|
HC PCI BYPASS GRAFT
|
Facility
|
IP
|
$12,647.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
906811440
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,529.40 |
| Max. Negotiated Rate |
$11,382.30 |
| Rate for Payer: Adventist Health Commercial |
$2,529.40
|
| Rate for Payer: Cash Price |
$5,691.15
|
| Rate for Payer: Central Health Plan Commercial |
$10,117.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,852.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,058.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,058.80
|
| Rate for Payer: Galaxy Health WC |
$10,749.95
|
| Rate for Payer: Global Benefits Group Commercial |
$7,588.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,382.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,030.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7,461.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,529.40
|
| Rate for Payer: Multiplan Commercial |
$9,485.25
|
| Rate for Payer: Networks By Design Commercial |
$8,220.55
|
| Rate for Payer: Prime Health Services Commercial |
$10,749.95
|
|
|
HC PCI BYPASS GRAFT
|
Facility
|
OP
|
$12,647.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
906811440
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$829.83 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,529.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$5,691.15
|
| Rate for Payer: Cash Price |
$5,691.15
|
| Rate for Payer: Cash Price |
$5,691.15
|
| Rate for Payer: Central Health Plan Commercial |
$10,117.60
|
| Rate for Payer: Cigna of CA HMO |
$8,220.55
|
| Rate for Payer: Cigna of CA PPO |
$9,358.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8,852.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$10,749.95
|
| Rate for Payer: Global Benefits Group Commercial |
$7,588.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,382.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$829.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8,030.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$916.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,529.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$9,485.25
|
| Rate for Payer: Networks By Design Commercial |
$8,220.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Prime Health Services Commercial |
$10,749.95
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,588.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7,588.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,323.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC PCI BYPASS GRAFT ADD
|
Facility
|
IP
|
$22,694.00
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
906811464
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,538.80 |
| Max. Negotiated Rate |
$20,424.60 |
| Rate for Payer: Adventist Health Commercial |
$4,538.80
|
| Rate for Payer: Cash Price |
$10,212.30
|
| Rate for Payer: Central Health Plan Commercial |
$18,155.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,885.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,077.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9,077.60
|
| Rate for Payer: Galaxy Health WC |
$19,289.90
|
| Rate for Payer: Global Benefits Group Commercial |
$13,616.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,424.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,410.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,389.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,538.80
|
| Rate for Payer: Multiplan Commercial |
$17,020.50
|
| Rate for Payer: Networks By Design Commercial |
$14,751.10
|
| Rate for Payer: Prime Health Services Commercial |
$19,289.90
|
|
|
HC PCI BYPASS GRAFT ADD
|
Facility
|
OP
|
$22,694.00
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
906811464
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$20,424.60 |
| Rate for Payer: Adventist Health Commercial |
$4,538.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13,782.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,289.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12,481.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17,020.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$10,212.30
|
| Rate for Payer: Cash Price |
$10,212.30
|
| Rate for Payer: Cash Price |
$10,212.30
|
| Rate for Payer: Central Health Plan Commercial |
$18,155.20
|
| Rate for Payer: Cigna of CA HMO |
$14,524.16
|
| Rate for Payer: Cigna of CA PPO |
$16,793.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,289.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$19,289.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19,289.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15,885.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,077.60
|
| Rate for Payer: EPIC Health Plan Senior |
$9,077.60
|
| Rate for Payer: Galaxy Health WC |
$19,289.90
|
| Rate for Payer: Global Benefits Group Commercial |
$13,616.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$20,424.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14,410.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8,237.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,389.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,538.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15,885.80
|
| Rate for Payer: Multiplan Commercial |
$17,020.50
|
| Rate for Payer: Networks By Design Commercial |
$14,751.10
|
| Rate for Payer: Prime Health Services Commercial |
$19,289.90
|
| Rate for Payer: Riverside University Health System MISP |
$9,077.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13,616.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13,616.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,289.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19,289.90
|
| Rate for Payer: Vantage Medical Group Senior |
$19,289.90
|
|
|
HC PCI BYPASS GRAFT, ADDN'L
|
Facility
|
OP
|
$6,323.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
906811441
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,264.60 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$1,264.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,374.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,477.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,742.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$2,845.35
