|
HC INSERT NON-INDWEL BLADDER CATH
|
Facility
|
OP
|
$332.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
906811389
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$66.40 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| 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 |
$199.20
|
| Rate for Payer: Blue Shield of California Commercial |
$208.83
|
| Rate for Payer: Blue Shield of California EPN |
$162.35
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Central Health Plan Commercial |
$265.60
|
| Rate for Payer: Cigna of CA HMO |
$212.48
|
| Rate for Payer: Cigna of CA PPO |
$245.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$282.20
|
| Rate for Payer: Global Benefits Group Commercial |
$199.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$298.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$249.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: InnovAge PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$221.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$208.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$249.00
|
| Rate for Payer: Networks By Design Commercial |
$215.80
|
| Rate for Payer: Prime Health Services Commercial |
$282.20
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health System MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$199.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$199.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.00
|
| Rate for Payer: United Healthcare All Other HMO |
$166.00
|
| Rate for Payer: United Healthcare HMO Rider |
$166.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$166.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC INSERT NON-INDWEL BLADDER CATH
|
Facility
|
IP
|
$332.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
906820132
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$66.40 |
| Max. Negotiated Rate |
$298.80 |
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Central Health Plan Commercial |
$265.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.80
|
| Rate for Payer: Galaxy Health WC |
$282.20
|
| Rate for Payer: Global Benefits Group Commercial |
$199.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$298.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$221.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$126.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.40
|
| Rate for Payer: Multiplan Commercial |
$249.00
|
| Rate for Payer: Networks By Design Commercial |
$215.80
|
| Rate for Payer: Prime Health Services Commercial |
$282.20
|
|
|
HC INSERT NON-INDWEL BLADDER CATH
|
Facility
|
OP
|
$332.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
906820132
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$66.40 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| 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 |
$199.20
|
| Rate for Payer: Blue Shield of California Commercial |
$208.83
|
| Rate for Payer: Blue Shield of California EPN |
$162.35
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Central Health Plan Commercial |
$265.60
|
| Rate for Payer: Cigna of CA HMO |
$212.48
|
| Rate for Payer: Cigna of CA PPO |
$245.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$282.20
|
| Rate for Payer: Global Benefits Group Commercial |
$199.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$298.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$249.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: InnovAge PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$221.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$208.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$249.00
|
| Rate for Payer: Networks By Design Commercial |
$215.80
|
| Rate for Payer: Prime Health Services Commercial |
$282.20
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health System MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$199.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$199.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$166.00
|
| Rate for Payer: United Healthcare All Other HMO |
$166.00
|
| Rate for Payer: United Healthcare HMO Rider |
$166.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$166.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC INSERT NON-INDWEL BLADDER CATH
|
Facility
|
IP
|
$391.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
909001904
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$78.20 |
| Max. Negotiated Rate |
$351.90 |
| Rate for Payer: Cash Price |
$175.95
|
| Rate for Payer: Central Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.40
|
| Rate for Payer: Galaxy Health WC |
$332.35
|
| Rate for Payer: Global Benefits Group Commercial |
$234.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$260.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.20
|
| Rate for Payer: Multiplan Commercial |
$293.25
|
| Rate for Payer: Networks By Design Commercial |
$254.15
|
| Rate for Payer: Prime Health Services Commercial |
$332.35
|
|
|
HC INSERT NON-INDWEL BLADDER CATH
|
Facility
|
IP
|
$332.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
906811389
|
|
Hospital Revenue Code
|
230
|
| Min. Negotiated Rate |
$66.40 |
| Max. Negotiated Rate |
$298.80 |
| Rate for Payer: Cash Price |
$149.40
|
| Rate for Payer: Central Health Plan Commercial |
$265.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.80
|
| Rate for Payer: Galaxy Health WC |
$282.20
|
| Rate for Payer: Global Benefits Group Commercial |
$199.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$298.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$221.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$126.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.40
|
| Rate for Payer: Multiplan Commercial |
$249.00
|
| Rate for Payer: Networks By Design Commercial |
$215.80
|
| Rate for Payer: Prime Health Services Commercial |
$282.20
|
|
|
HC INSERT NON-INDWEL BLADDER CATH
|
Facility
|
OP
|
$391.00
|
|
|
Service Code
|
CPT 51701
|
| Hospital Charge Code |
909001904
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$78.20 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$159.60
|
| 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 |
$234.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$175.95
|
| Rate for Payer: Cash Price |
$175.95
|
| Rate for Payer: Cash Price |
$175.95
|
| Rate for Payer: Central Health Plan Commercial |
$312.80
|
| Rate for Payer: Cigna of CA PPO |
$289.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: Dignity Health Media |
$159.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$175.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$332.35
|
| Rate for Payer: Global Benefits Group Commercial |
$234.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$293.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$263.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$159.60
|
| Rate for Payer: InnovAge PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$260.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$208.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$78.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$293.25
