|
HC INTESTINE CELLVIZIO
|
Facility
|
IP
|
$8,010.00
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
906744799
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,602.00 |
| Max. Negotiated Rate |
$7,209.00 |
| Rate for Payer: Cash Price |
$3,604.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,408.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,204.00
|
| Rate for Payer: Galaxy Health WC |
$6,808.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,806.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,209.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,342.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,051.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,602.00
|
| Rate for Payer: Multiplan Commercial |
$6,007.50
|
| Rate for Payer: Networks By Design Commercial |
$5,206.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,808.50
|
|
|
HC INTESTINE CELLVIZIO
|
Facility
|
OP
|
$8,010.00
|
|
|
Service Code
|
CPT 44799
|
| Hospital Charge Code |
906744799
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$1,132.59 |
| Max. Negotiated Rate |
$7,209.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,132.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,132.59
|
| 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 |
$4,806.00
|
| Rate for Payer: Blue Shield of California Commercial |
$5,038.29
|
| Rate for Payer: Blue Shield of California EPN |
$3,916.89
|
| Rate for Payer: Caremore Medicare Advantage |
$1,132.59
|
| Rate for Payer: Cash Price |
$3,604.50
|
| Rate for Payer: Cash Price |
$3,604.50
|
| Rate for Payer: Cash Price |
$3,604.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,408.00
|
| Rate for Payer: Cigna of CA HMO |
$5,126.40
|
| Rate for Payer: Cigna of CA PPO |
$5,927.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Dignity Health Media |
$1,132.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,245.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,529.00
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,132.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,132.59
|
| Rate for Payer: Galaxy Health WC |
$6,808.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,806.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,209.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,007.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,857.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,868.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,132.59
|
| Rate for Payer: InnovAge PACE Commercial |
$1,698.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,342.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,602.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,517.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,517.67
|
| Rate for Payer: Multiplan Commercial |
$6,007.50
|
| Rate for Payer: Networks By Design Commercial |
$5,206.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,808.50
|
| Rate for Payer: Prime Health Services Medicare |
$1,200.55
|
| Rate for Payer: Riverside University Health System MISP |
$1,245.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,806.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,806.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,005.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,005.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,005.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,005.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,698.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,245.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,132.59
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
OP
|
$3,162.00
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
906811310
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$411.69 |
| Max. Negotiated Rate |
$67,976.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,439.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,687.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,739.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,739.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,897.20
|
| 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 |
$1,422.90
|
| Rate for Payer: Cash Price |
$1,422.90
|
| Rate for Payer: Cash Price |
$1,422.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,529.60
|
| Rate for Payer: Cigna of CA PPO |
$2,339.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,687.70
|
| Rate for Payer: Dignity Health Media |
$2,687.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,687.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,264.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,264.80
|
| Rate for Payer: Galaxy Health WC |
$2,687.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,897.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,845.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,371.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,106.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,109.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$411.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$632.40
|
| Rate for Payer: Multiplan Commercial |
$2,371.50
|
| Rate for Payer: Networks By Design Commercial |
$2,055.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,687.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,264.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,897.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$57,775.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67,976.00
|
| Rate for Payer: United Healthcare HMO Rider |
$54,652.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,976.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,687.70
|
| Rate for Payer: Vantage Medical Group Senior |
$2,687.70
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
IP
|
$3,162.00
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
906820104
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$632.40 |
| Max. Negotiated Rate |
$2,845.80 |
| Rate for Payer: Cash Price |
$1,422.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,529.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,264.80
|
| Rate for Payer: Galaxy Health WC |
$2,687.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,897.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,845.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,109.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,204.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$632.40
|
| Rate for Payer: Multiplan Commercial |
$2,371.50
|
| Rate for Payer: Networks By Design Commercial |
