|
HC PASTE MEDIHONEY TUBE .5FL OZ
|
Facility
|
IP
|
$39.61
|
|
|
Service Code
|
CPT A6240
|
| Hospital Charge Code |
901698328
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$35.65 |
| Rate for Payer: Adventist Health Commercial |
$7.92
|
| Rate for Payer: Cash Price |
$21.79
|
| Rate for Payer: Central Health Plan Commercial |
$31.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.84
|
| Rate for Payer: EPIC Health Plan Senior |
$15.84
|
| Rate for Payer: Galaxy Health WC |
$33.67
|
| Rate for Payer: Global Benefits Group Commercial |
$23.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.92
|
| Rate for Payer: Multiplan Commercial |
$29.71
|
| Rate for Payer: Networks By Design Commercial |
$25.75
|
| Rate for Payer: Prime Health Services Commercial |
$33.67
|
|
|
HC PASTE MEDIHONEY TUBE .5FL OZ
|
Facility
|
OP
|
$39.61
|
|
|
Service Code
|
CPT A6240
|
| Hospital Charge Code |
901698328
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$35.65 |
| Rate for Payer: Adventist Health Commercial |
$7.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.26
|
| Rate for Payer: Blue Shield of California Commercial |
$24.20
|
| Rate for Payer: Blue Shield of California EPN |
$15.80
|
| Rate for Payer: Cash Price |
$21.79
|
| Rate for Payer: Central Health Plan Commercial |
$31.69
|
| Rate for Payer: Cigna of CA HMO |
$25.35
|
| Rate for Payer: Cigna of CA PPO |
$29.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.84
|
| Rate for Payer: EPIC Health Plan Senior |
$15.84
|
| Rate for Payer: Galaxy Health WC |
$33.67
|
| Rate for Payer: Global Benefits Group Commercial |
$23.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.65
|
| Rate for Payer: InnovAge PACE Commercial |
$19.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.73
|
| Rate for Payer: Multiplan Commercial |
$29.71
|
| Rate for Payer: Networks By Design Commercial |
$25.75
|
| Rate for Payer: Prime Health Services Commercial |
$33.67
|
| Rate for Payer: Riverside University Health System MISP |
$15.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.80
|
| Rate for Payer: United Healthcare All Other HMO |
$19.80
|
| Rate for Payer: United Healthcare HMO Rider |
$19.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.67
|
| Rate for Payer: Vantage Medical Group Senior |
$33.67
|
|
|
HC PATH CONSULT SURG ADDL BLOCK P
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800220
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Cash Price |
$13.75
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
|
|
HC PATH CONSULT SURG ADDL BLOCK P
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800220
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$60.68 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$60.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.32
|
| Rate for Payer: Blue Shield of California Commercial |
$15.18
|
| Rate for Payer: Blue Shield of California EPN |
$9.93
|
| Rate for Payer: Cash Price |
$13.75
|
| Rate for Payer: Cash Price |
$13.75
|
| Rate for Payer: Central Health Plan Commercial |
$20.00
|
| Rate for Payer: Cigna of CA HMO |
$16.00
|
| Rate for Payer: Cigna of CA PPO |
$18.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10.00
|
| Rate for Payer: Galaxy Health WC |
$21.25
|
| Rate for Payer: Global Benefits Group Commercial |
$15.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.35
|
| Rate for Payer: InnovAge PACE Commercial |
$12.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.50
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: Networks By Design Commercial |
$16.25
|
| Rate for Payer: Prime Health Services Commercial |
$21.25
|
| Rate for Payer: Riverside University Health System MISP |
$10.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.90
|
| Rate for Payer: United Healthcare All Other HMO |
$19.90
|
| Rate for Payer: United Healthcare HMO Rider |
$19.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.25
|
| Rate for Payer: Vantage Medical Group Senior |
$21.25
|
|
|
HC PATH CONSULT SURGERY FRZN PG
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
903800219
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Cash Price |
$93.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Senior |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$113.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$105.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.00
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
|
|
HC PATH CONSULT SURGERY FRZN PG
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
903800219
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$23.51 |
| Max. Negotiated Rate |
$357.08 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$217.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$103.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.51
|
| Rate for Payer: Blue Shield of California Commercial |
$103.19
|
| Rate for Payer: Blue Shield of California EPN |
$67.49
|
| Rate for Payer: Cash Price |
$93.50
|
| Rate for Payer: Cash Price |
$93.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: Cigna of CA HMO |
$108.80
|
| Rate for Payer: Cigna of CA PPO |
$125.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.94
|
| Rate for Payer: EPIC Health Plan Senior |
$217.73
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$357.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$76.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: InnovAge PACE Commercial |
$326.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$113.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$217.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$291.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$291.76
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$217.73
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: Prime Health Services Medicare |
$230.79
|
| Rate for Payer: Riverside University Health System MISP |
$239.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$217.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC PATTEN BOTTOM ADDITION LE
|
Facility
|
IP
|
$754.00
|
