|
HC INJ TEN SHEATH LIG TRIG PNTS
|
Facility
|
OP
|
$1,506.00
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
900501052
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$87.00 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$370.06
|
| 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: Blue Distinction Transplant |
$903.60
|
| Rate for Payer: Caremore Medicare Advantage |
$370.06
|
| Rate for Payer: Cash Price |
$677.70
|
| Rate for Payer: Cash Price |
$677.70
|
| Rate for Payer: Cash Price |
$677.70
|
| Rate for Payer: Cash Price |
$677.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,204.80
|
| Rate for Payer: Cigna of CA PPO |
$1,114.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: Dignity Health Media |
$370.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$370.06
|
| Rate for Payer: Galaxy Health WC |
$1,280.10
|
| Rate for Payer: Global Benefits Group Commercial |
$903.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,355.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,129.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$606.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$370.06
|
| Rate for Payer: InnovAge PACE Commercial |
$555.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,004.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$87.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$301.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$495.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$495.88
|
| Rate for Payer: Multiplan Commercial |
$1,129.50
|
| Rate for Payer: Networks By Design Commercial |
$978.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,280.10
|
| Rate for Payer: Prime Health Services Medicare |
$392.26
|
| Rate for Payer: Riverside University Health System MISP |
$407.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$903.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$753.00
|
| Rate for Payer: United Healthcare All Other HMO |
$753.00
|
| Rate for Payer: United Healthcare HMO Rider |
$753.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC INJ TEN SHEATH LIG TRIG PNTS
|
Facility
|
IP
|
$1,506.00
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
900501052
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$301.20 |
| Max. Negotiated Rate |
$1,355.40 |
| Rate for Payer: Cash Price |
$677.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,204.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$602.40
|
| Rate for Payer: Galaxy Health WC |
$1,280.10
|
| Rate for Payer: Global Benefits Group Commercial |
$903.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,355.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,004.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$573.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$301.20
|
| Rate for Payer: Multiplan Commercial |
$1,129.50
|
| Rate for Payer: Networks By Design Commercial |
$978.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,280.10
|
|
|
HC INJ TEN SHEATH LIG TRIG PNTS
|
Facility
|
OP
|
$1,506.00
|
|
|
Service Code
|
CPT 20550
|
| Hospital Charge Code |
900501052
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$87.00 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$370.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$370.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$903.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$370.06
|
| Rate for Payer: Cash Price |
$677.70
|
| Rate for Payer: Cash Price |
$677.70
|
| Rate for Payer: Central Health Plan Commercial |
$1,204.80
|
| Rate for Payer: Cigna of CA PPO |
$1,114.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: Dignity Health Media |
$370.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$370.06
|
| Rate for Payer: Galaxy Health WC |
$1,280.10
|
| Rate for Payer: Global Benefits Group Commercial |
$903.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,355.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,129.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$606.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$610.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$370.06
|
| Rate for Payer: InnovAge PACE Commercial |
$555.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,004.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$87.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$301.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$495.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$495.88
|
| Rate for Payer: Multiplan Commercial |
$1,129.50
|
| Rate for Payer: Networks By Design Commercial |
$978.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,280.10
|
| Rate for Payer: Prime Health Services Medicare |
$392.26
|
| Rate for Payer: Riverside University Health System MISP |
$407.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$903.60
|
| 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 Commercial/Exchange |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC INJ TRIGGER PTS 3+
|
Facility
|
OP
|
$1,673.00
|
|
|
Service Code
|
CPT 20553
|
| Hospital Charge Code |
909000261
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$106.82 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$370.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$370.06
|
| 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: Blue Distinction Transplant |
$1,003.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,052.32
|
| Rate for Payer: Blue Shield of California EPN |
$818.10
|
| Rate for Payer: Caremore Medicare Advantage |
$370.06
|
| Rate for Payer: Cash Price |
$752.85
|