$2,055.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,687.70
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
OP
|
$3,162.00
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
906820104
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$411.69 |
| Max. Negotiated Rate |
$67,976.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,439.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,687.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,739.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,739.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,830.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,897.20
|
| 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 |
$1,422.90
|
| Rate for Payer: Cash Price |
$1,422.90
|
| Rate for Payer: Cash Price |
$1,422.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,529.60
|
| Rate for Payer: Cigna of CA PPO |
$2,339.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,687.70
|
| Rate for Payer: Dignity Health Media |
$2,687.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,687.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,264.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,264.80
|
| Rate for Payer: Galaxy Health WC |
$2,687.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,897.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,845.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,371.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,106.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,109.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$411.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$632.40
|
| Rate for Payer: Multiplan Commercial |
$2,371.50
|
| Rate for Payer: Networks By Design Commercial |
$2,055.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,687.70
|
| Rate for Payer: Riverside University Health System MISP |
$1,264.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,897.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$57,775.00
|
| Rate for Payer: United Healthcare All Other HMO |
$67,976.00
|
| Rate for Payer: United Healthcare HMO Rider |
$54,652.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49,976.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,687.70
|
| Rate for Payer: Vantage Medical Group Senior |
$2,687.70
|
|
|
HC INTRA AORTIC BALLOON INSERTION
|
Facility
|
IP
|
$3,162.00
|
|
|
Service Code
|
CPT 33967
|
| Hospital Charge Code |
906811310
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$632.40 |
| Max. Negotiated Rate |
$2,845.80 |
| Rate for Payer: Cash Price |
$1,422.90
|
| Rate for Payer: Central Health Plan Commercial |
$2,529.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,264.80
|
| Rate for Payer: Galaxy Health WC |
$2,687.70
|
| Rate for Payer: Global Benefits Group Commercial |
$1,897.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,845.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,109.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,204.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$632.40
|
| Rate for Payer: Multiplan Commercial |
$2,371.50
|
| Rate for Payer: Networks By Design Commercial |
$2,055.30
|
| Rate for Payer: Prime Health Services Commercial |
$2,687.70
|
|
|
HC INTRA-ART INJ OR INFUS
|
Facility
|
OP
|
$895.00
|
|
|
Service Code
|
CPT 96379
|
| Hospital Charge Code |
911896379
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$59.35 |
| Max. Negotiated Rate |
$805.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$59.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$340.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$59.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$433.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$528.77
|
| Rate for Payer: Blue Distinction Transplant |
$537.00
|
| Rate for Payer: Caremore Medicare Advantage |
$59.35
|
| Rate for Payer: Cash Price |
$402.75
|
| Rate for Payer: Cash Price |
$402.75
|
| Rate for Payer: Cash Price |
$402.75
|
| Rate for Payer: Central Health Plan Commercial |
$716.00
|
| Rate for Payer: Cigna of CA HMO |
$572.80
|
| Rate for Payer: Cigna of CA PPO |
$662.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.02
|
| Rate for Payer: Dignity Health Media |
$59.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$65.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$59.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$59.35
|
| Rate for Payer: Galaxy Health WC |
$760.75
|
| Rate for Payer: Global Benefits Group Commercial |
$537.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$805.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$671.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$97.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$97.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$59.35
|
| Rate for Payer: InnovAge PACE Commercial |
$89.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$596.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.53
|
| Rate for Payer: Multiplan Commercial |
$671.25
|
| Rate for Payer: Networks By Design Commercial |
$581.75
|
| Rate for Payer: Prime Health Services Commercial |
$760.75
|
| Rate for Payer: Prime Health Services Medicare |
$62.91
|
| Rate for Payer: Riverside University Health System MISP |
$65.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$537.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$71.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$65.28
|
| Rate for Payer: Vantage Medical Group Senior |
$59.35
|
|
|
HC INTRA-ART INJ OR INFUS
|
Facility
|
IP
|
$895.00
|
|
|
Service Code
|
CPT 96379
|
| Hospital Charge Code |
911896379
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$179.00 |
| Max. Negotiated Rate |
$805.50 |
| Rate for Payer: Cash Price |
$402.75
|
| Rate for Payer: Central Health Plan Commercial |
$716.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$358.00
|
| Rate for Payer: Galaxy Health WC |
$760.75
|
| Rate for Payer: Global Benefits Group Commercial |
$537.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$805.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$596.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$341.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.00
|
| Rate for Payer: Multiplan Commercial |
$671.25
|
| Rate for Payer: Networks By Design Commercial |
$581.75
|
| Rate for Payer: Prime Health Services Commercial |
$760.75
|
|
|
HC INTRACARDIAC SHUNT STENT
|
Facility
|
IP
|
$38,623.00
|
|
|
Service Code
|
CPT 33745
|
| Hospital Charge Code |
906820318
