|
HC CORONARY STENT ADD'L VESSEL
|
Facility
|
OP
|
$9,892.00
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
906820240
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,978.40 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,300.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,408.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,440.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,440.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,935.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$4,451.40
|
| Rate for Payer: Cash Price |
$4,451.40
|
| Rate for Payer: Central Health Plan Commercial |
$7,913.60
|
| Rate for Payer: Cigna of CA PPO |
$7,320.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,408.20
|
| Rate for Payer: Dignity Health Media |
$8,408.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,408.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,956.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,956.80
|
| Rate for Payer: Galaxy Health WC |
$8,408.20
|
| Rate for Payer: Global Benefits Group Commercial |
$5,935.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,902.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,419.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,462.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,597.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,978.40
|
| Rate for Payer: Multiplan Commercial |
$7,419.00
|
| Rate for Payer: Networks By Design Commercial |
$6,429.80
|
| Rate for Payer: Prime Health Services Commercial |
$8,408.20
|
| Rate for Payer: Riverside University Health System MISP |
$3,956.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,935.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,935.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,408.20
|
| Rate for Payer: Vantage Medical Group Senior |
$8,408.20
|
|
|
HC CORONARY STENT ADD VESSEL
|
Facility
|
IP
|
$28,104.00
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
906820258
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5,620.80 |
| Max. Negotiated Rate |
$25,293.60 |
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Central Health Plan Commercial |
$22,483.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,241.60
|
| Rate for Payer: Galaxy Health WC |
$23,888.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,862.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,293.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,745.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,707.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,620.80
|
| Rate for Payer: Multiplan Commercial |
$21,078.00
|
| Rate for Payer: Networks By Design Commercial |
$18,267.60
|
| Rate for Payer: Prime Health Services Commercial |
$23,888.40
|
|
|
HC CORONARY STENT ADD VESSEL
|
Facility
|
OP
|
$28,104.00
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
906820258
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$25,293.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,566.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23,888.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,457.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15,457.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$16,862.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Central Health Plan Commercial |
$22,483.20
|
| Rate for Payer: Cigna of CA HMO |
$17,986.56
|
| Rate for Payer: Cigna of CA PPO |
$20,796.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,888.40
|
| Rate for Payer: Dignity Health Media |
$23,888.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,888.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,241.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$11,241.60
|
| Rate for Payer: Galaxy Health WC |
$23,888.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,862.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,293.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$21,078.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,836.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,745.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,707.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,620.80
|
| Rate for Payer: Multiplan Commercial |
$21,078.00
|
| Rate for Payer: Networks By Design Commercial |
$18,267.60
|
| Rate for Payer: Prime Health Services Commercial |
$23,888.40
|
| Rate for Payer: Riverside University Health System MISP |
$11,241.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,862.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,862.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,888.40
|
| Rate for Payer: Vantage Medical Group Senior |
$23,888.40
|
|
|
HC CORONARY STENT ADD VESSEL
|
Facility
|
OP
|
$28,104.00
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
906811460
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$25,293.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9,566.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23,888.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,457.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15,457.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$16,862.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Central Health Plan Commercial |
$22,483.20
|
| Rate for Payer: Cigna of CA HMO |
$17,986.56
|
| Rate for Payer: Cigna of CA PPO |
$20,796.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,888.40
|
| Rate for Payer: Dignity Health Media |
$23,888.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,888.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,241.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$11,241.60
|
| Rate for Payer: Galaxy Health WC |
$23,888.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,862.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,293.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$21,078.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,836.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,745.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,707.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,620.80
