MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,419.60
|
| 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
|
|
|
HC ATHRECTOMY AORTA
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
906820163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,473.20 |
| Max. Negotiated Rate |
$29,129.40 |
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,946.40
|
| Rate for Payer: Galaxy Health WC |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,588.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| Rate for Payer: Multiplan Commercial |
$24,274.50
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
|
|
HC ATHRECTOMY BRACHIOCEPHALIC
|
Facility
OP
|
$32,366.00
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
906820162
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,419.00 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: BCBS Transplant Transplant |
$19,419.60
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: Cigna of CA PPO |
$23,950.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| 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 |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24,274.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: IEHP medi-cal |
$22,679.61
|
| Rate for Payer: 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 |
$21,588.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| 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 |
$24,274.50
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19,419.60
|
| Rate for Payer: Riverside University Health MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,419.60
|
| 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
|
|
|
HC ATHRECTOMY BRACHIOCEPHALIC
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
906820162
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,473.20 |
| Max. Negotiated Rate |
$29,129.40 |
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,946.40
|
| Rate for Payer: Galaxy Health WC |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,588.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| Rate for Payer: Multiplan Commercial |
$24,274.50
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
|
|
HC ATHRECTOMY BRACHIOCEPHALIC
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
909020079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,473.20 |
| Max. Negotiated Rate |
$29,129.40 |
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,946.40
|
| Rate for Payer: Galaxy Health WC |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,588.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| Rate for Payer: Multiplan Commercial |
$24,274.50
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
|
|
HC ATHRECTOMY BRACHIOCEPHALIC
|
Facility
OP
|
$32,366.00
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
909020079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,419.00 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: BCBS Transplant Transplant |
$19,419.60
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: Cigna of CA PPO |
$23,950.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| 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 |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24,274.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: IEHP medi-cal |
$22,679.61
|
| Rate for Payer: 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 |
$21,588.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| 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 |
$24,274.50
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19,419.60
|
| Rate for Payer: Riverside University Health MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,419.60
|
| 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
|
|
|
HC ATHRECTOMY FEM/POP
|
Facility
OP
|
$28,001.00
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
906820149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,183.44 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,952.68
|
| Rate for Payer: BCBS Transplant Transplant |
$16,800.60
|
| Rate for Payer: Blue Shield of California Commercial |
$5,824.53
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.44
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$12,600.45
|
| Rate for Payer: Cash Price |
$12,600.45
|
| Rate for Payer: Central Health Plan Commercial |
$22,400.80
|
| Rate for Payer: Cigna of CA PPO |
$20,720.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| 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 |
$23,800.85
|
| Rate for Payer: Global Benefits Group Commercial |
$16,800.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,200.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21,000.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35,930.69
|
| Rate for Payer: IEHP medi-cal |
$36,149.78
|
| Rate for Payer: 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 |
$18,676.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,600.20
|
| 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 |
$21,000.75
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: Networks By Design Commercial |
$18,200.65
|
| Rate for Payer: Preferred Health Network WC |
$30,563.96
|
| Rate for Payer: Prime Health Services Commercial |
$23,800.85
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Prime Health Services WC |
$29,647.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16,800.60
|
| Rate for Payer: Riverside University Health MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,800.60
|
| 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 |
$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 ATHRECTOMY FEM/POP
|
Facility
IP
|
$28,001.00
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
906820149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,600.20 |
| Max. Negotiated Rate |
$25,200.90 |
| Rate for Payer: Cash Price |
$12,600.45
|
| Rate for Payer: Central Health Plan Commercial |
$22,400.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,200.40
|
| Rate for Payer: Galaxy Health WC |
$23,800.85
|
| Rate for Payer: Global Benefits Group Commercial |
$16,800.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,200.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,676.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,600.20
|
| Rate for Payer: Multiplan Commercial |
$21,000.75
|
| Rate for Payer: Networks By Design Commercial |
$18,200.65
|
| Rate for Payer: Prime Health Services Commercial |
$23,800.85
|
|
|
HC ATHRECTOMY FEM/POP
|
Facility
OP
|
$28,001.00
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
909020066
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,183.44 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,952.68
|
| Rate for Payer: BCBS Transplant Transplant |
$16,800.60
|
| Rate for Payer: Blue Shield of California Commercial |
$5,824.53
|
| Rate for Payer: Blue Shield of California EPN |
$4,183.44
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$12,600.45
|
| Rate for Payer: Cash Price |
$12,600.45
|
| Rate for Payer: Central Health Plan Commercial |
$22,400.80
|
| Rate for Payer: Cigna of CA PPO |
$20,720.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| 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 |
$23,800.85
|
| Rate for Payer: Global Benefits Group Commercial |
$16,800.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,200.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21,000.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35,930.69
