|
HC ATHRECTOMY RENAL
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
909020077
|
|
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 |
909020077
|
|
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 & STENT FEM/POP
|
Facility
IP
|
$49,537.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
909020068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,907.40 |
| Max. Negotiated Rate |
$44,583.30 |
| Rate for Payer: Cash Price |
$22,291.65
|
| Rate for Payer: Central Health Plan Commercial |
$39,629.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,814.80
|
| Rate for Payer: Galaxy Health WC |
$42,106.45
|
| Rate for Payer: Global Benefits Group Commercial |
$29,722.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$44,583.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33,041.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,907.40
|
| Rate for Payer: Multiplan Commercial |
$37,152.75
|
| Rate for Payer: Networks By Design Commercial |
$32,199.05
|
| Rate for Payer: Prime Health Services Commercial |
$42,106.45
|
|
|
HC ATHRECTOMY & STENT FEM/POP
|
Facility
OP
|
$49,537.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
906820151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,183.44 |
| Max. Negotiated Rate |
$67,976.00 |
| 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 |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,952.68
|
| Rate for Payer: BCBS Transplant Transplant |
$29,722.20
|
| 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 |
$22,291.65
|
| Rate for Payer: Cash Price |
$22,291.65
|
| Rate for Payer: Central Health Plan Commercial |
$39,629.60
|
| Rate for Payer: Cigna of CA PPO |
$36,657.38
|
| 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 |
$42,106.45
|
| Rate for Payer: Global Benefits Group Commercial |
$29,722.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$44,583.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37,152.75
|
| 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 |
$33,041.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,907.40
|
| 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 |
$37,152.75
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: Networks By Design Commercial |
$32,199.05
|
| Rate for Payer: Preferred Health Network WC |
$30,563.96
|
| Rate for Payer: Prime Health Services Commercial |
$42,106.45
|
| 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 |
$29,722.20
|
| Rate for Payer: Riverside University Health MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29,722.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$57,775.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67,976.00
|
| Rate for Payer: United Healthcare HMO Rider |
$54,652.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,976.00
|
| 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 & STENT FEM/POP
|
Facility
IP
|
$49,537.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
906820151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,907.40 |
| Max. Negotiated Rate |
$44,583.30 |
| Rate for Payer: Cash Price |
$22,291.65
|
| Rate for Payer: Central Health Plan Commercial |
$39,629.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,814.80
|
| Rate for Payer: Galaxy Health WC |
$42,106.45
|
| Rate for Payer: Global Benefits Group Commercial |
$29,722.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$44,583.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33,041.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,907.40
|
| Rate for Payer: Multiplan Commercial |
$37,152.75
|
| Rate for Payer: Networks By Design Commercial |
$32,199.05
|
| Rate for Payer: Prime Health Services Commercial |
$42,106.45
|
|
|
HC ATHRECTOMY & STENT FEM/POP
|
Facility
OP
|
$49,537.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
909020068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,183.44 |
| Max. Negotiated Rate |
$67,976.00 |
| 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 |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,952.68
|
| Rate for Payer: BCBS Transplant Transplant |
$29,722.20
|
| 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 |
$22,291.65
|
| Rate for Payer: Cash Price |
$22,291.65
|
| Rate for Payer: Central Health Plan Commercial |
$39,629.60
|
| Rate for Payer: Cigna of CA PPO |
$36,657.38
|
| 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 |
$42,106.45
|
| Rate for Payer: Global Benefits Group Commercial |
$29,722.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$44,583.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37,152.75
|
| 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 |
$33,041.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,907.40
|
| 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 |
$37,152.75
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: Networks By Design Commercial |
$32,199.05
|
| Rate for Payer: Preferred Health Network WC |
$30,563.96
|
| Rate for Payer: Prime Health Services Commercial |
$42,106.45
|
| 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 |
$29,722.20
|
| Rate for Payer: Riverside University Health MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29,722.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$57,775.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67,976.00
|
| Rate for Payer: United Healthcare HMO Rider |
$54,652.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,976.00
|
| 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 & STENT TIBIOPER EA
|
Facility
OP
|
$16,120.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
906820159
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,901.00 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,702.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8,866.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,866.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$9,672.00
|
| 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: Cash Price |
$7,254.00
|
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Central Health Plan Commercial |
$12,896.00
|
| Rate for Payer: Cigna of CA PPO |
$11,928.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,702.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,448.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,448.00
|
| Rate for Payer: Galaxy Health WC |
$13,702.00
|
| Rate for Payer: Global Benefits Group Commercial |
$9,672.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,508.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12,090.00
|
| Rate for Payer: IEHP medi-cal |
$5,642.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,752.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,224.00
|
| Rate for Payer: Multiplan Commercial |
$12,090.00
|
| Rate for Payer: Networks By Design Commercial |
$10,478.00
|