|
| Rate for Payer: Multiplan Commercial |
$21,078.00
|
| Rate for Payer: Networks By Design Commercial |
$18,267.60
|
| Rate for Payer: Prime Health Services Commercial |
$23,888.40
|
| Rate for Payer: Riverside University Health System MISP |
$11,241.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,862.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,862.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,888.40
|
| Rate for Payer: Vantage Medical Group Senior |
$23,888.40
|
|
|
HC CORONARY STENT ADD VESSEL
|
Facility
|
IP
|
$28,104.00
|
|
|
Service Code
|
CPT C9601
|
| Hospital Charge Code |
906811460
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5,620.80 |
| Max. Negotiated Rate |
$25,293.60 |
| Rate for Payer: Cash Price |
$12,646.80
|
| Rate for Payer: Central Health Plan Commercial |
$22,483.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,241.60
|
| Rate for Payer: Galaxy Health WC |
$23,888.40
|
| Rate for Payer: Global Benefits Group Commercial |
$16,862.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,293.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18,745.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,707.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,620.80
|
| Rate for Payer: Multiplan Commercial |
$21,078.00
|
| Rate for Payer: Networks By Design Commercial |
$18,267.60
|
| Rate for Payer: Prime Health Services Commercial |
$23,888.40
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
IP
|
$24,728.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
906820239
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,945.60 |
| Max. Negotiated Rate |
$22,255.20 |
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Central Health Plan Commercial |
$19,782.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,891.20
|
| Rate for Payer: Galaxy Health WC |
$21,018.80
|
| Rate for Payer: Global Benefits Group Commercial |
$14,836.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,255.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,493.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,421.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,945.60
|
| Rate for Payer: Multiplan Commercial |
$18,546.00
|
| Rate for Payer: Networks By Design Commercial |
$16,073.20
|
| Rate for Payer: Prime Health Services Commercial |
$21,018.80
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
OP
|
$24,728.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
906811436
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$917.80 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,316.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$14,836.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Central Health Plan Commercial |
$19,782.40
|
| Rate for Payer: Cigna of CA PPO |
$18,298.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$21,018.80
|
| Rate for Payer: Global Benefits Group Commercial |
$14,836.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,255.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18,546.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,679.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: InnovAge PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,493.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$917.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,945.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$18,546.00
|
| Rate for Payer: Networks By Design Commercial |
$16,073.20
|
| Rate for Payer: Prime Health Services Commercial |
$21,018.80
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,836.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14,836.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
OP
|
$24,728.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
906820239
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$917.80 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,316.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$14,836.80
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Central Health Plan Commercial |
$19,782.40
|
| Rate for Payer: Cigna of CA PPO |
$18,298.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$21,018.80
|
| Rate for Payer: Global Benefits Group Commercial |
$14,836.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,255.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18,546.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,679.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: InnovAge PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,493.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$917.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,945.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$18,546.00
|
| Rate for Payer: Networks By Design Commercial |
$16,073.20
|
| Rate for Payer: Prime Health Services Commercial |
$21,018.80
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,836.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14,836.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
OP
|
$46,221.00
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
906811459
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$41,598.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,785.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$27,732.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$20,799.45
|
| Rate for Payer: Cash Price |
$20,799.45
|
| Rate for Payer: Cash Price |
$20,799.45
|
| Rate for Payer: Central Health Plan Commercial |
$36,976.80
|
| Rate for Payer: Cigna of CA HMO |
$29,581.44
|
| Rate for Payer: Cigna of CA PPO |
$34,203.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$39,287.85
|
| Rate for Payer: Global Benefits Group Commercial |
