|
HC CONG R & L HEART W SEPTAL
|
Facility
|
IP
|
$7,338.00
|
|
|
Service Code
|
CPT 93533
|
| Hospital Charge Code |
906811253
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,467.60 |
| Max. Negotiated Rate |
$6,604.20 |
| Rate for Payer: Adventist Health Commercial |
$1,467.60
|
| Rate for Payer: Cash Price |
$4,035.90
|
| Rate for Payer: Central Health Plan Commercial |
$5,870.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,935.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,935.20
|
| Rate for Payer: Galaxy Health WC |
$6,237.30
|
| Rate for Payer: Global Benefits Group Commercial |
$4,402.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,604.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,894.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,795.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,542.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,467.60
|
| Rate for Payer: Multiplan Commercial |
$5,503.50
|
| Rate for Payer: Networks By Design Commercial |
$4,769.70
|
| Rate for Payer: Prime Health Services Commercial |
$6,237.30
|
|
|
HC CONG R & L HEART W TRANSEPTAL
|
Facility
|
OP
|
$6,638.00
|
|
|
Service Code
|
CPT 93532
|
| Hospital Charge Code |
906811252
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,327.60 |
| Max. Negotiated Rate |
$7,837.47 |
| Rate for Payer: Adventist Health Commercial |
$1,327.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,642.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,650.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,978.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,214.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,898.50
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,650.90
|
| Rate for Payer: Cash Price |
$3,650.90
|
| Rate for Payer: Central Health Plan Commercial |
$5,310.40
|
| Rate for Payer: Cigna of CA HMO |
$4,314.70
|
| Rate for Payer: Cigna of CA PPO |
$4,912.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,642.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,642.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,642.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,655.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,655.20
|
| Rate for Payer: Galaxy Health WC |
$5,642.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,982.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,974.20
|
| Rate for Payer: InnovAge PACE Commercial |
$3,319.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,427.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,529.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,108.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,327.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,646.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,646.60
|
| Rate for Payer: Multiplan Commercial |
$4,978.50
|
| Rate for Payer: Networks By Design Commercial |
$4,314.70
|
| Rate for Payer: Prime Health Services Commercial |
$5,642.30
|
| Rate for Payer: Riverside University Health System MISP |
$2,655.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,982.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,982.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,319.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,319.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,319.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,319.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,642.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,642.30
|
| Rate for Payer: Vantage Medical Group Senior |
$5,642.30
|
|
|
HC CONG R & L HEART W TRANSEPTAL
|
Facility
|
IP
|
$6,638.00
|
|
|
Service Code
|
CPT 93532
|
| Hospital Charge Code |
906811252
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,327.60 |
| Max. Negotiated Rate |
$5,974.20 |
| Rate for Payer: Adventist Health Commercial |
$1,327.60
|
| Rate for Payer: Cash Price |
$3,650.90
|
| Rate for Payer: Central Health Plan Commercial |
$5,310.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,655.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,655.20
|
| Rate for Payer: Galaxy Health WC |
$5,642.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3,982.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,974.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,427.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,529.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,108.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,327.60
|
| Rate for Payer: Multiplan Commercial |
$4,978.50
|
| Rate for Payer: Networks By Design Commercial |
$4,314.70
|
| Rate for Payer: Prime Health Services Commercial |
$5,642.30
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
|
OP
|
$5,680.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906811597
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,750.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,335.86
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: Cigna of CA HMO |
$3,692.00
|
| Rate for Payer: Cigna of CA PPO |
$4,203.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,788.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,408.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,408.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
|
IP
|
$6,682.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906820096
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,336.40 |
| Max. Negotiated Rate |
$6,013.80 |
| Rate for Payer: Adventist Health Commercial |
$1,336.40
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,345.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,672.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,672.80
|
| Rate for Payer: Galaxy Health WC |
$5,679.70
|
| Rate for Payer: Global Benefits Group Commercial |
$4,009.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,013.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,456.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,545.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,136.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,336.40
|
| Rate for Payer: Multiplan Commercial |
$5,011.50
|
| Rate for Payer: Networks By Design Commercial |