| Rate for Payer: Cash Price |
$752.85
|
| Rate for Payer: Cash Price |
$752.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,338.40
|
| Rate for Payer: Cigna of CA HMO |
$1,070.72
|
| Rate for Payer: Cigna of CA PPO |
$1,238.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: Dignity Health Media |
$370.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$370.06
|
| Rate for Payer: Galaxy Health WC |
$1,422.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,003.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,505.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,254.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$606.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$610.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$370.06
|
| Rate for Payer: InnovAge PACE Commercial |
$555.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,115.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$334.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$495.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$495.88
|
| Rate for Payer: Multiplan Commercial |
$1,254.75
|
| Rate for Payer: Networks By Design Commercial |
$1,087.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,422.05
|
| Rate for Payer: Prime Health Services Medicare |
$392.26
|
| Rate for Payer: Riverside University Health System MISP |
$407.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,003.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,003.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$836.50
|
| Rate for Payer: United Healthcare All Other HMO |
$836.50
|
| Rate for Payer: United Healthcare HMO Rider |
$836.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$836.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC INJ TRIGGER PTS 3+
|
Facility
|
OP
|
$1,673.00
|
|
|
Service Code
|
CPT 20553
|
| Hospital Charge Code |
909000261
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$106.82 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$370.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$370.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,003.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,033.91
|
| Rate for Payer: Blue Shield of California EPN |
$813.08
|
| Rate for Payer: Caremore Medicare Advantage |
$370.06
|
| Rate for Payer: Cash Price |
$752.85
|
| Rate for Payer: Cash Price |
$752.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,338.40
|
| Rate for Payer: Cigna of CA HMO |
$1,070.72
|
| Rate for Payer: Cigna of CA PPO |
$1,238.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: Dignity Health Media |
$370.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$407.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$370.06
|
| Rate for Payer: Galaxy Health WC |
$1,422.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,003.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,505.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,254.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$606.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$610.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$370.06
|
| Rate for Payer: InnovAge PACE Commercial |
$555.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,115.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$334.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$495.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$495.88
|
| Rate for Payer: Multiplan Commercial |
$1,254.75
|
| Rate for Payer: Networks By Design Commercial |
$1,087.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,422.05
|
| Rate for Payer: Prime Health Services Medicare |
$392.26
|
| Rate for Payer: Riverside University Health System MISP |
$407.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,003.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,003.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$836.50
|
| Rate for Payer: United Healthcare All Other HMO |
$836.50
|
| Rate for Payer: United Healthcare HMO Rider |
$836.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$836.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC INJ TRIGGER PTS 3+
|
Facility
|
IP
|
$1,673.00
|
|
|
Service Code
|
CPT 20553
|
| Hospital Charge Code |
909000261
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$334.60 |
| Max. Negotiated Rate |
$1,505.70 |
| Rate for Payer: Cash Price |
$752.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,338.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$669.20
|
| Rate for Payer: Galaxy Health WC |
$1,422.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,003.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,505.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,115.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$637.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$334.60
|
| Rate for Payer: Multiplan Commercial |
$1,254.75
|
| Rate for Payer: Networks By Design Commercial |
$1,087.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,422.05
|
|
|
HC INJ TRIGGER PTS 3+
|
Facility
|
IP
|
$1,673.00
|
|
|
Service Code
|
CPT 20553
|
| Hospital Charge Code |
909000261
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$334.60 |
| Max. Negotiated Rate |
$1,505.70 |
| Rate for Payer: Cash Price |
$752.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,338.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$669.20
|
| Rate for Payer: Galaxy Health WC |
$1,422.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,003.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,505.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,115.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$637.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$334.60
