|
HC PEROXIDASE STAIN
|
Facility
|
IP
|
$383.00
|
|
|
Service Code
|
CPT 88319
|
| Hospital Charge Code |
900910037
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$76.60 |
| Max. Negotiated Rate |
$344.70 |
| Rate for Payer: Adventist Health Commercial |
$76.60
|
| Rate for Payer: Cash Price |
$210.65
|
| Rate for Payer: Central Health Plan Commercial |
$306.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$153.20
|
| Rate for Payer: EPIC Health Plan Senior |
$153.20
|
| Rate for Payer: Galaxy Health WC |
$325.55
|
| Rate for Payer: Global Benefits Group Commercial |
$229.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$344.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$255.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$237.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.60
|
| Rate for Payer: Multiplan Commercial |
$287.25
|
| Rate for Payer: Networks By Design Commercial |
$248.95
|
| Rate for Payer: Prime Health Services Commercial |
$325.55
|
|
|
HC PERQ ABLTJ LIVER CRYOABLATION
|
Facility
|
OP
|
$24,886.00
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
909047383
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$717.21 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$4,977.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$13,228.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26,109.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19,842.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,551.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,228.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8,405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11,238.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$21,077.25
|
| Rate for Payer: Blue Shield of California Commercial |
$9,470.27
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Cash Price |
$13,687.30
|
| Rate for Payer: Cash Price |
$13,687.30
|
| Rate for Payer: Cash Price |
$13,687.30
|
| Rate for Payer: Central Health Plan Commercial |
$19,908.80
|
| Rate for Payer: Cigna of CA HMO |
$15,927.04
|
| Rate for Payer: Cigna of CA PPO |
$18,415.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,842.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$14,551.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,228.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,858.47
|
| Rate for Payer: EPIC Health Plan Senior |
$13,228.50
|
| Rate for Payer: Galaxy Health WC |
$21,153.10
|
| Rate for Payer: Global Benefits Group Commercial |
$14,931.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,397.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21,694.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$717.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,228.50
|
| Rate for Payer: InnovAge PACE Commercial |
$19,842.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,598.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$792.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,228.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,977.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,726.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,726.19
|
| Rate for Payer: Multiplan Commercial |
$18,664.50
|
| Rate for Payer: Multiplan WC |
$21,077.25
|
| Rate for Payer: Networks By Design Commercial |
$16,175.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,228.50
|
| Rate for Payer: Preferred Health Network WC |
$21,507.40
|
| Rate for Payer: Prime Health Services Commercial |
$21,153.10
|
| Rate for Payer: Prime Health Services Medicare |
$14,022.21
|
| Rate for Payer: Prime Health Services WC |
$20,862.18
|
| Rate for Payer: Riverside University Health System MISP |
$14,551.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,931.60
|
| 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 |
$13,228.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19,842.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14,551.35
|
| Rate for Payer: Vantage Medical Group Senior |
$13,228.50
|
|
|
HC PERQ ABLTJ LIVER CRYOABLATION
|
Facility
|
IP
|
$24,886.00
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
909047383
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,977.20 |
| Max. Negotiated Rate |
$22,397.40 |
| Rate for Payer: Adventist Health Commercial |
$4,977.20
|
| Rate for Payer: Cash Price |
$13,687.30
|
| Rate for Payer: Central Health Plan Commercial |
$19,908.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,954.40
|
| Rate for Payer: EPIC Health Plan Senior |
$9,954.40
|
| Rate for Payer: Galaxy Health WC |
$21,153.10
|
| Rate for Payer: Global Benefits Group Commercial |
$14,931.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$22,397.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16,598.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,481.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15,404.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,977.20
|
| Rate for Payer: Multiplan Commercial |
$18,664.50
|
| Rate for Payer: Networks By Design Commercial |
$16,175.90
|
| Rate for Payer: Prime Health Services Commercial |
$21,153.10
|
|
|
HC PERQ AV FIST UE SEP ACCESS PRPHL ARTERY AND VEIN
|
Facility
|
IP
|
$40,436.00
|
|
|
Service Code
|
CPT 36837
|
| Hospital Charge Code |
906816837
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,087.20 |
| Max. Negotiated Rate |
$36,392.40 |
| Rate for Payer: Adventist Health Commercial |
$8,087.20
|
| Rate for Payer: Cash Price |
$22,239.80
|
| Rate for Payer: Central Health Plan Commercial |
$32,348.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,174.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16,174.40
|
| Rate for Payer: Galaxy Health WC |
$34,370.60
|
| Rate for Payer: Global Benefits Group Commercial |
$24,261.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36,392.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26,970.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15,406.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,029.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,087.20
|
| Rate for Payer: Multiplan Commercial |
$30,327.00
|
| Rate for Payer: Networks By Design Commercial |
$26,283.40
|
| Rate for Payer: Prime Health Services Commercial |
$34,370.60
|
|
|