$4,343.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,679.70
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
|
OP
|
$6,682.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906820094
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,336.40 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$1,336.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,235.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,924.34
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,345.60
|
| Rate for Payer: Cigna of CA HMO |
$4,343.30
|
| Rate for Payer: Cigna of CA PPO |
$4,944.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$5,679.70
|
| Rate for Payer: Global Benefits Group Commercial |
$4,009.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,013.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,456.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,336.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$5,011.50
|
| Rate for Payer: Networks By Design Commercial |
$4,343.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$5,679.70
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,009.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,009.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
|
IP
|
$6,682.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906820094
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,336.40 |
| Max. Negotiated Rate |
$6,013.80 |
| Rate for Payer: Adventist Health Commercial |
$1,336.40
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,345.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,672.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,672.80
|
| Rate for Payer: Galaxy Health WC |
$5,679.70
|
| Rate for Payer: Global Benefits Group Commercial |
$4,009.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,013.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,456.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,545.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,136.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,336.40
|
| Rate for Payer: Multiplan Commercial |
$5,011.50
|
| Rate for Payer: Networks By Design Commercial |
$4,343.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,679.70
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
|
OP
|
$6,682.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906820096
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,336.40 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$1,336.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,235.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,924.34
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,345.60
|
| Rate for Payer: Cigna of CA HMO |
$4,343.30
|
| Rate for Payer: Cigna of CA PPO |
$4,944.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$5,679.70
|
| Rate for Payer: Global Benefits Group Commercial |
$4,009.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,013.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,456.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,336.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$5,011.50
|
| Rate for Payer: Networks By Design Commercial |
$4,343.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$5,679.70
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,009.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,009.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
|
IP
|
$5,680.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906811597
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$5,112.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,272.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,272.00
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,788.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,164.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,515.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
|
|
HC CONG RT AND LT HEART CATH NML NAT
|
Facility
|
IP
|
$6,682.00
|
|
|
Service Code
|
CPT 93596
|
| Hospital Charge Code |
906820093
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,336.40 |
| Max. Negotiated Rate |
$6,013.80 |
| Rate for Payer: Adventist Health Commercial |
$1,336.40
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,345.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,672.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,672.80
|
| Rate for Payer: Galaxy Health WC |
$5,679.70
|
| Rate for Payer: Global Benefits Group Commercial |
$4,009.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,013.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,456.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,545.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,136.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,336.40
|
| Rate for Payer: Multiplan Commercial |
$5,011.50
|
| Rate for Payer: Networks By Design Commercial |
$4,343.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,679.70
|
|
|
HC CONG RT AND LT HEART CATH NML NAT
|
Facility
|
OP
|
$6,682.00
|
|
|
Service Code
|
CPT 93596
|
| Hospital Charge Code |
906820093
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,336.40 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$1,336.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,235.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,924.34
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,345.60
|
| Rate for Payer: Cigna of CA HMO |
$4,343.30
|
| Rate for Payer: Cigna of CA PPO |
$4,944.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$5,679.70
|
| Rate for Payer: Global Benefits Group Commercial |
$4,009.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,013.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,456.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,336.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$5,011.50
|
| Rate for Payer: Networks By Design Commercial |
$4,343.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$5,679.70
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,009.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,009.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC CONG RT AND LT HEART CATH NML NAT
|
Facility
|
OP
|
$5,680.00
|
|
|
Service Code
|
CPT 93596
|