|
|
Service Code
|
CPT L2370
|
| Hospital Charge Code |
915352370
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Adventist Health Commercial |
$150.80
|
| Rate for Payer: Blue Shield of California Commercial |
$582.84
|
| Rate for Payer: Blue Shield of California EPN |
$380.02
|
| Rate for Payer: Cash Price |
$414.70
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: Cigna of CA HMO |
$527.80
|
| Rate for Payer: Cigna of CA PPO |
$527.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Senior |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$502.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$287.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$466.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.80
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$490.10
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$282.98
|
| Rate for Payer: United Healthcare All Other HMO |
$275.44
|
| Rate for Payer: United Healthcare HMO Rider |
$269.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.94
|
|
|
HC PATTEN BOTTOM ADDITION LE
|
Facility
|
OP
|
$754.00
|
|
|
Service Code
|
CPT L2370
|
| Hospital Charge Code |
915352370
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$246.94 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Adventist Health Commercial |
$309.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$640.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$414.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$565.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$442.82
|
| Rate for Payer: Blue Shield of California Commercial |
$582.84
|
| Rate for Payer: Blue Shield of California EPN |
$380.02
|
| Rate for Payer: Cash Price |
$414.70
|
| Rate for Payer: Cash Price |
$414.70
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: Cigna of CA HMO |
$527.80
|
| Rate for Payer: Cigna of CA PPO |
$527.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$640.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$640.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$640.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Senior |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$354.53
|
| Rate for Payer: InnovAge PACE Commercial |
$377.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$502.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$391.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$466.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$309.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$527.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$527.80
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: Riverside University Health System MISP |
$301.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$452.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$452.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$282.98
|
| Rate for Payer: United Healthcare All Other HMO |
$275.44
|
| Rate for Payer: United Healthcare HMO Rider |
$269.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$640.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$640.90
|
| Rate for Payer: Vantage Medical Group Senior |
$640.90
|
|
|
HC PATTEN BOTTOM ADDITION LE
|
Facility
|
IP
|
$754.00
|
|
|
Service Code
|
CPT L2370
|
| Hospital Charge Code |
905352370
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$150.80 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Adventist Health Commercial |
$150.80
|
| Rate for Payer: Blue Shield of California Commercial |
$582.84
|
| Rate for Payer: Blue Shield of California EPN |
$380.02
|
| Rate for Payer: Cash Price |
$414.70
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: Cigna of CA HMO |
$527.80
|
| Rate for Payer: Cigna of CA PPO |
$527.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Senior |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$502.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$287.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$466.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$150.80
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$490.10
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$282.98
|
| Rate for Payer: United Healthcare All Other HMO |
$275.44
|
| Rate for Payer: United Healthcare HMO Rider |
$269.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.94
|
|
|
HC PATTEN BOTTOM ADDITION LE
|
Facility
|
OP
|
$754.00
|
|
|
Service Code
|
CPT L2370
|
| Hospital Charge Code |
905352370
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$246.94 |
| Max. Negotiated Rate |
$678.60 |
| Rate for Payer: Adventist Health Commercial |
$309.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$640.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$414.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$565.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$442.82
|
| Rate for Payer: Blue Shield of California Commercial |
$582.84
|
| Rate for Payer: Blue Shield of California EPN |
$380.02
|
| Rate for Payer: Cash Price |
$414.70
|
| Rate for Payer: Cash Price |
$414.70
|
| Rate for Payer: Central Health Plan Commercial |
$603.20
|
| Rate for Payer: Cigna of CA HMO |
$527.80
|
| Rate for Payer: Cigna of CA PPO |
$527.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$640.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$640.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$640.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$301.60
|
| Rate for Payer: EPIC Health Plan Senior |
$301.60
|
| Rate for Payer: Galaxy Health WC |
$640.90
|
| Rate for Payer: Global Benefits Group Commercial |
$452.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$678.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$354.53
|
| Rate for Payer: InnovAge PACE Commercial |
$377.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$502.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$391.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$466.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$309.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$527.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$527.80
