|
HC COMPOSITE ELASTIC
|
Facility
OP
|
$175.00
|
|
| Hospital Charge Code |
903203946
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$61.25 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$148.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$96.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$96.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$84.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$103.39
|
| Rate for Payer: BCBS Transplant Transplant |
$105.00
|
| Rate for Payer: Blue Shield of California Commercial |
$131.25
|
| Rate for Payer: Blue Shield of California EPN |
$95.20
|
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Cash Price |
$78.75
|
| Rate for Payer: Central Health Plan Commercial |
$140.00
|
| Rate for Payer: Cigna of CA HMO |
$122.50
|
| Rate for Payer: Cigna of CA PPO |
$122.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$148.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$70.00
|
| Rate for Payer: Galaxy Health WC |
$148.75
|
| Rate for Payer: Global Benefits Group Commercial |
$105.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$157.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$131.25
|
| Rate for Payer: IEHP medi-cal |
$61.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$116.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.75
|
| Rate for Payer: Multiplan Commercial |
$131.25
|
| Rate for Payer: Networks By Design Commercial |
$87.50
|
| Rate for Payer: Prime Health Services Commercial |
$148.75
|
| Rate for Payer: Riverside University Health MISP |
$70.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$105.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$105.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$87.50
|
| Rate for Payer: United Healthcare All Other HMO |
$87.50
|
| Rate for Payer: United Healthcare HMO Rider |
$87.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$87.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$148.75
|
| Rate for Payer: Vantage Medical Group Senior |
$148.75
|
|
|
HC COMPREHENSIVE METABOLIC PANEL
|
Facility
IP
|
$850.00
|
|
|
Service Code
|
CPT 80053
|
| Hospital Charge Code |
900910423
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$170.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Cash Price |
$382.50
|
| Rate for Payer: Central Health Plan Commercial |
$680.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.00
|
| Rate for Payer: Galaxy Health WC |
$722.50
|
| Rate for Payer: Global Benefits Group Commercial |
$510.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$765.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$566.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.00
|
| Rate for Payer: Multiplan Commercial |
$637.50
|
| Rate for Payer: Networks By Design Commercial |
$552.50
|
| Rate for Payer: Prime Health Services Commercial |
$722.50
|
|
|
HC COMPREHENSIVE METABOLIC PANEL
|
Facility
OP
|
$25.00
|
|
|
Service Code
|
CPT 80053
|
| Hospital Charge Code |
900910423
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$93.91 |
| Rate for Payer: Adventist Health Medi-Cal |
$10.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$77.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15.84
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.62
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$76.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$93.91
|
| Rate for Payer: BCBS Transplant Transplant |
$15.00
|
| Rate for Payer: Blue Shield of California Commercial |
$15.45
|
| Rate for Payer: Blue Shield of California EPN |
$12.15
|
| Rate for Payer: Caremore Medicare Advantage |
$10.56
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.26
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$10.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.56
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$17.32
|
| Rate for Payer: IEHP medi-cal |
$17.42
|
| Rate for Payer: IEHP Medicare Advantage |
$10.56
|
| Rate for Payer: Innovage PACE Commercial |
$15.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.15
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Prime Health Services Medicare |
$11.19
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: Riverside University Health MISP |
$11.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.55
|
| Rate for Payer: United Healthcare All Other HMO |
$8.55
|
| Rate for Payer: United Healthcare HMO Rider |
$8.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.62
|
| Rate for Payer: Vantage Medical Group Senior |
$10.56
|
|
|
HC COMPUTER/DYNAMIC POSTUROGRAPHY
|
Facility
OP
|
$400.00
|
|
|
Service Code
|
CPT 92548
|
| Hospital Charge Code |
905101073
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$969.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$466.25
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$193.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.32
|
| Rate for Payer: BCBS Transplant Transplant |
$240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$247.20
|
| Rate for Payer: Blue Shield of California EPN |
$194.40
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$256.00
|
| Rate for Payer: Cigna of CA PPO |
$296.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$300.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: IEHP medi-cal |
$263.34
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Innovage PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$260.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: Riverside University Health MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other HMO |
$765.00
|
| Rate for Payer: United Healthcare HMO Rider |
$579.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC COMPUTER/DYNAMIC POSTUROGRAPHY
|
Facility
IP
|
$400.00
|
|
|
Service Code
|
CPT 92548
|
| Hospital Charge Code |
905101073
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$260.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
|
|
HC COMPUTER/DYNAMIC POSTUROGRAPHY COMM MCARE
|
Facility
IP
|
$400.00
|
|
|
Service Code
|
CPT 92548
|
| Hospital Charge Code |
900411039
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.00
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.00
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$260.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
|
|
HC COMPUTER/DYNAMIC POSTUROGRAPHY COMM MCARE
|
Facility
OP
|
$400.00
|
|
|
Service Code
|
CPT 92548
|
| Hospital Charge Code |
900411039
|
|
Hospital Revenue Code
|
929
|
| Min. Negotiated Rate |
$80.00 |
| Max. Negotiated Rate |
$969.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$466.25
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$193.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$236.32
|
| Rate for Payer: BCBS Transplant Transplant |
$240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$247.20
|
| Rate for Payer: Blue Shield of California EPN |
$194.40
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Central Health Plan Commercial |
$320.00
|
| Rate for Payer: Cigna of CA HMO |
$256.00
|
| Rate for Payer: Cigna of CA PPO |
$296.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$340.00
|
| Rate for Payer: Global Benefits Group Commercial |
$240.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$360.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$300.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: IEHP medi-cal |
$263.34
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Innovage PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$266.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$300.00
|