| Rate for Payer: Prime Health Services Commercial |
$13,702.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9,672.00
|
| Rate for Payer: Riverside University Health MISP |
$6,448.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,672.00
|
| 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 |
$13,702.00
|
| Rate for Payer: Vantage Medical Group Senior |
$13,702.00
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
IP
|
$16,120.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
909020076
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,224.00 |
| Max. Negotiated Rate |
$14,508.00 |
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Central Health Plan Commercial |
$12,896.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,448.00
|
| Rate for Payer: Galaxy Health WC |
$13,702.00
|
| Rate for Payer: Global Benefits Group Commercial |
$9,672.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,508.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,752.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,224.00
|
| Rate for Payer: Multiplan Commercial |
$12,090.00
|
| Rate for Payer: Networks By Design Commercial |
$10,478.00
|
| Rate for Payer: Prime Health Services Commercial |
$13,702.00
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
IP
|
$16,120.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
906820159
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,224.00 |
| Max. Negotiated Rate |
$14,508.00 |
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Central Health Plan Commercial |
$12,896.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,448.00
|
| Rate for Payer: Galaxy Health WC |
$13,702.00
|
| Rate for Payer: Global Benefits Group Commercial |
$9,672.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,508.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,752.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,224.00
|
| Rate for Payer: Multiplan Commercial |
$12,090.00
|
| Rate for Payer: Networks By Design Commercial |
$10,478.00
|
| Rate for Payer: Prime Health Services Commercial |
$13,702.00
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
OP
|
$16,120.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
909020076
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,901.00 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,702.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8,866.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,866.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$9,672.00
|
| 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: Cash Price |
$7,254.00
|
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Central Health Plan Commercial |
$12,896.00
|
| Rate for Payer: Cigna of CA PPO |
$11,928.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,702.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,448.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,448.00
|
| Rate for Payer: Galaxy Health WC |
$13,702.00
|
| Rate for Payer: Global Benefits Group Commercial |
$9,672.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$14,508.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12,090.00
|
| Rate for Payer: IEHP medi-cal |
$5,642.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,752.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,224.00
|
| Rate for Payer: Multiplan Commercial |
$12,090.00
|
| Rate for Payer: Networks By Design Commercial |
$10,478.00
|
| Rate for Payer: Prime Health Services Commercial |
$13,702.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9,672.00
|
| Rate for Payer: Riverside University Health MISP |
$6,448.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,672.00
|
| 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 |
$13,702.00
|
| Rate for Payer: Vantage Medical Group Senior |
$13,702.00
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
IP
|
$49,537.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
909020072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,907.40 |
| Max. Negotiated Rate |
$44,583.30 |
| Rate for Payer: Cash Price |
$22,291.65
|
| Rate for Payer: Central Health Plan Commercial |
$39,629.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,814.80
|
| Rate for Payer: Galaxy Health WC |
$42,106.45
|
| Rate for Payer: Global Benefits Group Commercial |
$29,722.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$44,583.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33,041.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,907.40
|
| Rate for Payer: Multiplan Commercial |
$37,152.75
|
| Rate for Payer: Networks By Design Commercial |
$32,199.05
|
| Rate for Payer: Prime Health Services Commercial |
$42,106.45
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
OP
|
$49,537.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
909020072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,183.44 |
| Max. Negotiated Rate |
$67,976.00 |
| 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 |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,952.68
|
| Rate for Payer: BCBS Transplant Transplant |
$29,722.20
|
| 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 |
$22,291.65
|
| Rate for Payer: Cash Price |
$22,291.65
|
| Rate for Payer: Central Health Plan Commercial |
$39,629.60
|
| Rate for Payer: Cigna of CA PPO |
$36,657.38
|
| 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 |
$42,106.45
|
| Rate for Payer: Global Benefits Group Commercial |
$29,722.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$44,583.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37,152.75
|
| 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 |
$33,041.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,907.40
|
| 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 |
$37,152.75
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: Networks By Design Commercial |
$32,199.05
|
| Rate for Payer: Preferred Health Network WC |
$30,563.96
|
| Rate for Payer: Prime Health Services Commercial |
$42,106.45
|
| 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 |
$29,722.20
|
| Rate for Payer: Riverside University Health MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29,722.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$57,775.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67,976.00
|
| Rate for Payer: United Healthcare HMO Rider |
$54,652.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,976.00
|
| 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 & STENT TIBIOPERONE
|
Facility
IP
|
$49,537.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
906820155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,907.40 |
| Max. Negotiated Rate |
$44,583.30 |
| Rate for Payer: Cash Price |
$22,291.65
|
| Rate for Payer: Central Health Plan Commercial |
$39,629.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,814.80