|
| Rate for Payer: Networks By Design Commercial |
$254.15
|
| Rate for Payer: Prime Health Services Commercial |
$332.35
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Riverside University Health System MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$234.60
|
| 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 |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
IP
|
$3,442.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906820087
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$688.40 |
| Max. Negotiated Rate |
$3,097.80 |
| Rate for Payer: Cash Price |
$1,548.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,753.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,376.80
|
| Rate for Payer: Galaxy Health WC |
$2,925.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,065.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,097.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,295.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,311.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$688.40
|
| Rate for Payer: Multiplan Commercial |
$2,581.50
|
| Rate for Payer: Networks By Design Commercial |
$2,237.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,925.70
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
IP
|
$3,442.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$688.40 |
| Max. Negotiated Rate |
$3,097.80 |
| Rate for Payer: Cash Price |
$1,548.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,753.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,376.80
|
| Rate for Payer: Galaxy Health WC |
$2,925.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,065.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,097.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,295.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,311.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$688.40
|
| Rate for Payer: Multiplan Commercial |
$2,581.50
|
| Rate for Payer: Networks By Design Commercial |
$2,237.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,925.70
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
OP
|
$3,442.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$164.35 |
| Max. Negotiated Rate |
$6,531.38 |
| 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 |
$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 |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,065.20
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$1,548.90
|
| Rate for Payer: Cash Price |
$1,548.90
|
| Rate for Payer: Cash Price |
$1,548.90
|
| Rate for Payer: Cash Price |
$1,548.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,753.60
|
| Rate for Payer: Cigna of CA PPO |
$2,547.08
|
| 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 |
$2,925.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,065.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,097.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,581.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| 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 |
$2,295.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$688.40
|
| 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 |
$2,581.50
|
| Rate for Payer: Networks By Design Commercial |
$2,237.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,925.70
|
| 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 |
$2,065.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,721.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,721.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,721.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,721.00
|
| 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 INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
IP
|
$3,442.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$688.40 |
| Max. Negotiated Rate |
$3,097.80 |
| Rate for Payer: Cash Price |
$1,548.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,753.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,376.80
|
| Rate for Payer: Galaxy Health WC |
$2,925.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,065.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,097.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,295.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,311.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$688.40
|
| Rate for Payer: Multiplan Commercial |
$2,581.50
|
| Rate for Payer: Networks By Design Commercial |
$2,237.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,925.70
|
|
|
HC INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
OP
|
$3,442.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906812249
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$164.35 |
| Max. Negotiated Rate |
$6,571.21 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,065.20
|
| 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 |
$3,982.55
|
| Rate for Payer: Cash Price |
$1,548.90
|
| Rate for Payer: Cash Price |
$1,548.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,753.60
|
| Rate for Payer: Cigna of CA PPO |
$2,547.08
|
| 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 |
$2,925.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,065.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,097.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,581.50
|
| 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 |
$2,295.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$688.40
|
| 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 |
$2,581.50
|
| Rate for Payer: Networks By Design Commercial |
$2,237.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,925.70
|
| 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 |
$2,065.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,065.20
|
| 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 |
$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 INSERT NON-TNEL CV CATH LT 5YR
|
Facility
|
OP
|
$3,442.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
906820087
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$164.35 |
| Max. Negotiated Rate |
$6,571.21 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,065.20
|
| 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 |
$3,982.55
|
| Rate for Payer: Cash Price |
$1,548.90
|
| Rate for Payer: Cash Price |
$1,548.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,753.60
|
| Rate for Payer: Cigna of CA PPO |
$2,547.08
|
| 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 |
$2,925.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,065.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,097.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,581.50
|
| 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 |
$2,295.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$688.40
|
| 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 |
$2,581.50
|
| Rate for Payer: Networks By Design Commercial |
$2,237.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,925.70
|
| 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 |
$2,065.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,065.20
|
| 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 |