|
| Rate for Payer: Multiplan Commercial |
$565.50
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$640.90
|
| Rate for Payer: Riverside University Health System MISP |
$301.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$452.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$452.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$282.98
|
| Rate for Payer: United Healthcare All Other HMO |
$275.44
|
| Rate for Payer: United Healthcare HMO Rider |
$269.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$246.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$640.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$640.90
|
| Rate for Payer: Vantage Medical Group Senior |
$640.90
|
|
|
HC PCI BYPASS GRAFT
|
Facility
|
OP
|
$14,879.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
906820243
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$829.83 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,975.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,409.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$8,183.45
|
| Rate for Payer: Cash Price |
$8,183.45
|
| Rate for Payer: Cash Price |
$8,183.45
|
| Rate for Payer: Central Health Plan Commercial |
$11,903.20
|
| Rate for Payer: Cigna of CA HMO |
$9,671.35
|
| Rate for Payer: Cigna of CA PPO |
$11,010.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$12,647.15
|
| Rate for Payer: Global Benefits Group Commercial |
$8,927.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,391.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$829.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: InnovAge PACE Commercial |
$21,613.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,924.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$916.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,975.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,308.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$11,159.25
|
| Rate for Payer: Networks By Design Commercial |
$9,671.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Prime Health Services Commercial |
$12,647.15
|
| Rate for Payer: Prime Health Services Medicare |
$15,273.89
|
| Rate for Payer: Riverside University Health System MISP |
$15,850.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,927.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8,927.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| 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: Upland Medical Group Pediatric |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
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 |
$6,955.85
|
| Rate for Payer: Central Health Plan Commercial |
$10,117.60
|
| 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 Permanente of CA Commercial/Self Funded |
$8,435.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,818.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,828.49
|
| 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 |
$14,409.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$6,955.85
|
| Rate for Payer: Cash Price |
$6,955.85
|
| Rate for Payer: Cash Price |
$6,955.85
|
| 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 |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| 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 |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$829.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: InnovAge PACE Commercial |
$21,613.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,435.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$916.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,529.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,308.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| 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 |
$14,409.33
|
| Rate for Payer: Prime Health Services Commercial |
$10,749.95
|
| Rate for Payer: Prime Health Services Medicare |
$15,273.89
|
| Rate for Payer: Riverside University Health System MISP |
$15,850.26
|
| 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 |
$17,712.00
|
| 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: Upland Medical Group Pediatric |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
HC PCI BYPASS GRAFT
|
Facility
|
IP
|
$14,879.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
906820243
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,975.80 |
| Max. Negotiated Rate |
$13,391.10 |
| Rate for Payer: Adventist Health Commercial |
$2,975.80
|
| Rate for Payer: Cash Price |
$8,183.45
|
| Rate for Payer: Central Health Plan Commercial |
$11,903.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,951.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5,951.60
|
| Rate for Payer: Galaxy Health WC |
$12,647.15
|
| Rate for Payer: Global Benefits Group Commercial |
$8,927.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,391.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,924.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,668.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,210.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,975.80
|
| Rate for Payer: Multiplan Commercial |
$11,159.25
|
| Rate for Payer: Networks By Design Commercial |
$9,671.35
|
| Rate for Payer: Prime Health Services Commercial |
$12,647.15
|
|
|
HC PCI BYPASS GRAFT ADD
|
Facility
|
IP
|
$26,699.00
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
906820262
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$5,339.80 |
| Max. Negotiated Rate |
$24,029.10 |
| Rate for Payer: Adventist Health Commercial |
$5,339.80
|
| Rate for Payer: Cash Price |
$14,684.45
|
| Rate for Payer: Central Health Plan Commercial |
$21,359.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,679.60
|
| Rate for Payer: EPIC Health Plan Senior |
$10,679.60
|
| Rate for Payer: Galaxy Health WC |
$22,694.15
|
| Rate for Payer: Global Benefits Group Commercial |
$16,019.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,029.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,808.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,172.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,526.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,339.80