|
| Rate for Payer: Multiplan Commercial |
$1,254.75
|
| Rate for Payer: Networks By Design Commercial |
$1,087.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,422.05
|
|
|
HC INJ VENOGRAPHY EXTREMITY
|
Facility
|
IP
|
$637.00
|
|
|
Service Code
|
CPT 36005
|
| Hospital Charge Code |
906811385
|
|
Hospital Revenue Code
|
329
|
| Min. Negotiated Rate |
$127.40 |
| Max. Negotiated Rate |
$573.30 |
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Central Health Plan Commercial |
$509.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.80
|
| Rate for Payer: Galaxy Health WC |
$541.45
|
| Rate for Payer: Global Benefits Group Commercial |
$382.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$573.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$424.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$242.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.40
|
| Rate for Payer: Multiplan Commercial |
$477.75
|
| Rate for Payer: Networks By Design Commercial |
$414.05
|
| Rate for Payer: Prime Health Services Commercial |
$541.45
|
|
|
HC INJ VENOGRAPHY EXTREMITY
|
Facility
|
OP
|
$637.00
|
|
|
Service Code
|
CPT 36005
|
| Hospital Charge Code |
906811385
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.40 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$541.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$350.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$350.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$382.20
|
| 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 |
$286.65
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Central Health Plan Commercial |
$509.60
|
| Rate for Payer: Cigna of CA PPO |
$471.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$541.45
|
| Rate for Payer: Dignity Health Media |
$541.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$541.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$254.80
|
| Rate for Payer: Galaxy Health WC |
$541.45
|
| Rate for Payer: Global Benefits Group Commercial |
$382.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$573.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$477.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$222.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$424.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$546.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.40
|
| Rate for Payer: Multiplan Commercial |
$477.75
|
| Rate for Payer: Networks By Design Commercial |
$414.05
|
| Rate for Payer: Prime Health Services Commercial |
$541.45
|
| Rate for Payer: Riverside University Health System MISP |
$254.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$382.20
|
| 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 |
$541.45
|
| Rate for Payer: Vantage Medical Group Senior |
$541.45
|
|
|
HC INJ VENOGRAPHY EXTREMITY
|
Facility
|
IP
|
$637.00
|
|
|
Service Code
|
CPT 36005
|
| Hospital Charge Code |
906811385
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.40 |
| Max. Negotiated Rate |
$573.30 |
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Central Health Plan Commercial |
$509.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.80
|
| Rate for Payer: Galaxy Health WC |
$541.45
|
| Rate for Payer: Global Benefits Group Commercial |
$382.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$573.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$424.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$242.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.40
|
| Rate for Payer: Multiplan Commercial |
$477.75
|
| Rate for Payer: Networks By Design Commercial |
$414.05
|
| Rate for Payer: Prime Health Services Commercial |
$541.45
|
|
|
HC INJ VENOGRAPHY EXTREMITY
|
Facility
|
IP
|
$637.00
|
|
|
Service Code
|
CPT 36005
|
| Hospital Charge Code |
906820129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.40 |
| Max. Negotiated Rate |
$573.30 |
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Central Health Plan Commercial |
$509.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.80
|
| Rate for Payer: Galaxy Health WC |
$541.45
|
| Rate for Payer: Global Benefits Group Commercial |
$382.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$573.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$424.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$242.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.40
|
| Rate for Payer: Multiplan Commercial |
$477.75
|
| Rate for Payer: Networks By Design Commercial |
$414.05
|
| Rate for Payer: Prime Health Services Commercial |
$541.45
|
|
|
HC INJ VENOGRAPHY EXTREMITY
|
Facility
|
OP
|
$637.00
|
|
|
Service Code
|
CPT 36005
|
| Hospital Charge Code |
906811385
|
|
Hospital Revenue Code
|
329
|
| Min. Negotiated Rate |
$127.40 |
| Max. Negotiated Rate |
$5,779.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$541.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$350.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$350.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$382.20
|
| Rate for Payer: Blue Shield of California Commercial |
$393.67
|
| Rate for Payer: Blue Shield of California EPN |
$309.58
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Central Health Plan Commercial |
$509.60
|
| Rate for Payer: Cigna of CA HMO |
$407.68
|
| Rate for Payer: Cigna of CA PPO |
$471.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$541.45
|
| Rate for Payer: Dignity Health Media |