$27,732.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$41,598.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$34,665.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,679.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: InnovAge PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30,829.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,610.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,244.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$34,665.75
|
| Rate for Payer: Networks By Design Commercial |
$30,043.65
|
| Rate for Payer: Prime Health Services Commercial |
$39,287.85
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27,732.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27,732.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
IP
|
$46,221.00
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
906811459
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$9,244.20 |
| Max. Negotiated Rate |
$41,598.90 |
| Rate for Payer: Cash Price |
$20,799.45
|
| Rate for Payer: Central Health Plan Commercial |
$36,976.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,488.40
|
| Rate for Payer: Galaxy Health WC |
$39,287.85
|
| Rate for Payer: Global Benefits Group Commercial |
$27,732.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$41,598.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30,829.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,610.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,244.20
|
| Rate for Payer: Multiplan Commercial |
$34,665.75
|
| Rate for Payer: Networks By Design Commercial |
$30,043.65
|
| Rate for Payer: Prime Health Services Commercial |
$39,287.85
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
OP
|
$46,221.00
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
906820257
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$41,598.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,785.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$27,732.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$20,799.45
|
| Rate for Payer: Cash Price |
$20,799.45
|
| Rate for Payer: Cash Price |
$20,799.45
|
| Rate for Payer: Central Health Plan Commercial |
$36,976.80
|
| Rate for Payer: Cigna of CA HMO |
$29,581.44
|
| Rate for Payer: Cigna of CA PPO |
$34,203.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$39,287.85
|
| Rate for Payer: Global Benefits Group Commercial |
$27,732.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$41,598.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$34,665.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,679.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: InnovAge PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30,829.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,610.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,244.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$34,665.75
|
| Rate for Payer: Networks By Design Commercial |
$30,043.65
|
| Rate for Payer: Prime Health Services Commercial |
$39,287.85
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27,732.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27,732.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
IP
|
$24,728.00
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
906811436
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,945.60 |
| Max. Negotiated Rate |
$22,255.20 |
| Rate for Payer: Cash Price |
$11,127.60
|
| Rate for Payer: Central Health Plan Commercial |
$19,782.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,891.20
|
| Rate for Payer: Galaxy Health WC |
$21,018.80
|
| Rate for Payer: Global Benefits Group Commercial |
$14,836.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,255.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,493.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,421.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,945.60
|
| Rate for Payer: Multiplan Commercial |
$18,546.00
|
| Rate for Payer: Networks By Design Commercial |
$16,073.20
|
| Rate for Payer: Prime Health Services Commercial |
$21,018.80
|
|
|
HC CORONARY STENT SINGLE VESSEL
|
Facility
|
IP
|
$46,221.00
|
|
|
Service Code
|
CPT C9600
|
| Hospital Charge Code |
906820257
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$9,244.20 |
| Max. Negotiated Rate |
$41,598.90 |
| Rate for Payer: Cash Price |
$20,799.45
|
| Rate for Payer: Central Health Plan Commercial |
$36,976.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,488.40
|
| Rate for Payer: Galaxy Health WC |
$39,287.85
|
| Rate for Payer: Global Benefits Group Commercial |
$27,732.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$41,598.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30,829.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,610.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,244.20
|
| Rate for Payer: Multiplan Commercial |
$34,665.75
|
| Rate for Payer: Networks By Design Commercial |
$30,043.65
|
| Rate for Payer: Prime Health Services Commercial |
$39,287.85
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
OP
|
$8,187.00
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
906820083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$278.75 |
| Max. Negotiated Rate |
$8,017.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,052.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,958.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,502.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,502.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,912.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$3,684.15
|
| Rate for Payer: Cash Price |
$3,684.15
|
| Rate for Payer: Cash Price |
$3,684.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,549.60
|
| Rate for Payer: Cigna of CA PPO |
$6,058.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,958.95
|
| Rate for Payer: Dignity Health Media |