$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 INSERT NON-TNNL CV CATH LT 5YR
|
Facility
|
IP
|
$3,442.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
909081358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$688.40 |
| Max. Negotiated Rate |
$3,097.80 |
| Rate for Payer: Cash Price |
$1,548.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,753.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,376.80
|
| Rate for Payer: Galaxy Health WC |
$2,925.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,065.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,097.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,295.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,311.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$688.40
|
| Rate for Payer: Multiplan Commercial |
$2,581.50
|
| Rate for Payer: Networks By Design Commercial |
$2,237.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,925.70
|
|
|
HC INSERT NON-TNNL CV CATH LT 5YR
|
Facility
|
OP
|
$3,442.00
|
|
|
Service Code
|
CPT 36555
|
| Hospital Charge Code |
909081358
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$164.35 |
| Max. Negotiated Rate |
$6,571.21 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,065.20
|
| 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 |
$3,982.55
|
| Rate for Payer: Cash Price |
$1,548.90
|
| Rate for Payer: Cash Price |
$1,548.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,753.60
|
| Rate for Payer: Cigna of CA PPO |
$2,547.08
|
| 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 |
$2,925.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,065.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,097.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,581.50
|
| 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 |
$2,295.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$688.40
|
| 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 |
$2,581.50
|
| Rate for Payer: Networks By Design Commercial |
$2,237.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,925.70
|
| 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 |
$2,065.20
|
| 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 |
$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 INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$5,741.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
901200045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,148.20 |
| Max. Negotiated Rate |
$5,166.90 |
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,296.40
|
| Rate for Payer: Galaxy Health WC |
$4,879.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,444.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,166.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,829.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,187.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,148.20
|
| Rate for Payer: Multiplan Commercial |
$4,305.75
|
| Rate for Payer: Networks By Design Commercial |
$3,731.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,879.85
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$5,741.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,148.20 |
| Max. Negotiated Rate |
$5,166.90 |
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,296.40
|
| Rate for Payer: Galaxy Health WC |
$4,879.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,444.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,166.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,829.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,187.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,148.20
|
| Rate for Payer: Multiplan Commercial |
$4,305.75
|
| Rate for Payer: Networks By Design Commercial |
$3,731.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,879.85
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$5,741.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906820086
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$141.00 |
| Max. Negotiated Rate |
$6,571.21 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,444.60
|
| 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 |
$3,982.55
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,592.80
|
| Rate for Payer: Cigna of CA PPO |
$4,248.34
|
| 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 |
$4,879.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,444.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,166.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,305.75
|
| 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 |
$3,829.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,148.20
|
| 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 |
$4,305.75
|
| Rate for Payer: Networks By Design Commercial |
$3,731.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,879.85
|
| 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 |
$3,444.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group 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 INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$5,741.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
901200045
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$141.00 |
| Max. Negotiated Rate |
$6,571.21 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,444.60
|
| 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 |
$3,982.55
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,592.80
|
| Rate for Payer: Cigna of CA PPO |
$4,248.34
|
| 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 |
$4,879.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,444.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,166.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,305.75
|
| 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 |
$3,829.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,148.20
|
| 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 |
$4,305.75
|
| Rate for Payer: Networks By Design Commercial |
$3,731.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,879.85
|
| 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 |
$3,444.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group 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 INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$5,741.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$141.00 |
| Max. Negotiated Rate |
$6,571.21 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,444.60
|
| 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 |
$3,982.55
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,592.80
|
| Rate for Payer: Cigna of CA PPO |
$4,248.34
|
| 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 |
$4,879.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,444.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,166.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,305.75
|
| 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 |
$3,829.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,148.20
|
| 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 |
$4,305.75
|
| Rate for Payer: Networks By Design Commercial |
$3,731.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,879.85