$541.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$541.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$254.80
|
| Rate for Payer: Galaxy Health WC |
$541.45
|
| Rate for Payer: Global Benefits Group Commercial |
$382.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$573.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$477.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$222.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$424.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$546.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.40
|
| Rate for Payer: Multiplan Commercial |
$477.75
|
| Rate for Payer: Networks By Design Commercial |
$414.05
|
| Rate for Payer: Prime Health Services Commercial |
$541.45
|
| Rate for Payer: Riverside University Health System MISP |
$254.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$382.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$382.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$318.50
|
| Rate for Payer: United Healthcare All Other HMO |
$318.50
|
| Rate for Payer: United Healthcare HMO Rider |
$318.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$318.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$541.45
|
| Rate for Payer: Vantage Medical Group Senior |
$541.45
|
|
|
HC INJ VENOGRAPHY EXTREMITY
|
Facility
|
OP
|
$637.00
|
|
|
Service Code
|
CPT 36005
|
| Hospital Charge Code |
906820129
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.40 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$541.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$350.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$350.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$382.20
|
| 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 |
$286.65
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Cash Price |
$286.65
|
| Rate for Payer: Central Health Plan Commercial |
$509.60
|
| Rate for Payer: Cigna of CA PPO |
$471.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$541.45
|
| Rate for Payer: Dignity Health Media |
$541.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$541.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$254.80
|
| Rate for Payer: Galaxy Health WC |
$541.45
|
| Rate for Payer: Global Benefits Group Commercial |
$382.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$573.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$477.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$222.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$424.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$546.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.40
|
| Rate for Payer: Multiplan Commercial |
$477.75
|
| Rate for Payer: Networks By Design Commercial |
$414.05
|
| Rate for Payer: Prime Health Services Commercial |
$541.45
|
| Rate for Payer: Riverside University Health System MISP |
$254.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$382.20
|
| 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 |
$541.45
|
| Rate for Payer: Vantage Medical Group Senior |
$541.45
|
|
|
HC INNER CANNULA
|
Facility
|
IP
|
$24.00
|
|
| Hospital Charge Code |
900800704
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
|
|
HC INNER CANNULA
|
Facility
|
OP
|
$24.00
|
|
| Hospital Charge Code |
900800704
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.18
|
| Rate for Payer: Blue Distinction Transplant |
$14.40
|
| Rate for Payer: Blue Shield of California Commercial |
$15.10
|
| Rate for Payer: Blue Shield of California EPN |
$11.74
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$15.36
|
| Rate for Payer: Cigna of CA PPO |
$17.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: Dignity Health Media |
$20.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$18.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$15.60
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Riverside University Health System MISP |
$9.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
|
|
HC INNOMINATE SUBCLAV UNI
|
Facility
|
OP
|
$11,135.00
|
|
|
Service Code
|
CPT 36225
|
| Hospital Charge Code |
906820223
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$485.96 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| 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 |
$6,681.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$5,010.75
|
| Rate for Payer: Cash Price |
$5,010.75
|
| Rate for Payer: Central Health Plan Commercial |
$8,908.00
|
| Rate for Payer: Cigna of CA PPO |
$8,239.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$9,464.75
|
| Rate for Payer: Global Benefits Group Commercial |
$6,681.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,021.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,351.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,427.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$485.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,227.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$8,351.25
|
| Rate for Payer: Networks By Design Commercial |
$7,237.75
|
| Rate for Payer: Prime Health Services Commercial |
$9,464.75
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,681.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC INNOMINATE SUBCLAV UNI
|
Facility
|
OP
|
$11,135.00
|
|
|
Service Code
|
CPT 36225
|
| Hospital Charge Code |
909020148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$485.96 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| 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 |
$6,681.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$5,010.75
|
| Rate for Payer: Cash Price |
$5,010.75
|