|
| Rate for Payer: Multiplan Commercial |
$20,024.25
|
| Rate for Payer: Networks By Design Commercial |
$17,354.35
|
| Rate for Payer: Prime Health Services Commercial |
$22,694.15
|
|
|
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 |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$12,481.70
|
| Rate for Payer: Cash Price |
$12,481.70
|
| 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: 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: InnovAge PACE Commercial |
$11,347.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,136.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,646.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,047.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,538.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15,885.80
|
| Rate for Payer: Molina Healthcare of CA 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 ADD
|
Facility
|
OP
|
$26,699.00
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
906820262
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$676.00 |
| Max. Negotiated Rate |
$24,029.10 |
| Rate for Payer: Adventist Health Commercial |
$5,339.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16,214.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,694.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,684.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,024.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$14,684.45
|
| Rate for Payer: Cash Price |
$14,684.45
|
| Rate for Payer: Central Health Plan Commercial |
$21,359.20
|
| Rate for Payer: Cigna of CA HMO |
$17,087.36
|
| Rate for Payer: Cigna of CA PPO |
$19,757.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,694.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,694.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,694.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,679.60
|
| Rate for Payer: EPIC Health Plan Senior |
$10,679.60
|
| Rate for Payer: Galaxy Health WC |
$22,694.15
|
| Rate for Payer: Global Benefits Group Commercial |
$16,019.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$24,029.10
|
| Rate for Payer: InnovAge PACE Commercial |
$13,349.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17,808.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,172.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,526.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,339.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,689.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,689.30
|
| Rate for Payer: Multiplan Commercial |
$20,024.25
|
| Rate for Payer: Networks By Design Commercial |
$17,354.35
|
| Rate for Payer: Prime Health Services Commercial |
$22,694.15
|
| Rate for Payer: Riverside University Health System MISP |
$10,679.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16,019.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16,019.40
|
| 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 |
$22,694.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22,694.15
|
| Rate for Payer: Vantage Medical Group Senior |
$22,694.15
|
|
|
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 |
$12,481.70
|
| Rate for Payer: Central Health Plan Commercial |
$18,155.20
|
| 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 Permanente of CA Commercial/Self Funded |
$15,136.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,646.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,047.59
|
| 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, 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 |
$3,477.65
|
| Rate for Payer: Central Health Plan Commercial |
$5,058.40
|
| 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 Permanente of CA Commercial/Self Funded |
$4,217.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,409.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,913.94
|
| 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 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 |
$2,901.00
|
| 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 |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$3,477.65
|
| Rate for Payer: Cash Price |
$3,477.65
|
| 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: 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: InnovAge PACE Commercial |
$3,161.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,217.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,913.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,264.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,426.10
|
| Rate for Payer: Molina Healthcare of CA 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 |
$17,712.00
|
| 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 |
$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
|
$7,439.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
906820244
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,487.80 |
| Max. Negotiated Rate |
$6,695.10 |
| Rate for Payer: Adventist Health Commercial |
$1,487.80
|
| Rate for Payer: Cash Price |
$4,091.45
|
| Rate for Payer: Central Health Plan Commercial |
$5,951.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,975.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,975.60
|
| Rate for Payer: Galaxy Health WC |
$6,323.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,463.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,695.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,961.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,834.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,604.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,487.80
|
| Rate for Payer: Multiplan Commercial |
$5,579.25
|
| Rate for Payer: Networks By Design Commercial |
$4,835.35
|
| Rate for Payer: Prime Health Services Commercial |
$6,323.15
|
|
|
HC PCI BYPASS GRAFT, ADDN'L
|
Facility
|
OP
|
$7,439.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
906820244