$6,958.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,958.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,274.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,274.80
|
| Rate for Payer: Galaxy Health WC |
$6,958.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,912.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,368.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,140.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,865.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,460.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$278.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,637.40
|
| Rate for Payer: Multiplan Commercial |
$6,140.25
|
| Rate for Payer: Networks By Design Commercial |
$5,321.55
|
| Rate for Payer: Prime Health Services Commercial |
$6,958.95
|
| Rate for Payer: Riverside University Health System MISP |
$3,274.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,912.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,912.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,958.95
|
| Rate for Payer: Vantage Medical Group Senior |
$6,958.95
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
IP
|
$8,187.00
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
906812217
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,637.40 |
| Max. Negotiated Rate |
$7,368.30 |
| Rate for Payer: Cash Price |
$3,684.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,549.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,274.80
|
| Rate for Payer: Galaxy Health WC |
$6,958.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,912.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,368.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,460.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,119.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,637.40
|
| Rate for Payer: Multiplan Commercial |
$6,140.25
|
| Rate for Payer: Networks By Design Commercial |
$5,321.55
|
| Rate for Payer: Prime Health Services Commercial |
$6,958.95
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
OP
|
$8,187.00
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
906812217
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$278.75 |
| Max. Negotiated Rate |
$8,017.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,052.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,958.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,502.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,502.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,912.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$3,684.15
|
| Rate for Payer: Cash Price |
$3,684.15
|
| Rate for Payer: Cash Price |
$3,684.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,549.60
|
| Rate for Payer: Cigna of CA PPO |
$6,058.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,958.95
|
| Rate for Payer: Dignity Health Media |
$6,958.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,958.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,274.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,274.80
|
| Rate for Payer: Galaxy Health WC |
$6,958.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,912.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,368.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,140.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,865.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,460.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$278.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,637.40
|
| Rate for Payer: Multiplan Commercial |
$6,140.25
|
| Rate for Payer: Networks By Design Commercial |
$5,321.55
|
| Rate for Payer: Prime Health Services Commercial |
$6,958.95
|
| Rate for Payer: Riverside University Health System MISP |
$3,274.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,912.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,912.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,958.95
|
| Rate for Payer: Vantage Medical Group Senior |
$6,958.95
|
|
|
HC CORONARY THROMBECTOMY
|
Facility
|
IP
|
$8,187.00
|
|
|
Service Code
|
CPT 92973
|
| Hospital Charge Code |
906820083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,637.40 |
| Max. Negotiated Rate |
$7,368.30 |
| Rate for Payer: Cash Price |
$3,684.15
|
| Rate for Payer: Central Health Plan Commercial |
$6,549.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,274.80
|
| Rate for Payer: Galaxy Health WC |
$6,958.95
|
| Rate for Payer: Global Benefits Group Commercial |
$4,912.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,368.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,460.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,119.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,637.40
|
| Rate for Payer: Multiplan Commercial |
$6,140.25
|
| Rate for Payer: Networks By Design Commercial |
$5,321.55
|
| Rate for Payer: Prime Health Services Commercial |
$6,958.95
|
|
|
HC CORPORA CAVERNOSA-GLANS PENIS
|
Facility
|
IP
|
$10,905.00
|
|
|
Service Code
|
CPT 54435
|
| Hospital Charge Code |
900501751
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,181.00 |
| Max. Negotiated Rate |
$9,814.50 |
| Rate for Payer: Cash Price |
$4,907.25
|
| Rate for Payer: Central Health Plan Commercial |
$8,724.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,362.00
|
| Rate for Payer: Galaxy Health WC |
$9,269.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,543.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,814.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,273.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,154.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,181.00
|
| Rate for Payer: Multiplan Commercial |
$8,178.75
|
| Rate for Payer: Networks By Design Commercial |
$7,088.25
|
| Rate for Payer: Prime Health Services Commercial |
$9,269.25
|
|
|
HC CORPORA CAVERNOSA-GLANS PENIS
|
Facility
|
OP
|
$10,905.00
|
|
|
Service Code
|
CPT 54435
|
| Hospital Charge Code |
900501751