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,724.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Central Health Plan Commercial |
$30,898.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,449.20
|
| Rate for Payer: Galaxy Health WC |
$32,829.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,173.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,760.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,761.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,715.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,724.60
|
| Rate for Payer: Multiplan Commercial |
$28,967.25
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$32,829.55
|
|
|
HC INTRACARDIAC SHUNT STENT
|
Facility
|
OP
|
$38,623.00
|
|
|
Service Code
|
CPT 33745
|
| Hospital Charge Code |
906811745
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,692.03 |
| Max. Negotiated Rate |
$34,760.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,633.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32,829.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21,242.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,242.65
|
| 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 |
$23,173.80
|
| 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: Cash Price |
$17,380.35
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Central Health Plan Commercial |
$30,898.40
|
| Rate for Payer: Cigna of CA PPO |
$28,581.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,829.55
|
| Rate for Payer: Dignity Health Media |
$32,829.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,829.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,449.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$15,449.20
|
| Rate for Payer: Galaxy Health WC |
$32,829.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,173.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,760.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$28,967.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13,518.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,761.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,692.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,724.60
|
| Rate for Payer: Multiplan Commercial |
$28,967.25
|
| Rate for Payer: Networks By Design Commercial |
$25,104.95
|
| Rate for Payer: Prime Health Services Commercial |
$32,829.55
|
| Rate for Payer: Riverside University Health System MISP |
$15,449.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,173.80
|
| 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 |
$32,829.55
|
| Rate for Payer: Vantage Medical Group Senior |
$32,829.55
|
|
|
HC INTRACARDIAC SHUNT STENT
|
Facility
|
IP
|
$38,623.00
|
|
|
Service Code
|
CPT 33745
|
| Hospital Charge Code |
906811745
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,724.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Central Health Plan Commercial |
$30,898.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,449.20
|
| Rate for Payer: Galaxy Health WC |
$32,829.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,173.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,760.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,761.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,715.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,724.60
|
| Rate for Payer: Multiplan Commercial |
$28,967.25
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$32,829.55
|
|
|
HC INTRACARDIAC SHUNT STENT
|
Facility
|
OP
|
$38,623.00
|
|
|
Service Code
|
CPT 33745
|
| Hospital Charge Code |
906820318
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,692.03 |
| Max. Negotiated Rate |
$34,760.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,633.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32,829.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21,242.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,242.65
|
| 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 |
$23,173.80
|
| 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: Cash Price |
$17,380.35
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Central Health Plan Commercial |
$30,898.40
|
| Rate for Payer: Cigna of CA PPO |
$28,581.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,829.55
|
| Rate for Payer: Dignity Health Media |
$32,829.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,829.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,449.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$15,449.20
|
| Rate for Payer: Galaxy Health WC |
$32,829.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,173.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,760.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$28,967.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13,518.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,761.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,692.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,724.60
|
| Rate for Payer: Multiplan Commercial |
$28,967.25
|
| Rate for Payer: Networks By Design Commercial |
$25,104.95
|
| Rate for Payer: Prime Health Services Commercial |
$32,829.55
|
| Rate for Payer: Riverside University Health System MISP |
$15,449.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,173.80
|
| 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 |
$32,829.55
|
| Rate for Payer: Vantage Medical Group Senior |
$32,829.55
|
|
|
HC INTRACARDIAC SHUNT STENT ADDL
|
Facility
|
IP
|
$38,623.00
|
|
|
Service Code
|
CPT 33746
|
| Hospital Charge Code |
906811746
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,724.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Central Health Plan Commercial |
$30,898.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,449.20
|
| Rate for Payer: Galaxy Health WC |
$32,829.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,173.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,760.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,761.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,715.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,724.60
|
| Rate for Payer: Multiplan Commercial |
$28,967.25
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$32,829.55
|
|
|
HC INTRACARDIAC SHUNT STENT ADDL
|
Facility
|
IP
|
$38,623.00
|
|
|
Service Code
|
CPT 33746
|
| Hospital Charge Code |
906820319
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,724.60 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Central Health Plan Commercial |
$30,898.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,449.20
|
| Rate for Payer: Galaxy Health WC |