HC PERQ AV FIST UE SEP ACCESS PRPHL ARTERY AND VEIN
|
Facility
|
OP
|
$40,436.00
|
|
|
Service Code
|
CPT 36837
|
| Hospital Charge Code |
906816837
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,165.61 |
| Max. Negotiated Rate |
$50,447.00 |
| Rate for Payer: Adventist Health Commercial |
$8,087.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$36,352.92
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$22,239.80
|
| Rate for Payer: Cash Price |
$22,239.80
|
| Rate for Payer: Cash Price |
$22,239.80
|
| Rate for Payer: Central Health Plan Commercial |
$32,348.80
|
| Rate for Payer: Cigna of CA HMO |
$25,879.04
|
| Rate for Payer: Cigna of CA PPO |
$29,922.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$34,370.60
|
| Rate for Payer: Global Benefits Group Commercial |
$24,261.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36,392.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: InnovAge PACE Commercial |
$34,223.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26,970.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,087.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,573.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$30,327.00
|
| Rate for Payer: Multiplan WC |
$36,352.92
|
| Rate for Payer: Networks By Design Commercial |
$26,283.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Preferred Health Network WC |
$37,094.82
|
| Rate for Payer: Prime Health Services Commercial |
$34,370.60
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Prime Health Services WC |
$35,981.98
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24,261.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$31,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$50,447.00
|
| Rate for Payer: United Healthcare HMO Rider |
$32,656.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30,398.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC PERQ CERVICOTHORACIC INJECT
|
Facility
|
OP
|
$13,725.00
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
909022510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$677.49 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,745.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,122.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| 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 |
$7,548.75
|
| Rate for Payer: Cash Price |
$7,548.75
|
| Rate for Payer: Cash Price |
$7,548.75
|
| Rate for Payer: Central Health Plan Commercial |
$10,980.00
|
| Rate for Payer: Cigna of CA HMO |
$8,784.00
|
| Rate for Payer: Cigna of CA PPO |
$10,156.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,565.51
|
| Rate for Payer: EPIC Health Plan Senior |
$4,122.60
|
| Rate for Payer: Galaxy Health WC |
$11,666.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8,235.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,352.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,761.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$677.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: InnovAge PACE Commercial |
$6,183.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,154.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$748.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,122.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,745.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,524.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,524.28
|
| Rate for Payer: Multiplan Commercial |
$10,293.75
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$8,921.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$11,666.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,369.96
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,534.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,235.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,122.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC PERQ CERVICOTHORACIC INJECT
|
Facility
|
IP
|
$13,725.00
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
909022510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,745.00 |
| Max. Negotiated Rate |
$12,352.50 |
| Rate for Payer: Adventist Health Commercial |
$2,745.00
|
| Rate for Payer: Cash Price |
$7,548.75
|
| Rate for Payer: Central Health Plan Commercial |
$10,980.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,490.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,490.00
|
| Rate for Payer: Galaxy Health WC |
$11,666.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8,235.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,352.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,154.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,229.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,495.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,745.00
|
| Rate for Payer: Multiplan Commercial |
$10,293.75
|
| Rate for Payer: Networks By Design Commercial |
$8,921.25
|
| Rate for Payer: Prime Health Services Commercial |
$11,666.25
|
|
|
HC PERQ LUMBOSACRAL INJECT
|
Facility
|
OP
|
$13,725.00
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
909022511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$636.52 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$2,745.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4,122.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,122.60
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| 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 |
$7,548.75
|
| Rate for Payer: Cash Price |
$7,548.75
|
| Rate for Payer: Cash Price |
$7,548.75
|
| Rate for Payer: Central Health Plan Commercial |
$10,980.00
|
| Rate for Payer: Cigna of CA HMO |
$8,784.00
|
| Rate for Payer: Cigna of CA PPO |
$10,156.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,534.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,122.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,565.51
|
| Rate for Payer: EPIC Health Plan Senior |
$4,122.60
|
| Rate for Payer: Galaxy Health WC |
$11,666.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8,235.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,352.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,761.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$636.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,122.60
|
| Rate for Payer: InnovAge PACE Commercial |