|
| Rate for Payer: Cash Price |
$2,845.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,058.40
|
| Rate for Payer: Cigna of CA HMO |
$4,109.95
|
| Rate for Payer: Cigna of CA PPO |
$4,679.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,374.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,374.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,374.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,426.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,529.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,529.20
|
| Rate for Payer: Galaxy Health WC |
$5,374.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,793.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,690.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,015.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,295.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,730.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,264.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,426.10
|
| Rate for Payer: Multiplan Commercial |
$4,742.25
|
| Rate for Payer: Networks By Design Commercial |
$4,109.95
|
| Rate for Payer: Prime Health Services Commercial |
$5,374.55
|
| Rate for Payer: Riverside University Health System MISP |
$2,529.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,793.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,793.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,161.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,374.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,374.55
|
| Rate for Payer: Vantage Medical Group Senior |
$5,374.55
|
|
|
HC PCI BYPASS GRAFT, ADDN'L
|
Facility
|
IP
|
$6,323.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
906811441
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,264.60 |
| Max. Negotiated Rate |
$5,690.70 |
| Rate for Payer: Adventist Health Commercial |
$1,264.60
|
| Rate for Payer: Cash Price |
$2,845.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,058.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4,426.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,529.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2,529.20
|
| Rate for Payer: Galaxy Health WC |
$5,374.55
|
| Rate for Payer: Global Benefits Group Commercial |
$3,793.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,690.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,015.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,730.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,264.60
|
| Rate for Payer: Multiplan Commercial |
$4,742.25
|
| Rate for Payer: Networks By Design Commercial |
$4,109.95
|
| Rate for Payer: Prime Health Services Commercial |
$5,374.55
|
|
|
HC PCI CORO/BYPASS CHRNC CMBND AG AND RG
|
Facility
|
IP
|
$36,182.00
|
|
|
Service Code
|
CPT 92945
|
| Hospital Charge Code |
906811867
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,236.40 |
| Max. Negotiated Rate |
$32,563.80 |
| Rate for Payer: Adventist Health Commercial |
$7,236.40
|
| Rate for Payer: Cash Price |
$16,281.90
|
| Rate for Payer: Central Health Plan Commercial |
$28,945.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25,327.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,472.80
|
| Rate for Payer: EPIC Health Plan Senior |
$14,472.80
|
| Rate for Payer: Galaxy Health WC |
$30,754.70
|
| Rate for Payer: Global Benefits Group Commercial |
$21,709.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$32,563.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22,975.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21,347.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,236.40
|
| Rate for Payer: Multiplan Commercial |
$27,136.50
|
| Rate for Payer: Networks By Design Commercial |
$23,518.30
|
| Rate for Payer: Prime Health Services Commercial |
$30,754.70
|
|
|
HC PCI CORO/BYPASS CHRNC CMBND AG AND RG
|
Facility
|
OP
|
$36,182.00
|
|
|
Service Code
|
CPT 92945
|
| Hospital Charge Code |
906811867
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,113.68 |
| Max. Negotiated Rate |
$32,563.80 |
| Rate for Payer: Adventist Health Commercial |
$7,236.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,519.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,047.07
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$16,281.90
|
| Rate for Payer: Cash Price |
$16,281.90
|
| Rate for Payer: Cash Price |
$16,281.90
|
| Rate for Payer: Central Health Plan Commercial |
$28,945.60
|
| Rate for Payer: Cigna of CA HMO |
$23,518.30
|
| Rate for Payer: Cigna of CA PPO |
$26,774.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25,327.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$30,754.70
|
| Rate for Payer: Global Benefits Group Commercial |
$21,709.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$32,563.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22,975.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,236.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$27,136.50
|
| Rate for Payer: Networks By Design Commercial |
$23,518.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Prime Health Services Commercial |
$30,754.70
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21,709.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21,709.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$18,091.00
|
| Rate for Payer: United Healthcare All Other HMO |
$18,091.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,091.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18,091.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC PCI CORO/BYPASS CHRONIC 1 VESL
|
Facility
|
OP
|
$15,177.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
906811443
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$930.83 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,035.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$6,829.65
|
| Rate for Payer: Cash Price |
$6,829.65
|
| Rate for Payer: Cash Price |
$6,829.65
|
| Rate for Payer: Central Health Plan Commercial |
$12,141.60
|
| Rate for Payer: Cigna of CA HMO |
$9,865.05
|
| Rate for Payer: Cigna of CA PPO |