|
| 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 |
$3,444.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group 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 INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$5,741.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906820086
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,148.20 |
| Max. Negotiated Rate |
$5,166.90 |
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,296.40
|
| Rate for Payer: Galaxy Health WC |
$4,879.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,444.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,166.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,829.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,187.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,148.20
|
| Rate for Payer: Multiplan Commercial |
$4,305.75
|
| Rate for Payer: Networks By Design Commercial |
$3,731.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,879.85
|
|
|
HC INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
OP
|
$5,741.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$141.00 |
| Max. Negotiated Rate |
$6,531.38 |
| 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 |
$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 |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,444.60
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,592.80
|
| Rate for Payer: Cigna of CA PPO |
$4,248.34
|
| 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 |
$4,879.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,444.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,166.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,305.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| 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 |
$3,829.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$141.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,148.20
|
| 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 |
$4,305.75
|
| Rate for Payer: Networks By Design Commercial |
$3,731.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,879.85
|
| 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 |
$3,444.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,870.50
|
| Rate for Payer: United Healthcare All Other HMO |
$2,870.50
|
| Rate for Payer: United Healthcare HMO Rider |
$2,870.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,870.50
|
| 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 INSERT NON-TUNNEL CV CATH GT 5YR
|
Facility
|
IP
|
$5,741.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
906812248
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,148.20 |
| Max. Negotiated Rate |
$5,166.90 |
| Rate for Payer: Cash Price |
$2,583.45
|
| Rate for Payer: Central Health Plan Commercial |
$4,592.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,296.40
|
| Rate for Payer: Galaxy Health WC |
$4,879.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,444.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,166.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,829.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,187.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,148.20
|
| Rate for Payer: Multiplan Commercial |
$4,305.75
|
| Rate for Payer: Networks By Design Commercial |
$3,731.65
|
| Rate for Payer: Prime Health Services Commercial |
$4,879.85
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
OP
|
$32,231.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906811995
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$573.69 |
| Max. Negotiated Rate |
$29,007.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,989.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27,396.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17,727.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17,727.05
|
| 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 |
$19,338.60
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Cash Price |
$14,503.95
|
| Rate for Payer: Cash Price |
$14,503.95
|
| Rate for Payer: Central Health Plan Commercial |
$25,784.80
|
| Rate for Payer: Cigna of CA PPO |
$23,850.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27,396.35
|
| Rate for Payer: Dignity Health Media |
$27,396.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,396.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,892.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$12,892.40
|
| Rate for Payer: Galaxy Health WC |
$27,396.35
|
| Rate for Payer: Global Benefits Group Commercial |
$19,338.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,007.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$24,173.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,280.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,498.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$573.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,446.20
|
| Rate for Payer: Multiplan Commercial |
$24,173.25
|
| Rate for Payer: Networks By Design Commercial |
$20,950.15
|
| Rate for Payer: Prime Health Services Commercial |
$27,396.35
|
| Rate for Payer: Riverside University Health System MISP |
$12,892.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,338.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,396.35
|
| Rate for Payer: Vantage Medical Group Senior |
$27,396.35
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
IP
|
$32,231.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906820320
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,446.20 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$14,503.95
|
| Rate for Payer: Cash Price |
$14,503.95
|
| Rate for Payer: Central Health Plan Commercial |
$25,784.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,892.40
|
| Rate for Payer: Galaxy Health WC |
$27,396.35
|
| Rate for Payer: Global Benefits Group Commercial |
$19,338.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,007.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,498.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,280.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,446.20
|
| Rate for Payer: Multiplan Commercial |
$24,173.25
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$27,396.35
|
|
|
HC INSERT PERC VAD RIGHT VENOUS
|
Facility
|
IP
|
$32,231.00
|
|
|
Service Code
|
CPT 33995
|
| Hospital Charge Code |
906811995
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,446.20 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$14,503.95
|
| Rate for Payer: Cash Price |
$14,503.95
|
| Rate for Payer: Central Health Plan Commercial |
$25,784.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,892.40
|
| Rate for Payer: Galaxy Health WC |
$27,396.35
|
| Rate for Payer: Global Benefits Group Commercial |
$19,338.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,007.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,498.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,280.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,446.20
|
| Rate for Payer: Multiplan Commercial |
$24,173.25
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$27,396.35
|
|