| Rate for Payer: Central Health Plan Commercial |
$8,908.00
|
| Rate for Payer: Cigna of CA PPO |
$8,239.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$9,464.75
|
| Rate for Payer: Global Benefits Group Commercial |
$6,681.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,021.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,351.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,427.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$485.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,227.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$8,351.25
|
| Rate for Payer: Networks By Design Commercial |
$7,237.75
|
| Rate for Payer: Prime Health Services Commercial |
$9,464.75
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,681.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC INNOMINATE SUBCLAV UNI
|
Facility
|
IP
|
$11,135.00
|
|
|
Service Code
|
CPT 36225
|
| Hospital Charge Code |
909020148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,227.00 |
| Max. Negotiated Rate |
$10,021.50 |
| Rate for Payer: Cash Price |
$5,010.75
|
| Rate for Payer: Central Health Plan Commercial |
$8,908.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,454.00
|
| Rate for Payer: Galaxy Health WC |
$9,464.75
|
| Rate for Payer: Global Benefits Group Commercial |
$6,681.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,021.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,427.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,242.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,227.00
|
| Rate for Payer: Multiplan Commercial |
$8,351.25
|
| Rate for Payer: Networks By Design Commercial |
$7,237.75
|
| Rate for Payer: Prime Health Services Commercial |
$9,464.75
|
|
|
HC INNOMINATE SUBCLAV UNI
|
Facility
|
IP
|
$11,135.00
|
|
|
Service Code
|
CPT 36225
|
| Hospital Charge Code |
906820223
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,227.00 |
| Max. Negotiated Rate |
$10,021.50 |
| Rate for Payer: Cash Price |
$5,010.75
|
| Rate for Payer: Central Health Plan Commercial |
$8,908.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,454.00
|
| Rate for Payer: Galaxy Health WC |
$9,464.75
|
| Rate for Payer: Global Benefits Group Commercial |
$6,681.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,021.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,427.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,242.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,227.00
|
| Rate for Payer: Multiplan Commercial |
$8,351.25
|
| Rate for Payer: Networks By Design Commercial |
$7,237.75
|
| Rate for Payer: Prime Health Services Commercial |
$9,464.75
|
|
|
HC INSERT BRONCHIAL VALVE
|
Facility
|
IP
|
$9,665.00
|
|
|
Service Code
|
CPT 31647
|
| Hospital Charge Code |
900803113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,933.00 |
| Max. Negotiated Rate |
$8,698.50 |
| Rate for Payer: Cash Price |
$4,349.25
|
| Rate for Payer: Central Health Plan Commercial |
$7,732.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,866.00
|
| Rate for Payer: Galaxy Health WC |
$8,215.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5,799.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,698.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,446.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,682.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,933.00
|
| Rate for Payer: Multiplan Commercial |
$7,248.75
|
| Rate for Payer: Networks By Design Commercial |
$6,282.25
|
| Rate for Payer: Prime Health Services Commercial |
$8,215.25
|
|
|
HC INSERT BRONCHIAL VALVE
|
Facility
|
OP
|
$9,665.00
|
|
|
Service Code
|
CPT 31647
|
| Hospital Charge Code |
900803113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$351.56 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,551.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,551.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,691.12
|
| Rate for Payer: Blue Distinction Transplant |
$5,799.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$8,551.50
|
| Rate for Payer: Cash Price |
$4,349.25
|
| Rate for Payer: Cash Price |
$4,349.25
|
| Rate for Payer: Central Health Plan Commercial |
$7,732.00
|
| Rate for Payer: Cigna of CA PPO |
$7,152.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Dignity Health Media |
$8,551.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,406.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,544.52
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,551.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,551.50
|
| Rate for Payer: Galaxy Health WC |
$8,215.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5,799.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,698.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,248.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,024.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14,109.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,551.50
|
| Rate for Payer: InnovAge PACE Commercial |
$12,827.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,446.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$351.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,551.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,933.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,459.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,459.01
|
| Rate for Payer: Multiplan Commercial |
$7,248.75
|
| Rate for Payer: Multiplan WC |
$11,691.12
|
| Rate for Payer: Networks By Design Commercial |
$6,282.25
|
| Rate for Payer: Preferred Health Network WC |
$11,929.71
|
| Rate for Payer: Prime Health Services Commercial |