$11,230.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,623.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$12,900.45
|
| Rate for Payer: Global Benefits Group Commercial |
$9,106.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,659.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$930.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,637.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,028.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,035.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$11,382.75
|
| Rate for Payer: Networks By Design Commercial |
$9,865.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Prime Health Services Commercial |
$12,900.45
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,106.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9,106.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$7,588.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC PCI CORO/BYPASS CHRONIC 1 VESL
|
Facility
|
IP
|
$15,177.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
906811443
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,035.40 |
| Max. Negotiated Rate |
$13,659.30 |
| Rate for Payer: Adventist Health Commercial |
$3,035.40
|
| Rate for Payer: Cash Price |
$6,829.65
|
| Rate for Payer: Central Health Plan Commercial |
$12,141.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10,623.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,070.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6,070.80
|
| Rate for Payer: Galaxy Health WC |
$12,900.45
|
| Rate for Payer: Global Benefits Group Commercial |
$9,106.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,659.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9,637.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,954.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,035.40
|
| Rate for Payer: Multiplan Commercial |
$11,382.75
|
| Rate for Payer: Networks By Design Commercial |
$9,865.05
|
| Rate for Payer: Prime Health Services Commercial |
$12,900.45
|
|
|
HC PCI CORO BYPASS CHRONIC 1 VSL
|
Facility
|
OP
|
$31,352.00
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
906811466
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$38,902.96 |
| Rate for Payer: Adventist Health Commercial |
$6,270.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$23,577.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,035.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,577.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$14,108.40
|
| Rate for Payer: Cash Price |
$14,108.40
|
| Rate for Payer: Cash Price |
$14,108.40
|
| Rate for Payer: Cash Price |
$14,108.40
|
| Rate for Payer: Central Health Plan Commercial |
$25,081.60
|
| Rate for Payer: Cigna of CA HMO |
$20,065.28
|
| Rate for Payer: Cigna of CA PPO |
$23,200.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,935.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,577.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21,946.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$38,902.96
|
| Rate for Payer: EPIC Health Plan Senior |
$25,935.31
|
| Rate for Payer: Galaxy Health WC |
$26,649.20
|
| Rate for Payer: Global Benefits Group Commercial |
$18,811.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,216.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$38,667.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19,908.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11,380.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33,008.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,270.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$31,593.92
|
| Rate for Payer: Multiplan Commercial |
$23,514.00
|
| Rate for Payer: Networks By Design Commercial |
$20,378.80
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Prime Health Services Commercial |
$26,649.20
|
| Rate for Payer: Prime Health Services Medicare |
$24,992.20
|
| Rate for Payer: Riverside University Health System MISP |
$25,935.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,811.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18,811.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$23,577.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Vantage Medical Group Senior |
$23,577.55
|
|
|
HC PCI CORO BYPASS CHRONIC 1 VSL
|
Facility
|
IP
|
$31,352.00
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
906811466
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$6,270.40 |
| Max. Negotiated Rate |
$28,216.80 |
| Rate for Payer: Adventist Health Commercial |
$6,270.40
|
| Rate for Payer: Cash Price |
$14,108.40
|
| Rate for Payer: Central Health Plan Commercial |
$25,081.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21,946.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,540.80
|
| Rate for Payer: EPIC Health Plan Senior |
$12,540.80
|
| Rate for Payer: Galaxy Health WC |
$26,649.20
|
| Rate for Payer: Global Benefits Group Commercial |
$18,811.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,216.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19,908.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,497.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,270.40
|
| Rate for Payer: Multiplan Commercial |
$23,514.00
|
| Rate for Payer: Networks By Design Commercial |
$20,378.80
|
| Rate for Payer: Prime Health Services Commercial |
$26,649.20
|
|
|
HC PCI CORO BYPASS CHRONIC ADD
|
Facility
|
OP
|
$29,859.00
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
906811467
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$26,873.10 |
| Rate for Payer: Adventist Health Commercial |
$5,971.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18,133.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25,380.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,422.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,394.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$13,436.55
|
| Rate for Payer: Cash Price |
$13,436.55
|
| Rate for Payer: Cash Price |
$13,436.55
|
| Rate for Payer: Central Health Plan Commercial |
$23,887.20
|
| Rate for Payer: Cigna of CA HMO |
$19,109.76
|
| Rate for Payer: Cigna of CA PPO |