|
| Rate for Payer: IEHP medi-cal |
$36,149.78
|
| Rate for Payer: 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 |
$18,676.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,600.20
|
| 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 |
$21,000.75
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: Networks By Design Commercial |
$18,200.65
|
| Rate for Payer: Preferred Health Network WC |
$30,563.96
|
| Rate for Payer: Prime Health Services Commercial |
$23,800.85
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Prime Health Services WC |
$29,647.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16,800.60
|
| Rate for Payer: Riverside University Health MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,800.60
|
| 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 |
$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 ATHRECTOMY FEM/POP
|
Facility
IP
|
$28,001.00
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
909020066
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,600.20 |
| Max. Negotiated Rate |
$25,200.90 |
| Rate for Payer: Cash Price |
$12,600.45
|
| Rate for Payer: Central Health Plan Commercial |
$22,400.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,200.40
|
| Rate for Payer: Galaxy Health WC |
$23,800.85
|
| Rate for Payer: Global Benefits Group Commercial |
$16,800.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,200.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,676.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,600.20
|
| Rate for Payer: Multiplan Commercial |
$21,000.75
|
| Rate for Payer: Networks By Design Commercial |
$18,200.65
|
| Rate for Payer: Prime Health Services Commercial |
$23,800.85
|
|
|
HC ATHRECTOMY ILIAC
|
Facility
OP
|
$32,366.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
906820164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,419.00 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14,850.48
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,952.68
|
| Rate for Payer: BCBS Transplant Transplant |
$19,419.60
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: Cigna of CA PPO |
$23,950.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| 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 |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24,274.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35,930.69
|
| Rate for Payer: IEHP medi-cal |
$36,149.78
|
| Rate for Payer: 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 |
$21,588.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| 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 |
$24,274.50
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Preferred Health Network WC |
$30,563.96
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Prime Health Services WC |
$29,647.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19,419.60
|
| Rate for Payer: Riverside University Health MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,419.60
|
| 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 |
$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 ATHRECTOMY ILIAC
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
909020081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,473.20 |
| Max. Negotiated Rate |
$29,129.40 |
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,946.40
|
| Rate for Payer: Galaxy Health WC |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,588.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| Rate for Payer: Multiplan Commercial |
$24,274.50
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
|
|
HC ATHRECTOMY ILIAC
|
Facility
OP
|
$32,366.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
909020081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,419.00 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14,850.48
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,952.68
|
| Rate for Payer: BCBS Transplant Transplant |
$19,419.60
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: Cigna of CA PPO |
$23,950.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| 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 |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24,274.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35,930.69
|
| Rate for Payer: IEHP medi-cal |
$36,149.78
|
| Rate for Payer: 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 |
$21,588.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| 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 |
$24,274.50
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Preferred Health Network WC |
$30,563.96
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Prime Health Services WC |
$29,647.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19,419.60
|
| Rate for Payer: Riverside University Health MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,419.60
|
| 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 |
$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 ATHRECTOMY ILIAC
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
906820164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,473.20 |
| Max. Negotiated Rate |
$29,129.40 |
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,946.40
|
| Rate for Payer: Galaxy Health WC |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,588.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| Rate for Payer: Multiplan Commercial |
$24,274.50
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
|
|
HC ATHRECTOMY RENAL
|
Facility
OP
|
$32,366.00
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
906820160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,419.00 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: BCBS Transplant Transplant |
$19,419.60
|
| Rate for Payer: Blue Shield of California Commercial |
$9,194.24
|
| Rate for Payer: Blue Shield of California EPN |
$6,603.71
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: Cigna of CA PPO |
$23,950.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| 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 |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24,274.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: IEHP medi-cal |
$22,679.61
|
| Rate for Payer: 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 |
$21,588.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| 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 |
$24,274.50
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19,419.60
|
| Rate for Payer: Riverside University Health MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,419.60
|
| 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
|
|
|
HC ATHRECTOMY RENAL
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
906820160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,473.20 |
| Max. Negotiated Rate |
$29,129.40 |
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Central Health Plan Commercial |
$25,892.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,946.40
|
| Rate for Payer: Galaxy Health WC |
$27,511.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,419.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,129.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,588.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,473.20
|
| Rate for Payer: Multiplan Commercial |
$24,274.50
|
| Rate for Payer: Networks By Design Commercial |
$21,037.90
|
| Rate for Payer: Prime Health Services Commercial |
$27,511.10
|
|