$32,829.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,173.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,760.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,761.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,715.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,724.60
|
| Rate for Payer: Multiplan Commercial |
$28,967.25
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$32,829.55
|
|
|
HC INTRACARDIAC SHUNT STENT ADDL
|
Facility
|
OP
|
$38,623.00
|
|
|
Service Code
|
CPT 33746
|
| Hospital Charge Code |
906820319
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$134.12 |
| Max. Negotiated Rate |
$34,760.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,633.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32,829.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21,242.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,242.65
|
| 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 |
$23,173.80
|
| 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 |
$17,380.35
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Central Health Plan Commercial |
$30,898.40
|
| Rate for Payer: Cigna of CA PPO |
$28,581.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,829.55
|
| Rate for Payer: Dignity Health Media |
$32,829.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,829.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,449.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$15,449.20
|
| Rate for Payer: Galaxy Health WC |
$32,829.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,173.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,760.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$28,967.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13,518.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,761.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,724.60
|
| Rate for Payer: Multiplan Commercial |
$28,967.25
|
| Rate for Payer: Networks By Design Commercial |
$25,104.95
|
| Rate for Payer: Prime Health Services Commercial |
$32,829.55
|
| Rate for Payer: Riverside University Health System MISP |
$15,449.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,173.80
|
| 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 |
$32,829.55
|
| Rate for Payer: Vantage Medical Group Senior |
$32,829.55
|
|
|
HC INTRACARDIAC SHUNT STENT ADDL
|
Facility
|
OP
|
$38,623.00
|
|
|
Service Code
|
CPT 33746
|
| Hospital Charge Code |
906811746
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$134.12 |
| Max. Negotiated Rate |
$34,760.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,633.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32,829.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21,242.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,242.65
|
| 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 |
$23,173.80
|
| 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 |
$17,380.35
|
| Rate for Payer: Cash Price |
$17,380.35
|
| Rate for Payer: Central Health Plan Commercial |
$30,898.40
|
| Rate for Payer: Cigna of CA PPO |
$28,581.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,829.55
|
| Rate for Payer: Dignity Health Media |
$32,829.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$32,829.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,449.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$15,449.20
|
| Rate for Payer: Galaxy Health WC |
$32,829.55
|
| Rate for Payer: Global Benefits Group Commercial |
$23,173.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,760.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$28,967.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13,518.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,761.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$134.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,724.60
|
| Rate for Payer: Multiplan Commercial |
$28,967.25
|
| Rate for Payer: Networks By Design Commercial |
$25,104.95
|
| Rate for Payer: Prime Health Services Commercial |
$32,829.55
|
| Rate for Payer: Riverside University Health System MISP |
$15,449.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,173.80
|
| 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 |
$32,829.55
|
| Rate for Payer: Vantage Medical Group Senior |
$32,829.55
|
|
|
HC INTRACAVITARY INTER
|
Facility
|
OP
|
$54,260.00
|
|
|
Service Code
|
CPT 77762
|
| Hospital Charge Code |
909100402
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$735.49 |
| Max. Negotiated Rate |
$48,834.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$735.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,152.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,103.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$809.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$735.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$768.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$937.50
|
| Rate for Payer: Blue Distinction Transplant |
$32,556.00
|
| Rate for Payer: Blue Shield of California Commercial |
$33,532.68
|
| Rate for Payer: Blue Shield of California EPN |
$26,370.36
|
| Rate for Payer: Caremore Medicare Advantage |
$735.49
|
| Rate for Payer: Cash Price |
$24,417.00
|
| Rate for Payer: Cash Price |
$24,417.00
|
| Rate for Payer: Central Health Plan Commercial |
$43,408.00
|
| Rate for Payer: Cigna of CA HMO |
$34,726.40
|
| Rate for Payer: Cigna of CA PPO |
$40,152.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,103.24
|
| Rate for Payer: Dignity Health Media |
$735.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$809.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$992.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$735.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$735.49
|
| Rate for Payer: Galaxy Health WC |
$46,121.00
|
| Rate for Payer: Global Benefits Group Commercial |
$32,556.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,834.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$40,695.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,206.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,213.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$735.49
|
| Rate for Payer: InnovAge PACE Commercial |
$1,103.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,191.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$812.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$735.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,852.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$985.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$985.56
|
| Rate for Payer: Multiplan Commercial |
$40,695.00
|