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$164.10 |
| Max. Negotiated Rate |
$10,567.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,533.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,791.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,355.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,543.00
|
| Rate for Payer: Caremore Medicare Advantage |
$4,355.72
|
| Rate for Payer: Cash Price |
$4,907.25
|
| Rate for Payer: Cash Price |
$4,907.25
|
| Rate for Payer: Cash Price |
$4,907.25
|
| Rate for Payer: Cash Price |
$4,907.25
|
| Rate for Payer: Central Health Plan Commercial |
$8,724.00
|
| Rate for Payer: Cigna of CA PPO |
$8,069.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,533.58
|
| Rate for Payer: Dignity Health Media |
$4,355.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,791.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,880.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,355.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,355.72
|
| Rate for Payer: Galaxy Health WC |
$9,269.25
|
| Rate for Payer: Global Benefits Group Commercial |
$6,543.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,814.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,178.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,143.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,355.72
|
| Rate for Payer: InnovAge PACE Commercial |
$6,533.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,273.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,355.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,181.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,836.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,836.66
|
| Rate for Payer: Multiplan Commercial |
$8,178.75
|
| Rate for Payer: Networks By Design Commercial |
$7,088.25
|
| Rate for Payer: Prime Health Services Commercial |
$9,269.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,617.06
|
| Rate for Payer: Riverside University Health System MISP |
$4,791.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,543.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,452.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,452.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,452.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,452.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,533.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,791.29
|
| Rate for Payer: Vantage Medical Group Senior |
$4,355.72
|
|
|
HC CORPORA CAVERNOSOGRAPHY
|
Facility
|
IP
|
$690.00
|
|
|
Service Code
|
CPT 74445
|
| Hospital Charge Code |
909080040
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$138.00 |
| Max. Negotiated Rate |
$621.00 |
| Rate for Payer: Cash Price |
$310.50
|
| Rate for Payer: Central Health Plan Commercial |
$552.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$276.00
|
| Rate for Payer: Galaxy Health WC |
$586.50
|
| Rate for Payer: Global Benefits Group Commercial |
$414.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$262.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.00
|
| Rate for Payer: Multiplan Commercial |
$517.50
|
| Rate for Payer: Networks By Design Commercial |
$448.50
|
| Rate for Payer: Prime Health Services Commercial |
$586.50
|
|
|
HC CORPORA CAVERNOSOGRAPHY
|
Facility
|
OP
|
$690.00
|
|
|
Service Code
|
CPT 74445
|
| Hospital Charge Code |
909080040
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$98.63 |
| Max. Negotiated Rate |
$988.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$137.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$988.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$137.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$236.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$288.13
|
| Rate for Payer: Blue Distinction Transplant |
$414.00
|
| Rate for Payer: Blue Shield of California Commercial |
$426.42
|
| Rate for Payer: Blue Shield of California EPN |
$335.34
|
| Rate for Payer: Caremore Medicare Advantage |
$137.36
|
| Rate for Payer: Cash Price |
$310.50
|
| Rate for Payer: Cash Price |
$310.50
|
| Rate for Payer: Central Health Plan Commercial |
$552.00
|
| Rate for Payer: Cigna of CA HMO |
$441.60
|
| Rate for Payer: Cigna of CA PPO |
$510.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.04
|
| Rate for Payer: Dignity Health Media |
$137.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$151.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$185.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$137.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$137.36
|
| Rate for Payer: Galaxy Health WC |
$586.50
|
| Rate for Payer: Global Benefits Group Commercial |
$414.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$621.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$517.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$225.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$226.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$137.36
|
| Rate for Payer: InnovAge PACE Commercial |
$206.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$460.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.06
|
| Rate for Payer: Multiplan Commercial |
$517.50
|
| Rate for Payer: Networks By Design Commercial |
$448.50
|
| Rate for Payer: Prime Health Services Commercial |
$586.50
|
| Rate for Payer: Prime Health Services Medicare |
$145.60
|
| Rate for Payer: Riverside University Health System MISP |
$151.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$414.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$414.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$470.69
|
| Rate for Payer: United Healthcare All Other HMO |
$470.69
|
| Rate for Payer: United Healthcare HMO Rider |
$470.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$470.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$151.10
|
| Rate for Payer: Vantage Medical Group Senior |
$137.36