| Hospital Charge Code |
906811596
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,750.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,335.86
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: Cigna of CA HMO |
$3,692.00
|
| Rate for Payer: Cigna of CA PPO |
$4,203.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,788.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,408.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,408.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC CONG RT AND LT HEART CATH NML NAT
|
Facility
|
IP
|
$5,680.00
|
|
|
Service Code
|
CPT 93596
|
| Hospital Charge Code |
906811596
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$5,112.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,272.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,272.00
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,788.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,164.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,515.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
|
|
HC CONG RT HEART CATH ABNL NAT
|
Facility
|
OP
|
$5,680.00
|
|
|
Service Code
|
CPT 93594
|
| Hospital Charge Code |
906811594
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,750.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,335.86
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: Cigna of CA HMO |
$3,692.00
|
| Rate for Payer: Cigna of CA PPO |
$4,203.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,788.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,408.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,408.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC CONG RT HEART CATH ABNL NAT
|
Facility
|
IP
|
$5,680.00
|
|
|
Service Code
|
CPT 93594
|
| Hospital Charge Code |
906811594
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$5,112.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,272.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,272.00
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,788.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,164.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,515.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
|
|
HC CONG RT HEART CONG NML NAT
|
Facility
|
IP
|
$6,682.00
|
|
|
Service Code
|
CPT 93593
|
| Hospital Charge Code |
906820095
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,336.40 |
| Max. Negotiated Rate |
$6,013.80 |
| Rate for Payer: Adventist Health Commercial |
$1,336.40
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,345.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,672.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,672.80
|
| Rate for Payer: Galaxy Health WC |
$5,679.70
|
| Rate for Payer: Global Benefits Group Commercial |
$4,009.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,013.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,456.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,545.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,136.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,336.40
|
| Rate for Payer: Multiplan Commercial |
$5,011.50
|
| Rate for Payer: Networks By Design Commercial |
$4,343.30
|
| Rate for Payer: Prime Health Services Commercial |
$5,679.70
|
|
|
HC CONG RT HEART CONG NML NAT
|
Facility
|
IP
|
$5,680.00
|
|
|
Service Code
|
CPT 93593
|
| Hospital Charge Code |
906811593
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$5,112.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,272.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,272.00
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,788.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,164.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,515.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
|
|
HC CONG RT HEART CONG NML NAT
|
Facility
|
OP
|
$5,680.00
|
|
|
Service Code
|
CPT 93593
|
| Hospital Charge Code |
906811593
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,136.00 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$1,136.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2,750.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,335.86
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Cash Price |
$3,124.00
|
| Rate for Payer: Central Health Plan Commercial |
$4,544.00
|
| Rate for Payer: Cigna of CA HMO |
$3,692.00
|
| Rate for Payer: Cigna of CA PPO |
$4,203.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$4,828.00
|
| Rate for Payer: Global Benefits Group Commercial |
$3,408.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,112.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,788.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,136.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$4,260.00
|
| Rate for Payer: Networks By Design Commercial |
$3,692.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$4,828.00
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,408.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,408.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC CONG RT HEART CONG NML NAT
|
Facility
|
OP
|
$6,682.00
|
|
|
Service Code
|
CPT 93593
|
| Hospital Charge Code |
906820095
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,336.40 |
| Max. Negotiated Rate |
$26,788.00 |
| Rate for Payer: Adventist Health Commercial |
$1,336.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,086.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,086.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,235.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,924.34
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Cash Price |
$3,675.10
|
| Rate for Payer: Central Health Plan Commercial |
$5,345.60
|
| Rate for Payer: Cigna of CA HMO |
$4,343.30
|
| Rate for Payer: Cigna of CA PPO |
$4,944.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,495.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,086.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,517.14
|
| Rate for Payer: EPIC Health Plan Senior |
$4,086.77
|
| Rate for Payer: Galaxy Health WC |
$5,679.70
|
| Rate for Payer: Global Benefits Group Commercial |
$4,009.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,013.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,702.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,086.77