$22,095.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25,380.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,380.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25,380.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20,901.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,943.60
|
| Rate for Payer: EPIC Health Plan Senior |
$11,943.60
|
| Rate for Payer: Galaxy Health WC |
$25,380.15
|
| Rate for Payer: Global Benefits Group Commercial |
$17,915.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$26,873.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18,960.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10,838.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17,616.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,971.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20,901.30
|
| Rate for Payer: Multiplan Commercial |
$22,394.25
|
| Rate for Payer: Networks By Design Commercial |
$19,408.35
|
| Rate for Payer: Prime Health Services Commercial |
$25,380.15
|
| Rate for Payer: Riverside University Health System MISP |
$11,943.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,915.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17,915.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25,380.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,380.15
|
| Rate for Payer: Vantage Medical Group Senior |
$25,380.15
|
|
|
HC PCI CORO BYPASS CHRONIC ADD
|
Facility
|
IP
|
$29,859.00
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
906811467
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5,971.80 |
| Max. Negotiated Rate |
$26,873.10 |
| Rate for Payer: Adventist Health Commercial |
$5,971.80
|
| Rate for Payer: Cash Price |
$13,436.55
|
| Rate for Payer: Central Health Plan Commercial |
$23,887.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20,901.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,943.60
|
| Rate for Payer: EPIC Health Plan Senior |
$11,943.60
|
| Rate for Payer: Galaxy Health WC |
$25,380.15
|
| Rate for Payer: Global Benefits Group Commercial |
$17,915.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$26,873.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18,960.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17,616.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,971.80
|
| Rate for Payer: Multiplan Commercial |
$22,394.25
|
| Rate for Payer: Networks By Design Commercial |
$19,408.35
|
| Rate for Payer: Prime Health Services Commercial |
$25,380.15
|
|
|
HC PCI CORO/BYPASS CHRONIC, ADD'L
|
Facility
|
OP
|
$7,588.00
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
906811444
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,517.60 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$1,517.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,449.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,173.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,691.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$3,414.60
|
| Rate for Payer: Cash Price |
$3,414.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,070.40
|
| Rate for Payer: Cigna of CA HMO |
$4,932.20
|
| Rate for Payer: Cigna of CA PPO |
$5,615.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,449.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,449.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,449.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,311.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,035.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,035.20
|
| Rate for Payer: Galaxy Health WC |
$6,449.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,552.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,829.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,818.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,754.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,476.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,517.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,311.60
|
| Rate for Payer: Multiplan Commercial |
$5,691.00
|
| Rate for Payer: Networks By Design Commercial |
$4,932.20
|
| Rate for Payer: Prime Health Services Commercial |
$6,449.80
|
| Rate for Payer: Riverside University Health System MISP |
$3,035.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,552.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,552.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,794.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,449.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,449.80
|
| Rate for Payer: Vantage Medical Group Senior |
$6,449.80
|
|
|
HC PCI CORO/BYPASS CHRONIC, ADD'L
|
Facility
|
IP
|
$7,588.00
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
906811444
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,517.60 |
| Max. Negotiated Rate |
$6,829.20 |
| Rate for Payer: Adventist Health Commercial |
$1,517.60
|
| Rate for Payer: Cash Price |
$3,414.60
|
| Rate for Payer: Central Health Plan Commercial |
$6,070.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,311.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,035.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,035.20
|
| Rate for Payer: Galaxy Health WC |
$6,449.80
|
| Rate for Payer: Global Benefits Group Commercial |
$4,552.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,829.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4,818.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,476.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,517.60
|
| Rate for Payer: Multiplan Commercial |
$5,691.00
|
| Rate for Payer: Networks By Design Commercial |
$4,932.20
|
| Rate for Payer: Prime Health Services Commercial |
$6,449.80
|
|
|
HC PCI CORO BYPASS W MI 1 VESSEL
|
Facility
|
IP
|
$31,352.00
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
906811465
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$6,270.40 |
| Max. Negotiated Rate |
$28,216.80 |
| Rate for Payer: Adventist Health Commercial |
$6,270.40
|
| Rate for Payer: Cash Price |
$14,108.40
|
| Rate for Payer: Central Health Plan Commercial |
$25,081.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21,946.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,540.80
|