$6,183.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,154.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$703.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,122.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,745.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,524.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,524.28
|
| Rate for Payer: Multiplan Commercial |
$10,293.75
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: Networks By Design Commercial |
$8,921.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,122.60
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Commercial |
$11,666.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,369.96
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,534.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,235.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,122.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,183.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,534.86
|
| Rate for Payer: Vantage Medical Group Senior |
$4,122.60
|
|
|
HC PERQ LUMBOSACRAL INJECT
|
Facility
|
IP
|
$13,725.00
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
909022511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,745.00 |
| Max. Negotiated Rate |
$12,352.50 |
| Rate for Payer: Adventist Health Commercial |
$2,745.00
|
| Rate for Payer: Cash Price |
$7,548.75
|
| Rate for Payer: Central Health Plan Commercial |
$10,980.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,490.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5,490.00
|
| Rate for Payer: Galaxy Health WC |
$11,666.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8,235.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,352.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9,154.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,229.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,495.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,745.00
|
| Rate for Payer: Multiplan Commercial |
$10,293.75
|
| Rate for Payer: Networks By Design Commercial |
$8,921.25
|
| Rate for Payer: Prime Health Services Commercial |
$11,666.25
|
|
|
HC PERQ PRCRD DRG INS CATH CT GDN
|
Facility
|
IP
|
$1,328.00
|
|
|
Service Code
|
CPT 33019
|
| Hospital Charge Code |
900503019
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.60 |
| Max. Negotiated Rate |
$1,195.20 |
| Rate for Payer: Adventist Health Commercial |
$265.60
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,062.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$531.20
|
| Rate for Payer: EPIC Health Plan Senior |
$531.20
|
| Rate for Payer: Galaxy Health WC |
$1,128.80
|
| Rate for Payer: Global Benefits Group Commercial |
$796.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,195.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$885.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$505.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$822.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$265.60
|
| Rate for Payer: Multiplan Commercial |
$996.00
|
| Rate for Payer: Networks By Design Commercial |
$863.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,128.80
|
|
|
HC PERQ PRCRD DRG INS CATH CT GDN
|
Facility
|
OP
|
$1,328.00
|
|
|
Service Code
|
CPT 33019
|
| Hospital Charge Code |
900503019
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.60 |
| Max. Negotiated Rate |
$4,460.00 |
| Rate for Payer: Adventist Health Commercial |
$265.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,128.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$730.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$996.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$643.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$779.93
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Cash Price |
$730.40
|
| Rate for Payer: Central Health Plan Commercial |
$1,062.40
|
| Rate for Payer: Cigna of CA HMO |
$849.92
|
| Rate for Payer: Cigna of CA PPO |
$982.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,128.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,128.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,128.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$531.20
|
| Rate for Payer: EPIC Health Plan Senior |
$531.20
|
| Rate for Payer: Galaxy Health WC |
$1,128.80
|
| Rate for Payer: Global Benefits Group Commercial |
$796.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,195.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$332.34
|
| Rate for Payer: InnovAge PACE Commercial |
$664.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$885.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$367.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$822.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$265.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$929.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$929.60
|
| Rate for Payer: Multiplan Commercial |
$996.00
|
| Rate for Payer: Networks By Design Commercial |
$863.20
|
| Rate for Payer: Prime Health Services Commercial |
$1,128.80
|
| Rate for Payer: Riverside University Health System MISP |
$531.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$796.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,128.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,128.80
|
| Rate for Payer: Vantage Medical Group Senior |
$1,128.80
|
|
|
HC PERQ STEN/CHEST VERT ART
|
Facility
|
IP
|
$32,626.00
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
909081390
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,525.20 |
| Max. Negotiated Rate |
$29,363.40 |
| Rate for Payer: Adventist Health Commercial |
$6,525.20
|
| Rate for Payer: Cash Price |
$17,944.30
|
| Rate for Payer: Central Health Plan Commercial |
$26,100.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,050.40
|
| Rate for Payer: EPIC Health Plan Senior |
$13,050.40
|
| Rate for Payer: Galaxy Health WC |
$27,732.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,575.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,363.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,761.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,430.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,195.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,525.20
|