|
|
|
HC CORTISOL
|
Facility
|
IP
|
$268.00
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
900912125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.60 |
| Max. Negotiated Rate |
$241.20 |
| Rate for Payer: Cash Price |
$120.60
|
| Rate for Payer: Central Health Plan Commercial |
$214.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.20
|
| Rate for Payer: Galaxy Health WC |
$227.80
|
| Rate for Payer: Global Benefits Group Commercial |
$160.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$241.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$178.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.60
|
| Rate for Payer: Multiplan Commercial |
$201.00
|
| Rate for Payer: Networks By Design Commercial |
$174.20
|
| Rate for Payer: Prime Health Services Commercial |
$227.80
|
|
|
HC CORTISOL
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
900912125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$144.81 |
| Rate for Payer: Adventist Health Medi-Cal |
$16.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$118.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.81
|
| Rate for Payer: Blue Distinction Transplant |
$32.40
|
| Rate for Payer: Blue Shield of California Commercial |
$33.37
|
| Rate for Payer: Blue Shield of California EPN |
$26.24
|
| Rate for Payer: Caremore Medicare Advantage |
$16.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Cash Price |
$24.30
|
| Rate for Payer: Central Health Plan Commercial |
$43.20
|
| Rate for Payer: Cigna of CA HMO |
$34.56
|
| Rate for Payer: Cigna of CA PPO |
$39.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.45
|
| Rate for Payer: Dignity Health Media |
$16.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$16.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.30
|
| Rate for Payer: Galaxy Health WC |
$45.90
|
| Rate for Payer: Global Benefits Group Commercial |
$32.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$48.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$40.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$26.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$26.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.30
|
| Rate for Payer: InnovAge PACE Commercial |
$24.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$27.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.84
|
| Rate for Payer: Multiplan Commercial |
$40.50
|
| Rate for Payer: Networks By Design Commercial |
$35.10
|
| Rate for Payer: Prime Health Services Commercial |
$45.90
|
| Rate for Payer: Prime Health Services Medicare |
$17.28
|
| Rate for Payer: Riverside University Health System MISP |
$17.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.20
|
| Rate for Payer: United Healthcare All Other HMO |
$13.20
|
| Rate for Payer: United Healthcare HMO Rider |
$13.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$16.30
|
|
|
HC COUGH ASSIST
|
Facility
|
OP
|
$420.00
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
900801124
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$725.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$195.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$255.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$203.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$248.14
|
| Rate for Payer: Blue Distinction Transplant |
$252.00
|
| Rate for Payer: Blue Shield of California Commercial |
$259.56
|
| Rate for Payer: Blue Shield of California EPN |
$204.12
|
| Rate for Payer: Caremore Medicare Advantage |
$195.17
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Central Health Plan Commercial |
$336.00
|
| Rate for Payer: Cigna of CA HMO |
$268.80
|
| Rate for Payer: Cigna of CA PPO |
$310.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$292.76
|
| Rate for Payer: Dignity Health Media |
$195.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.48
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.17
|
| Rate for Payer: Galaxy Health WC |
$357.00
|
| Rate for Payer: Global Benefits Group Commercial |
$252.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$378.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$315.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$322.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.17
|
| Rate for Payer: InnovAge PACE Commercial |
$292.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$280.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.53
|
| Rate for Payer: Multiplan Commercial |
$315.00
|
| Rate for Payer: Networks By Design Commercial |
$273.00
|
| Rate for Payer: Prime Health Services Commercial |
$357.00
|
| Rate for Payer: Prime Health Services Medicare |
$206.88
|
| Rate for Payer: Riverside University Health System MISP |
$214.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$252.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$252.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$725.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$696.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$636.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$292.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.69
|
| Rate for Payer: Vantage Medical Group Senior |
$195.17
|
|
|
HC COUGH ASSIST
|
Facility
|
IP
|
$420.00
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
900801124
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$378.00 |
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Central Health Plan Commercial |
$336.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.00
|
| Rate for Payer: Galaxy Health WC |
$357.00
|
| Rate for Payer: Global Benefits Group Commercial |
$252.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$378.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$280.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$315.00
|
| Rate for Payer: Networks By Design Commercial |
$273.00
|
| Rate for Payer: Prime Health Services Commercial |
$357.00
|
|