|
| Rate for Payer: InnovAge PACE Commercial |
$6,130.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,456.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,086.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,336.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,476.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,476.27
|
| Rate for Payer: Multiplan Commercial |
$5,011.50
|
| Rate for Payer: Networks By Design Commercial |
$4,343.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,086.77
|
| Rate for Payer: Prime Health Services Commercial |
$5,679.70
|
| Rate for Payer: Prime Health Services Medicare |
$4,331.98
|
| Rate for Payer: Riverside University Health System MISP |
$4,495.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,009.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,009.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$15,630.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,086.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,130.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,495.45
|
| Rate for Payer: Vantage Medical Group Senior |
$4,086.77
|
|
|
HC CONIZATION CERVIX LOOP ELECTRODE EXCISSION
|
Facility
|
OP
|
$12,504.00
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
900100035
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$386.09 |
| Max. Negotiated Rate |
$11,253.60 |
| Rate for Payer: Adventist Health Commercial |
$2,500.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,039.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,443.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,039.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,639.94
|
| Rate for Payer: Blue Shield of California EPN |
$4,989.10
|
| Rate for Payer: Cash Price |
$6,877.20
|
| Rate for Payer: Cash Price |
$6,877.20
|
| Rate for Payer: Cash Price |
$6,877.20
|
| Rate for Payer: Central Health Plan Commercial |
$10,003.20
|
| Rate for Payer: Cigna of CA HMO |
$8,002.56
|
| Rate for Payer: Cigna of CA PPO |
$9,252.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,443.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,039.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,453.88
|
| Rate for Payer: EPIC Health Plan Senior |
$4,039.91
|
| Rate for Payer: Galaxy Health WC |
$10,628.40
|
| Rate for Payer: Global Benefits Group Commercial |
$7,502.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,253.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,625.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$386.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,039.91
|
| Rate for Payer: InnovAge PACE Commercial |
$6,059.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,340.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$426.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,039.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,500.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,413.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,413.48
|
| Rate for Payer: Multiplan Commercial |
$9,378.00
|
| Rate for Payer: Networks By Design Commercial |
$8,127.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,039.91
|
| Rate for Payer: Prime Health Services Commercial |
$10,628.40
|
| Rate for Payer: Prime Health Services Medicare |
$4,282.30
|
| Rate for Payer: Riverside University Health System MISP |
$4,443.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,502.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,502.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,252.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6,252.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6,252.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,252.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,039.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,059.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,443.90
|
| Rate for Payer: Vantage Medical Group Senior |
$4,039.91
|
|
|
HC CONIZATION CERVIX LOOP ELECTRODE EXCISSION
|
Facility
|
IP
|
$12,504.00
|
|
|
Service Code
|
CPT 57522
|
| Hospital Charge Code |
900100035
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$2,500.80 |
| Max. Negotiated Rate |
$11,253.60 |
| Rate for Payer: Adventist Health Commercial |
$2,500.80
|
| Rate for Payer: Cash Price |
$6,877.20
|
| Rate for Payer: Central Health Plan Commercial |
$10,003.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,001.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5,001.60
|
| Rate for Payer: Galaxy Health WC |
$10,628.40
|
| Rate for Payer: Global Benefits Group Commercial |
$7,502.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,253.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,340.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,764.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,739.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,500.80
|
| Rate for Payer: Multiplan Commercial |
$9,378.00
|
| Rate for Payer: Networks By Design Commercial |
$8,127.60
|
| Rate for Payer: Prime Health Services Commercial |
$10,628.40
|
|
|
HC CONSULT WITH SLIDE PREP
|
Facility
|
IP
|
$192.00
|
|
|
Service Code
|
CPT 88323
|
| Hospital Charge Code |
903800034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$38.40 |
| Max. Negotiated Rate |
$172.80 |
| Rate for Payer: Adventist Health Commercial |
$38.40
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Central Health Plan Commercial |
$153.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$76.80
|
| Rate for Payer: EPIC Health Plan Senior |
$76.80
|
| Rate for Payer: Galaxy Health WC |
$163.20
|
| Rate for Payer: Global Benefits Group Commercial |
$115.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$172.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$73.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$118.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.40
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
| Rate for Payer: Networks By Design Commercial |
$124.80
|
| Rate for Payer: Prime Health Services Commercial |
$163.20
|
|
|
HC CONSULT WITH SLIDE PREP
|
Facility
|
OP
|
$192.00
|