| Rate for Payer: Multiplan Commercial |
$24,469.50
|
| Rate for Payer: Networks By Design Commercial |
$21,206.90
|
| Rate for Payer: Prime Health Services Commercial |
$27,732.10
|
|
|
HC PERQ STEN/CHEST VERT ART
|
Facility
|
OP
|
$32,626.00
|
|
|
Service Code
|
CPT 0075T
|
| Hospital Charge Code |
909081390
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,374.00 |
| Max. Negotiated Rate |
$29,363.40 |
| Rate for Payer: Adventist Health Commercial |
$6,525.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27,732.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17,944.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,469.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,797.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19,161.25
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$17,944.30
|
| Rate for Payer: Cash Price |
$17,944.30
|
| Rate for Payer: Central Health Plan Commercial |
$26,100.80
|
| Rate for Payer: Cigna of CA HMO |
$20,880.64
|
| Rate for Payer: Cigna of CA PPO |
$24,143.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27,732.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,732.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27,732.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,050.40
|
| Rate for Payer: EPIC Health Plan Senior |
$13,050.40
|
| Rate for Payer: Galaxy Health WC |
$27,732.10
|
| Rate for Payer: Global Benefits Group Commercial |
$19,575.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$29,363.40
|
| Rate for Payer: InnovAge PACE Commercial |
$16,313.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21,761.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,430.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20,195.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,525.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22,838.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22,838.20
|
| Rate for Payer: Multiplan Commercial |
$24,469.50
|
| Rate for Payer: Networks By Design Commercial |
$21,206.90
|
| Rate for Payer: Prime Health Services Commercial |
$27,732.10
|
| Rate for Payer: Riverside University Health System MISP |
$13,050.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19,575.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27,732.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,732.10
|
| Rate for Payer: Vantage Medical Group Senior |
$27,732.10
|
|
|
HC PERQ TRANSCATH CLOSURE PDA
|
Facility
|
IP
|
$39,019.00
|
|
|
Service Code
|
CPT 93582
|
| Hospital Charge Code |
906811455
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,803.80 |
| Max. Negotiated Rate |
$35,117.10 |
| Rate for Payer: Adventist Health Commercial |
$7,803.80
|
| Rate for Payer: Cash Price |
$21,460.45
|
| Rate for Payer: Central Health Plan Commercial |
$31,215.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,607.60
|
| Rate for Payer: EPIC Health Plan Senior |
$15,607.60
|
| Rate for Payer: Galaxy Health WC |
$33,166.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23,411.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$35,117.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26,025.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,866.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,152.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,803.80
|
| Rate for Payer: Multiplan Commercial |
$29,264.25
|
| Rate for Payer: Networks By Design Commercial |
$25,362.35
|
| Rate for Payer: Prime Health Services Commercial |
$33,166.15
|
|
|
HC PERQ TRANSCATH CLOSURE PDA
|
Facility
|
OP
|
$39,019.00
|
|
|
Service Code
|
CPT 93582
|
| Hospital Charge Code |
906811455
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$972.26 |
| Max. Negotiated Rate |
$53,714.00 |
| Rate for Payer: Adventist Health Commercial |
$7,803.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,893.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,915.86
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$21,460.45
|
| Rate for Payer: Cash Price |
$21,460.45
|
| Rate for Payer: Cash Price |
$21,460.45
|
| Rate for Payer: Central Health Plan Commercial |
$31,215.20
|
| Rate for Payer: Cigna of CA HMO |
$25,362.35
|
| Rate for Payer: Cigna of CA PPO |
$28,874.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$33,166.15
|
| Rate for Payer: Global Benefits Group Commercial |
$23,411.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$35,117.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$972.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: InnovAge PACE Commercial |
$34,223.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26,025.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,074.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,803.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,573.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$29,264.25
|
| Rate for Payer: Networks By Design Commercial |
$25,362.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Prime Health Services Commercial |
$33,166.15
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,411.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23,411.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$43,822.00
|
| Rate for Payer: United Healthcare All Other HMO |
$53,714.00
|
| Rate for Payer: United Healthcare HMO Rider |
$37,572.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$34,424.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC PERQ TRANSCATH CLS AORTIC
|
Facility
|
OP
|
$47,231.00
|
|
|
Service Code
|
CPT 93591
|
| Hospital Charge Code |
906820092
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,436.41 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$9,446.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,568.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,738.77
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$25,977.05
|
| Rate for Payer: Cash Price |
$25,977.05
|
| Rate for Payer: Cash Price |
$25,977.05
|
| Rate for Payer: Central Health Plan Commercial |
$37,784.80
|
| Rate for Payer: Cigna of CA HMO |
$30,700.15
|
| Rate for Payer: Cigna of CA PPO |
$34,950.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$40,146.35
|
| Rate for Payer: Global Benefits Group Commercial |
$28,338.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,507.90