|
| Rate for Payer: Galaxy Health WC |
$42,106.45
|
| Rate for Payer: Global Benefits Group Commercial |
$29,722.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$44,583.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33,041.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,907.40
|
| Rate for Payer: Multiplan Commercial |
$37,152.75
|
| Rate for Payer: Networks By Design Commercial |
$32,199.05
|
| Rate for Payer: Prime Health Services Commercial |
$42,106.45
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
OP
|
$49,537.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
906820155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,183.44 |
| Max. Negotiated Rate |
$67,976.00 |
| 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 |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$29,952.68
|
| Rate for Payer: BCBS Transplant Transplant |
$29,722.20
|
| 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 |
$22,291.65
|
| Rate for Payer: Cash Price |
$22,291.65
|
| Rate for Payer: Central Health Plan Commercial |
$39,629.60
|
| Rate for Payer: Cigna of CA PPO |
$36,657.38
|
| 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 |
$42,106.45
|
| Rate for Payer: Global Benefits Group Commercial |
$29,722.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$44,583.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37,152.75
|
| 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 |
$33,041.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,907.40
|
| 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 |
$37,152.75
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: Networks By Design Commercial |
$32,199.05
|
| Rate for Payer: Preferred Health Network WC |
$30,563.96
|
| Rate for Payer: Prime Health Services Commercial |
$42,106.45
|
| 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 |
$29,722.20
|
| Rate for Payer: Riverside University Health MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29,722.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$57,775.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67,976.00
|
| Rate for Payer: United Healthcare HMO Rider |
$54,652.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,976.00
|
| 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 TIBIOPERONEAL
|
Facility
OP
|
$28,001.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
909020070
|
|
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 |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| 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 TIBIOPERONEAL
|
Facility
OP
|
$28,001.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
906820153
|
|
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 |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| 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 TIBIOPERONEAL
|
Facility
IP
|
$28,001.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
906820153
|
|
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 TIBIOPERONEAL
|
Facility
IP
|
$28,001.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
909020070
|
|
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 TIBIOPERONEAL EA AD
|
Facility
IP
|
$28,001.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
909020074
|
|
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 TIBIOPERONEAL EA AD
|
Facility
OP
|
$28,001.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
909020074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,901.00 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$23,800.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,400.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15,400.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: 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: 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 |
$23,800.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,200.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$21,000.75
|
| Rate for Payer: IEHP medi-cal |
$9,800.35
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16,800.60
|
| Rate for Payer: Riverside University Health MISP |
$11,200.40
|
| 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 Medi-Cal |
$23,800.85
|
| Rate for Payer: Vantage Medical Group Senior |
$23,800.85
|
|
|
HC ATHRECTOMY TIBIOPERONEAL EA AD
|
Facility
OP
|
$28,001.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
906820157
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,901.00 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$23,800.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,400.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15,400.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: 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: 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 |
$23,800.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,200.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$21,000.75
|
| Rate for Payer: IEHP medi-cal |
$9,800.35
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16,800.60
|
| Rate for Payer: Riverside University Health MISP |
$11,200.40
|
| 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 Medi-Cal |
$23,800.85
|
| Rate for Payer: Vantage Medical Group Senior |
$23,800.85
|
|
|
HC ATHRECTOMY TIBIOPERONEAL EA AD
|
Facility
IP
|
$28,001.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
906820157
|
|
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 VISCERAL
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
909020078
|
|
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 VISCERAL
|
Facility
OP
|
$32,366.00
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
909020078
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,257.00 |
| Max. Negotiated Rate |
$29,129.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13,268.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27,511.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17,801.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17,801.30
|
| 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: 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: 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 |
$27,511.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,946.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$24,274.50
|
| Rate for Payer: IEHP medi-cal |
$11,328.10
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19,419.60
|
| Rate for Payer: Riverside University Health MISP |
$12,946.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,419.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,511.10
|
| Rate for Payer: Vantage Medical Group Senior |
$27,511.10
|
|
|
HC ATHRECTOMY VISCERAL
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
906820161
|
|
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
|
|