|
|
Service Code
|
CPT 88323
|
| Hospital Charge Code |
903800034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.74 |
| Max. Negotiated Rate |
$172.80 |
| Rate for Payer: Adventist Health Commercial |
$38.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$67.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$116.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$101.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$74.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.74
|
| Rate for Payer: Blue Shield of California Commercial |
$116.54
|
| Rate for Payer: Blue Shield of California EPN |
$76.22
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Central Health Plan Commercial |
$153.60
|
| Rate for Payer: Cigna of CA HMO |
$122.88
|
| Rate for Payer: Cigna of CA PPO |
$142.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$74.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$67.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$91.65
|
| Rate for Payer: EPIC Health Plan Senior |
$67.89
|
| Rate for Payer: Galaxy Health WC |
$163.20
|
| Rate for Payer: Global Benefits Group Commercial |
$115.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$172.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$111.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$152.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.89
|
| Rate for Payer: InnovAge PACE Commercial |
$101.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$128.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$167.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$67.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$90.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90.97
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
| Rate for Payer: Networks By Design Commercial |
$124.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$67.89
|
| Rate for Payer: Prime Health Services Commercial |
$163.20
|
| Rate for Payer: Prime Health Services Medicare |
$71.96
|
| Rate for Payer: Riverside University Health System MISP |
$74.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$115.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$115.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.11
|
| Rate for Payer: United Healthcare All Other HMO |
$41.11
|
| Rate for Payer: United Healthcare HMO Rider |
$41.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.11
|
| Rate for Payer: Upland Medical Group Pediatric |
$67.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$101.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$74.68
|
| Rate for Payer: Vantage Medical Group Senior |
$67.89
|
|
|
HC CONT GLUC MNTR PT PROV EQP
|
Facility
|
OP
|
$484.00
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
900095249
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$75.47 |
| Max. Negotiated Rate |
$1,021.00 |
| Rate for Payer: Adventist Health Commercial |
$96.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$75.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$293.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$75.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$329.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$284.25
|
| Rate for Payer: Blue Shield of California Commercial |
$293.79
|
| Rate for Payer: Blue Shield of California EPN |
$192.15
|
| Rate for Payer: Cash Price |
$266.20
|
| Rate for Payer: Cash Price |
$266.20
|
| Rate for Payer: Cash Price |
$266.20
|
| Rate for Payer: Central Health Plan Commercial |
$387.20
|
| Rate for Payer: Cigna of CA HMO |
$309.76
|
| Rate for Payer: Cigna of CA PPO |
$358.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$101.88
|
| Rate for Payer: EPIC Health Plan Senior |
$75.47
|
| Rate for Payer: Galaxy Health WC |
$411.40
|
| Rate for Payer: Global Benefits Group Commercial |
$290.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$435.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$123.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75.47
|
| Rate for Payer: InnovAge PACE Commercial |
$113.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$322.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$184.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$101.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101.13
|
| Rate for Payer: Multiplan Commercial |
$363.00
|
| Rate for Payer: Networks By Design Commercial |
$314.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$75.47
|
| Rate for Payer: Prime Health Services Commercial |
$411.40
|
| Rate for Payer: Prime Health Services Medicare |
$80.00
|
| Rate for Payer: Riverside University Health System MISP |
$83.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$290.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$290.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,021.00
|
| Rate for Payer: United Healthcare All Other HMO |
$803.00
|
| Rate for Payer: United Healthcare HMO Rider |
$608.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$558.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$75.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.02
|
| Rate for Payer: Vantage Medical Group Senior |
$75.47
|
|
|
HC CONT GLUC MNTR PT PROV EQP
|
Facility
|
IP
|
$484.00
|
|
|
Service Code
|
CPT 95249
|
| Hospital Charge Code |
900095249
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$435.60 |
| Rate for Payer: Adventist Health Commercial |
$96.80
|
| Rate for Payer: Cash Price |
$266.20
|
| Rate for Payer: Central Health Plan Commercial |
$387.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$193.60
|
| Rate for Payer: EPIC Health Plan Senior |
$193.60
|
| Rate for Payer: Galaxy Health WC |
$411.40
|
| Rate for Payer: Global Benefits Group Commercial |
$290.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$435.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$322.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$184.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$299.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.80
|
| Rate for Payer: Multiplan Commercial |
$363.00
|
| Rate for Payer: Networks By Design Commercial |
$314.60
|
| Rate for Payer: Prime Health Services Commercial |
$411.40
|
|