| Rate for Payer: Networks By Design Commercial |
$35,269.00
|
| Rate for Payer: Prime Health Services Commercial |
$46,121.00
|
| Rate for Payer: Prime Health Services Medicare |
$779.62
|
| Rate for Payer: Riverside University Health System MISP |
$809.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32,556.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32,556.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,130.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,130.00
|
| Rate for Payer: United Healthcare HMO Rider |
$27,130.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27,130.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,103.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$809.04
|
| Rate for Payer: Vantage Medical Group Senior |
$735.49
|
|
|
HC INTRACAVITARY INTER
|
Facility
|
IP
|
$54,260.00
|
|
|
Service Code
|
CPT 77762
|
| Hospital Charge Code |
909100402
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$10,852.00 |
| Max. Negotiated Rate |
$48,834.00 |
| Rate for Payer: Cash Price |
$24,417.00
|
| Rate for Payer: Central Health Plan Commercial |
$43,408.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$21,704.00
|
| Rate for Payer: Galaxy Health WC |
$46,121.00
|
| Rate for Payer: Global Benefits Group Commercial |
$32,556.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$48,834.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36,191.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20,673.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,852.00
|
| Rate for Payer: Multiplan Commercial |
$40,695.00
|
| Rate for Payer: Networks By Design Commercial |
$35,269.00
|
| Rate for Payer: Prime Health Services Commercial |
$46,121.00
|
|
|
HC INTRACAVITARY SIMPLE
|
Facility
|
OP
|
$51,678.00
|
|
|
Service Code
|
CPT 77761
|
| Hospital Charge Code |
909100401
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$535.32 |
| Max. Negotiated Rate |
$46,510.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$735.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$985.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,103.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$809.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$735.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$535.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$652.96
|
| Rate for Payer: Blue Distinction Transplant |
$31,006.80
|
| Rate for Payer: Blue Shield of California Commercial |
$31,937.00
|
| Rate for Payer: Blue Shield of California EPN |
$25,115.51
|
| Rate for Payer: Caremore Medicare Advantage |
$735.49
|
| Rate for Payer: Cash Price |
$23,255.10
|
| Rate for Payer: Cash Price |
$23,255.10
|
| Rate for Payer: Central Health Plan Commercial |
$41,342.40
|
| Rate for Payer: Cigna of CA HMO |
$33,073.92
|
| Rate for Payer: Cigna of CA PPO |
$38,241.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,103.24
|
| Rate for Payer: Dignity Health Media |
$735.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$809.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$992.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$735.49
|
| Rate for Payer: EPIC Health Plan Transplant |
$735.49
|
| Rate for Payer: Galaxy Health WC |
$43,926.30
|
| Rate for Payer: Global Benefits Group Commercial |
$31,006.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$46,510.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$38,758.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,206.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,213.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$735.49
|
| Rate for Payer: InnovAge PACE Commercial |
$1,103.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34,469.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$612.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$735.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,335.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$985.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$985.56
|
| Rate for Payer: Multiplan Commercial |
$38,758.50
|
| Rate for Payer: Networks By Design Commercial |
$33,590.70
|
| Rate for Payer: Prime Health Services Commercial |
$43,926.30
|
| Rate for Payer: Prime Health Services Medicare |
$779.62
|
| Rate for Payer: Riverside University Health System MISP |
$809.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31,006.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31,006.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$25,839.00
|
| Rate for Payer: United Healthcare All Other HMO |
$25,839.00
|
| Rate for Payer: United Healthcare HMO Rider |
$25,839.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25,839.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,103.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$809.04
|
| Rate for Payer: Vantage Medical Group Senior |
$735.49
|
|
|
HC INTRACAVITARY SIMPLE
|
Facility
|
IP
|
$51,678.00
|
|
|
Service Code
|
CPT 77761
|
| Hospital Charge Code |
909100401
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$10,335.60 |
| Max. Negotiated Rate |
$46,510.20 |
| Rate for Payer: Cash Price |
$23,255.10
|
| Rate for Payer: Central Health Plan Commercial |
$41,342.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,671.20
|
| Rate for Payer: Galaxy Health WC |
$43,926.30
|
| Rate for Payer: Global Benefits Group Commercial |
$31,006.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$46,510.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34,469.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19,689.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10,335.60
|
| Rate for Payer: Multiplan Commercial |
$38,758.50
|
| Rate for Payer: Networks By Design Commercial |
$33,590.70
|
| Rate for Payer: Prime Health Services Commercial |
$43,926.30
|
|
|
HC INTRACRAN CAROTID/VERT
|
Facility
|
OP
|
$1,280.00
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
909020161
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$256.00 |
| Max. Negotiated Rate |
$7,084.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,088.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$704.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$704.00
|
| 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 |
$768.00
|
| 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: Cash Price |
$576.00
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,024.00
|
| Rate for Payer: Cigna of CA PPO |
$947.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,088.00
|
| Rate for Payer: Dignity Health Media |