| Rate for Payer: Networks By Design Commercial |
$260.00
|
| Rate for Payer: Prime Health Services Commercial |
$340.00
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: Riverside University Health MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$240.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$240.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$969.00
|
| Rate for Payer: United Healthcare All Other HMO |
$765.00
|
| Rate for Payer: United Healthcare HMO Rider |
$579.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC COMVAX ADMINISTRATION
|
Facility
OP
|
$23.00
|
|
| Hospital Charge Code |
902890226
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13.97
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$13.80
|
| Rate for Payer: Blue Shield of California Commercial |
$14.47
|
| Rate for Payer: Blue Shield of California EPN |
$11.25
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Central Health Plan Commercial |
$18.40
|
| Rate for Payer: Cigna of CA HMO |
$14.72
|
| Rate for Payer: Cigna of CA PPO |
$17.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17.25
|
| Rate for Payer: IEHP medi-cal |
$8.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.60
|
| Rate for Payer: Multiplan Commercial |
$17.25
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.80
|
| Rate for Payer: Riverside University Health MISP |
$9.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.50
|
| Rate for Payer: United Healthcare All Other HMO |
$11.50
|
| Rate for Payer: United Healthcare HMO Rider |
$11.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.55
|
| Rate for Payer: Vantage Medical Group Senior |
$19.55
|
|
|
HC COMVAX ADMINISTRATION
|
Facility
IP
|
$23.00
|
|
| Hospital Charge Code |
902890226
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$20.70 |
| Rate for Payer: Cash Price |
$10.35
|
| Rate for Payer: Central Health Plan Commercial |
$18.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.20
|
| Rate for Payer: Galaxy Health WC |
$19.55
|
| Rate for Payer: Global Benefits Group Commercial |
$13.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.60
|
| Rate for Payer: Multiplan Commercial |
$17.25
|
| Rate for Payer: Networks By Design Commercial |
$14.95
|
| Rate for Payer: Prime Health Services Commercial |
$19.55
|
|
|
HC CONG LT HEART CATH NML OR ABNL
|
Facility
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93595
|
| Hospital Charge Code |
906811595
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$6,330.60 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
|
HC CONG LT HEART CATH NML OR ABNL
|
Facility
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93595
|
| Hospital Charge Code |
906820097
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONG LT HEART CATH NML OR ABNL
|
Facility
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93595
|
| Hospital Charge Code |
906820097
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$6,330.60 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
|
HC CONG LT HEART CATH NML OR ABNL
|
Facility
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93595
|
| Hospital Charge Code |
906811595
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906820094
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906820096
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$6,330.60 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906820096
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906820094
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$6,330.60 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906811597
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONG RT AND LT HEAR CATH ABNL NAT
|
Facility
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93597
|
| Hospital Charge Code |
906811597
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$6,330.60 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
|
HC CONG RT AND LT HEART CATH NML NAT
|
Facility
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93596
|
| Hospital Charge Code |
906811596
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONG RT AND LT HEART CATH NML NAT
|
Facility
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93596
|
| Hospital Charge Code |
906820093
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$6,330.60 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
|
HC CONG RT AND LT HEART CATH NML NAT
|
Facility
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93596
|
| Hospital Charge Code |
906820093
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONG RT AND LT HEART CATH NML NAT
|
Facility
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93596
|
| Hospital Charge Code |
906811596
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$6,330.60 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
|
HC CONG RT HEART CATH ABNL NAT
|
Facility
OP
|
$7,034.00
|
|
|
Service Code
|
CPT 93594
|
| Hospital Charge Code |
906811594
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$25,512.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,071.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,071.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,220.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$4,071.36
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: Cigna of CA PPO |
$5,205.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,107.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,496.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,071.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,071.36
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,275.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,677.03
|
| Rate for Payer: IEHP medi-cal |
$6,717.74
|
| Rate for Payer: IEHP Medicare Advantage |
$4,071.36
|
| Rate for Payer: Innovage PACE Commercial |
$6,107.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,071.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,455.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,455.62
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
| Rate for Payer: Prime Health Services Medicare |
$4,315.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: Riverside University Health MISP |
$4,478.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,220.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,220.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,836.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,512.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,069.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,692.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,107.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,478.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,071.36
|
|
|
HC CONG RT HEART CATH ABNL NAT
|
Facility
IP
|
$7,034.00
|
|
|
Service Code
|
CPT 93594
|
| Hospital Charge Code |
906811594
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,406.80 |
| Max. Negotiated Rate |
$6,330.60 |
| Rate for Payer: Cash Price |
$3,165.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,627.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,813.60
|
| Rate for Payer: Galaxy Health WC |
$5,978.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,220.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,330.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,691.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,406.80
|
| Rate for Payer: Multiplan Commercial |
$5,275.50
|
| Rate for Payer: Networks By Design Commercial |
$4,572.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,978.90
|
|