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,487.80 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$1,487.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,323.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,091.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,579.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$4,091.45
|
| Rate for Payer: Cash Price |
$4,091.45
|
| Rate for Payer: Central Health Plan Commercial |
$5,951.20
|
| Rate for Payer: Cigna of CA HMO |
$4,835.35
|
| Rate for Payer: Cigna of CA PPO |
$5,504.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,323.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,323.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,323.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,975.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,975.60
|
| Rate for Payer: Galaxy Health WC |
$6,323.15
|
| Rate for Payer: Global Benefits Group Commercial |
$4,463.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,695.10
|
| Rate for Payer: InnovAge PACE Commercial |
$3,719.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,961.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,604.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,487.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,207.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,207.30
|
| Rate for Payer: Multiplan Commercial |
$5,579.25
|
| Rate for Payer: Networks By Design Commercial |
$4,835.35
|
| Rate for Payer: Prime Health Services Commercial |
$6,323.15
|
| Rate for Payer: Riverside University Health System MISP |
$2,975.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,463.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,463.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| 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 |
$6,323.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,323.15
|
| Rate for Payer: Vantage Medical Group Senior |
$6,323.15
|
|
|
HC PCI CORO/BYPASS CHRONIC 1 VESL
|
Facility
|
OP
|
$17,855.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
906820246
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$930.83 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,571.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$14,409.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,409.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,786.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,820.46
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Cash Price |
$9,820.25
|
| Rate for Payer: Cash Price |
$9,820.25
|
| Rate for Payer: Cash Price |
$9,820.25
|
| Rate for Payer: Central Health Plan Commercial |
$14,284.00
|
| Rate for Payer: Cigna of CA HMO |
$11,605.75
|
| Rate for Payer: Cigna of CA PPO |
$13,212.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,850.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,409.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,452.60
|
| Rate for Payer: EPIC Health Plan Senior |
$14,409.33
|
| Rate for Payer: Galaxy Health WC |
$15,176.75
|
| Rate for Payer: Global Benefits Group Commercial |
$10,713.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,069.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23,631.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$930.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,409.33
|
| Rate for Payer: InnovAge PACE Commercial |
$21,613.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,909.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,028.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14,409.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,571.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19,308.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19,308.50
|
| Rate for Payer: Multiplan Commercial |
$13,391.25
|
| Rate for Payer: Networks By Design Commercial |
$11,605.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,409.33
|
| Rate for Payer: Prime Health Services Commercial |
$15,176.75
|
| Rate for Payer: Prime Health Services Medicare |
$15,273.89
|
| Rate for Payer: Riverside University Health System MISP |
$15,850.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10,713.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10,713.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| 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: Upland Medical Group Pediatric |
$14,409.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21,613.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,850.26
|
| Rate for Payer: Vantage Medical Group Senior |
$14,409.33
|
|
|
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 |
$8,347.35
|
| Rate for Payer: Central Health Plan Commercial |
$12,141.60
|
| 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 Permanente of CA Commercial/Self Funded |
$10,123.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,782.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,394.56
|
| 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 VESL
|
Facility
|
IP
|
$17,855.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
906820246
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,571.00 |
| Max. Negotiated Rate |
$16,069.50 |
| Rate for Payer: Adventist Health Commercial |
$3,571.00
|
| Rate for Payer: Cash Price |
$9,820.25
|
| Rate for Payer: Central Health Plan Commercial |
$14,284.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,142.00
|
| Rate for Payer: EPIC Health Plan Senior |
$7,142.00
|
| Rate for Payer: Galaxy Health WC |
$15,176.75
|
| Rate for Payer: Global Benefits Group Commercial |
$10,713.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,069.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,909.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,802.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11,052.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,571.00
|
| Rate for Payer: Multiplan Commercial |
$13,391.25
|
| Rate for Payer: Networks By Design Commercial |
$11,605.75
|
| Rate for Payer: Prime Health Services Commercial |
$15,176.75
|
|