| Rate for Payer: EPIC Health Plan Senior |
$12,540.80
|
| Rate for Payer: Galaxy Health WC |
$26,649.20
|
| Rate for Payer: Global Benefits Group Commercial |
$18,811.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,216.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19,908.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,497.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,270.40
|
| Rate for Payer: Multiplan Commercial |
$23,514.00
|
| Rate for Payer: Networks By Design Commercial |
$20,378.80
|
| Rate for Payer: Prime Health Services Commercial |
$26,649.20
|
|
|
HC PCI CORO BYPASS W MI 1 VESSEL
|
Facility
|
OP
|
$31,352.00
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
906811465
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$28,216.80 |
| Rate for Payer: Adventist Health Commercial |
$6,270.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,221.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26,649.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17,243.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,514.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$14,108.40
|
| Rate for Payer: Cash Price |
$14,108.40
|
| Rate for Payer: Cash Price |
$14,108.40
|
| Rate for Payer: Cash Price |
$14,108.40
|
| Rate for Payer: Central Health Plan Commercial |
$25,081.60
|
| Rate for Payer: Cigna of CA HMO |
$20,065.28
|
| Rate for Payer: Cigna of CA PPO |
$23,200.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26,649.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,649.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26,649.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21,946.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,540.80
|
| Rate for Payer: EPIC Health Plan Senior |
$12,540.80
|
| Rate for Payer: Galaxy Health WC |
$26,649.20
|
| Rate for Payer: Global Benefits Group Commercial |
$18,811.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,216.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19,908.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11,380.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,497.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,270.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21,946.40
|
| Rate for Payer: Multiplan Commercial |
$23,514.00
|
| Rate for Payer: Networks By Design Commercial |
$20,378.80
|
| Rate for Payer: Prime Health Services Commercial |
$26,649.20
|
| Rate for Payer: Riverside University Health System MISP |
$12,540.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,811.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18,811.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26,649.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,649.20
|
| Rate for Payer: Vantage Medical Group Senior |
$26,649.20
|
|
|
HC PCI CORO/BYPASS W MI, 1 VESSEL
|
Facility
|
OP
|
$18,971.00
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
906811442
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$930.83 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,794.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16,125.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,434.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,228.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$8,536.95
|
| Rate for Payer: Cash Price |
$8,536.95
|
| Rate for Payer: Cash Price |
$8,536.95
|
| Rate for Payer: Central Health Plan Commercial |
$15,176.80
|
| Rate for Payer: Cigna of CA HMO |
$12,331.15
|
| Rate for Payer: Cigna of CA PPO |
$14,038.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16,125.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,125.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16,125.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13,279.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,588.40
|
| Rate for Payer: EPIC Health Plan Senior |
$7,588.40
|
| Rate for Payer: Galaxy Health WC |
$16,125.35
|
| Rate for Payer: Global Benefits Group Commercial |
$11,382.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,073.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$930.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,046.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,028.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,192.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,794.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,279.70
|
| Rate for Payer: Multiplan Commercial |
$14,228.25
|
| Rate for Payer: Networks By Design Commercial |
$12,331.15
|
| Rate for Payer: Prime Health Services Commercial |
$16,125.35
|
| Rate for Payer: Riverside University Health System MISP |
$7,588.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,382.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,382.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$9,485.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16,125.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,125.35
|
| Rate for Payer: Vantage Medical Group Senior |
$16,125.35
|
|
|
HC PCI CORO/BYPASS W MI, 1 VESSEL
|
Facility
|
IP
|
$18,971.00
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
906811442
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,794.20 |
| Max. Negotiated Rate |
$17,073.90 |
| Rate for Payer: Adventist Health Commercial |
$3,794.20
|
| Rate for Payer: Cash Price |
$8,536.95
|
| Rate for Payer: Central Health Plan Commercial |
$15,176.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13,279.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,588.40
|
| Rate for Payer: EPIC Health Plan Senior |
$7,588.40
|
| Rate for Payer: Galaxy Health WC |
$16,125.35
|
| Rate for Payer: Global Benefits Group Commercial |
$11,382.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,073.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12,046.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,192.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,794.20
|
| Rate for Payer: Multiplan Commercial |
$14,228.25
|
| Rate for Payer: Networks By Design Commercial |
$12,331.15
|
| Rate for Payer: Prime Health Services Commercial |
$16,125.35
|
|
|
HC PCI PERCUTANEOUS CORONARY INTERVENTION BYPASS GRAFT
|