$1,088.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,088.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$512.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$512.00
|
| Rate for Payer: Galaxy Health WC |
$1,088.00
|
| Rate for Payer: Global Benefits Group Commercial |
$768.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,152.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$960.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$448.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$853.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$344.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.00
|
| Rate for Payer: Multiplan Commercial |
$960.00
|
| Rate for Payer: Networks By Design Commercial |
$832.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,088.00
|
| Rate for Payer: Riverside University Health System MISP |
$512.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$768.00
|
| 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 |
$1,088.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,088.00
|
|
|
HC INTRACRAN CAROTID/VERT
|
Facility
|
IP
|
$1,280.00
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
906820229
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$256.00 |
| Max. Negotiated Rate |
$1,152.00 |
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,024.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$512.00
|
| Rate for Payer: Galaxy Health WC |
$1,088.00
|
| Rate for Payer: Global Benefits Group Commercial |
$768.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,152.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$853.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$487.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.00
|
| Rate for Payer: Multiplan Commercial |
$960.00
|
| Rate for Payer: Networks By Design Commercial |
$832.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,088.00
|
|
|
HC INTRACRAN CAROTID/VERT
|
Facility
|
IP
|
$1,280.00
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
909020161
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$256.00 |
| Max. Negotiated Rate |
$1,152.00 |
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,024.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$512.00
|
| Rate for Payer: Galaxy Health WC |
$1,088.00
|
| Rate for Payer: Global Benefits Group Commercial |
$768.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,152.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$853.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$487.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.00
|
| Rate for Payer: Multiplan Commercial |
$960.00
|
| Rate for Payer: Networks By Design Commercial |
$832.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,088.00
|
|
|
HC INTRACRAN CAROTID/VERT
|
Facility
|
OP
|
$1,280.00
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
906820229
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$256.00 |
| Max. Negotiated Rate |
$7,084.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,088.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$704.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$704.00
|
| 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 |
$768.00
|
| 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: Cash Price |
$576.00
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Central Health Plan Commercial |
$1,024.00
|
| Rate for Payer: Cigna of CA PPO |
$947.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,088.00
|
| Rate for Payer: Dignity Health Media |
$1,088.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,088.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$512.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$512.00
|
| Rate for Payer: Galaxy Health WC |
$1,088.00
|
| Rate for Payer: Global Benefits Group Commercial |
$768.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,152.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$960.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$448.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$853.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$344.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$256.00
|
| Rate for Payer: Multiplan Commercial |
$960.00
|
| Rate for Payer: Networks By Design Commercial |
$832.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,088.00
|
| Rate for Payer: Riverside University Health System MISP |
$512.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$768.00
|
| 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 |
$1,088.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,088.00
|
|
|
HC INTRACRANIAL ARTL THROMBECTOMY
|
Facility
|
OP
|
$16,905.00
|
|
|
Service Code
|
CPT 61645
|
| Hospital Charge Code |
909061645
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,258.41 |
| Max. Negotiated Rate |
$15,214.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11,417.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,369.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,297.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,297.75
|
| 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 |
$10,143.00
|
| 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 |
$7,607.25
|
| Rate for Payer: Cash Price |
$7,607.25
|
| Rate for Payer: Cash Price |
$7,607.25
|
| Rate for Payer: Central Health Plan Commercial |
$13,524.00
|
| Rate for Payer: Cigna of CA PPO |
$12,509.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,369.25
|
| Rate for Payer: Dignity Health Media |
$14,369.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,369.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,762.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,762.00
|
| Rate for Payer: Galaxy Health WC |
$14,369.25
|
| Rate for Payer: Global Benefits Group Commercial |
$10,143.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,214.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12,678.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,916.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,275.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,258.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,381.00
|
| Rate for Payer: Multiplan Commercial |
$12,678.75
|
| Rate for Payer: Networks By Design Commercial |
$10,988.25
|
| Rate for Payer: Prime Health Services Commercial |
$14,369.25
|
| Rate for Payer: Riverside University Health System MISP |
$6,762.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,143.00
|
| 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 |
$14,369.25
|
| Rate for Payer: Vantage Medical Group Senior |
$14,369.25
|
|