$8,215.25
|
| Rate for Payer: Prime Health Services Medicare |
$9,064.59
|
| Rate for Payer: Prime Health Services WC |
$11,571.82
|
| Rate for Payer: Riverside University Health System MISP |
$9,406.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,799.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12,827.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,406.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8,551.50
|
|
|
HC INSERTION PICC W RS &I 5YRS/GT
|
Facility
|
OP
|
$3,521.00
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
909036573
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$689.68 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,112.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$1,584.45
|
| Rate for Payer: Cash Price |
$1,584.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,816.80
|
| Rate for Payer: Cigna of CA PPO |
$2,605.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$2,992.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,112.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,168.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,640.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,301.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,001.01
|
| Rate for Payer: InnovAge PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,348.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$689.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$704.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$2,640.75
|
| Rate for Payer: Networks By Design Commercial |
$2,288.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,992.85
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Riverside University Health System MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,112.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC INSERTION PICC W RS &I 5YRS/GT
|
Facility
|
IP
|
$3,521.00
|
|
|
Service Code
|
CPT 36573
|
| Hospital Charge Code |
909036573
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$704.20 |
| Max. Negotiated Rate |
$3,168.90 |
| Rate for Payer: Cash Price |
$1,584.45
|
| Rate for Payer: Central Health Plan Commercial |
$2,816.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,408.40
|
| Rate for Payer: Galaxy Health WC |
$2,992.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,112.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,168.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,348.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,341.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$704.20
|
| Rate for Payer: Multiplan Commercial |
$2,640.75
|
| Rate for Payer: Networks By Design Commercial |
$2,288.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,992.85
|
|
|
HC INSERTION PICC W RS&I LT 5 YRS
|
Facility
|
OP
|
$1,997.00
|
|
|
Service Code
|
CPT 36572
|
| Hospital Charge Code |
909036572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$399.40 |
| Max. Negotiated Rate |
$5,779.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$784.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$784.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,198.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$784.90
|
| Rate for Payer: Cash Price |
$898.65
|
| Rate for Payer: Cash Price |
$898.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,597.60
|
| Rate for Payer: Cigna of CA PPO |
$1,477.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Dignity Health Media |
$784.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$863.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.90
|
| Rate for Payer: Galaxy Health WC |
$1,697.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,198.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,797.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,497.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,287.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,295.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$784.90
|
| Rate for Payer: InnovAge PACE Commercial |
$1,177.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,332.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$734.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.77
|
| Rate for Payer: Multiplan Commercial |
$1,497.75
|
| Rate for Payer: Networks By Design Commercial |
$1,298.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,697.45
|
| Rate for Payer: Prime Health Services Medicare |
$831.99
|
| Rate for Payer: Riverside University Health System MISP |
$863.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,198.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Vantage Medical Group Senior |
$784.90
|
|
|
HC INSERTION PICC W RS&I LT 5 YRS
|
Facility
|
IP
|
$1,997.00
|
|
|
Service Code
|
CPT 36572
|
| Hospital Charge Code |
909036572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$399.40 |
| Max. Negotiated Rate |
$1,797.30 |
| Rate for Payer: Cash Price |
$898.65
|
| Rate for Payer: Central Health Plan Commercial |
$1,597.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$798.80
|
| Rate for Payer: Galaxy Health WC |
$1,697.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,198.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,797.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,332.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$760.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$399.40
|
| Rate for Payer: Multiplan Commercial |
$1,497.75
|
| Rate for Payer: Networks By Design Commercial |
$1,298.05
|
| Rate for Payer: Prime Health Services Commercial |
$1,697.45
|
|