Facility
|
OP
|
$28,367.00
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
906811463
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$25,530.30 |
| Rate for Payer: Adventist Health Commercial |
$5,673.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,847.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17,227.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$12,765.15
|
| Rate for Payer: Cash Price |
$12,765.15
|
| Rate for Payer: Cash Price |
$12,765.15
|
| Rate for Payer: Cash Price |
$12,765.15
|
| Rate for Payer: Central Health Plan Commercial |
$22,693.60
|
| Rate for Payer: Cigna of CA HMO |
$18,154.88
|
| Rate for Payer: Cigna of CA PPO |
$20,991.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,856.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,498.80
|
| Rate for Payer: EPIC Health Plan Senior |
$16,332.54
|
| Rate for Payer: Galaxy Health WC |
$24,111.95
|
| Rate for Payer: Global Benefits Group Commercial |
$17,020.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,530.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24,350.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18,013.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10,297.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,786.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,673.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$21,275.25
|
| Rate for Payer: Networks By Design Commercial |
$18,438.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Prime Health Services Commercial |
$24,111.95
|
| Rate for Payer: Prime Health Services Medicare |
$15,738.63
|
| Rate for Payer: Riverside University Health System MISP |
$16,332.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,020.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17,020.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,136.00
|
| Rate for Payer: United Healthcare All Other HMO |
$868.00
|
| Rate for Payer: United Healthcare HMO Rider |
$737.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$676.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$14,847.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC PCI PERCUTANEOUS CORONARY INTERVENTION BYPASS GRAFT
|
Facility
|
IP
|
$28,367.00
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
906811463
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5,673.40 |
| Max. Negotiated Rate |
$25,530.30 |
| Rate for Payer: Adventist Health Commercial |
$5,673.40
|
| Rate for Payer: Cash Price |
$12,765.15
|
| Rate for Payer: Central Health Plan Commercial |
$22,693.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19,856.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,346.80
|
| Rate for Payer: EPIC Health Plan Senior |
$11,346.80
|
| Rate for Payer: Galaxy Health WC |
$24,111.95
|
| Rate for Payer: Global Benefits Group Commercial |
$17,020.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$25,530.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18,013.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16,736.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,673.40
|
| Rate for Payer: Multiplan Commercial |
$21,275.25
|
| Rate for Payer: Networks By Design Commercial |
$18,438.55
|
| Rate for Payer: Prime Health Services Commercial |
$24,111.95
|
|
|
HC PDL TUBE
|
Facility
|
IP
|
$210.00
|
|
| Hospital Charge Code |
900800709
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC PDL TUBE
|
Facility
|
OP
|
$210.00
|
|
| Hospital Charge Code |
900800709
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$127.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$115.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$157.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$101.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.16
|
| Rate for Payer: Blue Shield of California Commercial |
$133.14
|
| Rate for Payer: Blue Shield of California EPN |
$83.79
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$178.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$178.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$178.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$76.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$147.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Riverside University Health System MISP |
$84.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$105.00
|
| Rate for Payer: United Healthcare All Other HMO |
$105.00
|
| Rate for Payer: United Healthcare HMO Rider |
$105.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$105.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$178.50
|
| Rate for Payer: Vantage Medical Group Senior |
$178.50
|
|
|
HC PEDIATRIC ELECTRIC HAND
|
Facility
|
IP
|
$9,680.00
|
|
|
Service Code
|
CPT L7008
|
| Hospital Charge Code |
915357008
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,936.00 |
| Max. Negotiated Rate |
$8,712.00 |
| Rate for Payer: Cash Price |
$4,356.00
|
| Rate for Payer: Central Health Plan Commercial |
$7,744.00
|
| Rate for Payer: Cigna of CA HMO |
$6,776.00
|
| Rate for Payer: Cigna of CA PPO |
$6,776.00
|
| Rate for Payer: Adventist Health Commercial |
$1,936.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,763.36
|
| Rate for Payer: Blue Shield of California EPN |
$4,878.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6,776.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,872.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,872.00
|
| Rate for Payer: Galaxy Health WC |
$8,228.00
|
| Rate for Payer: Global Benefits Group Commercial |
$5,808.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,712.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,146.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,711.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,936.00
|
| Rate for Payer: Multiplan Commercial |
$7,260.00
|
| Rate for Payer: Networks By Design Commercial |
$6,292.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,228.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,632.90
|
| Rate for Payer: United Healthcare All Other HMO |
$3,536.10
|
| Rate for Payer: United Healthcare HMO Rider |
$3,459.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,170.20
|
|