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,436.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: InnovAge PACE Commercial |
$34,223.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,503.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,586.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,446.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,573.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$35,423.25
|
| Rate for Payer: Networks By Design Commercial |
$30,700.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Prime Health Services Commercial |
$40,146.35
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28,338.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28,338.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,866.00
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC PERQ TRANSCATH CLS AORTIC
|
Facility
|
OP
|
$40,146.00
|
|
|
Service Code
|
CPT 93591
|
| Hospital Charge Code |
900093591
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,436.41 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$8,029.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,568.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23,577.75
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$22,080.30
|
| Rate for Payer: Cash Price |
$22,080.30
|
| Rate for Payer: Cash Price |
$22,080.30
|
| Rate for Payer: Central Health Plan Commercial |
$32,116.80
|
| Rate for Payer: Cigna of CA HMO |
$26,094.90
|
| Rate for Payer: Cigna of CA PPO |
$29,708.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$34,124.10
|
| Rate for Payer: Global Benefits Group Commercial |
$24,087.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36,131.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,436.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: InnovAge PACE Commercial |
$34,223.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26,777.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,586.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,029.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,573.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$30,109.50
|
| Rate for Payer: Networks By Design Commercial |
$26,094.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Prime Health Services Commercial |
$34,124.10
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24,087.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24,087.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,866.00
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC PERQ TRANSCATH CLS AORTIC
|
Facility
|
IP
|
$47,231.00
|
|
|
Service Code
|
CPT 93591
|
| Hospital Charge Code |
906820092
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,446.20 |
| Max. Negotiated Rate |
$42,507.90 |
| Rate for Payer: Adventist Health Commercial |
$9,446.20
|
| Rate for Payer: Cash Price |
$25,977.05
|
| Rate for Payer: Central Health Plan Commercial |
$37,784.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,892.40
|
| Rate for Payer: EPIC Health Plan Senior |
$18,892.40
|
| Rate for Payer: Galaxy Health WC |
$40,146.35
|
| Rate for Payer: Global Benefits Group Commercial |
$28,338.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,507.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,503.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17,995.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,235.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,446.20
|
| Rate for Payer: Multiplan Commercial |
$35,423.25
|
| Rate for Payer: Networks By Design Commercial |
$30,700.15
|
| Rate for Payer: Prime Health Services Commercial |
$40,146.35
|
|
|
HC PERQ TRANSCATH CLS AORTIC
|
Facility
|
IP
|
$40,146.00
|
|
|
Service Code
|
CPT 93591
|
| Hospital Charge Code |
900093591
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,029.20 |
| Max. Negotiated Rate |
$36,131.40 |
| Rate for Payer: Adventist Health Commercial |
$8,029.20
|
| Rate for Payer: Cash Price |
$22,080.30
|
| Rate for Payer: Central Health Plan Commercial |
$32,116.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,058.40
|
| Rate for Payer: EPIC Health Plan Senior |
$16,058.40
|
| Rate for Payer: Galaxy Health WC |
$34,124.10
|
| Rate for Payer: Global Benefits Group Commercial |
$24,087.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$36,131.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26,777.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15,295.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24,850.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,029.20
|
| Rate for Payer: Multiplan Commercial |
$30,109.50
|
| Rate for Payer: Networks By Design Commercial |
$26,094.90
|
| Rate for Payer: Prime Health Services Commercial |
$34,124.10
|
|
|
HC PERQ TRANSCATH CLSRE MITRAL
|
Facility
|
IP
|
$31,457.00
|
|
|
Service Code
|
CPT 93590
|
| Hospital Charge Code |
906811590
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,291.40 |
| Max. Negotiated Rate |
$28,311.30 |
| Rate for Payer: Adventist Health Commercial |
$6,291.40
|
| Rate for Payer: Cash Price |
$17,301.35
|
| Rate for Payer: Central Health Plan Commercial |
$25,165.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,582.80
|
| Rate for Payer: EPIC Health Plan Senior |
$12,582.80
|
| Rate for Payer: Galaxy Health WC |
$26,738.45
|
| Rate for Payer: Global Benefits Group Commercial |
$18,874.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,311.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,981.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,985.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19,471.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,291.40
|
| Rate for Payer: Multiplan Commercial |
$23,592.75
|
| Rate for Payer: Networks By Design Commercial |
$20,447.05
|
| Rate for Payer: Prime Health Services Commercial |
$26,738.45
|
|
|
HC PERQ TRANSCATH CLSRE MITRAL
|
Facility
|
OP
|
$31,457.00
|
|
|
Service Code
|
CPT 93590
|
| Hospital Charge Code |
906811590
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,730.37 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$6,291.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,912.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,474.70
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$17,301.35
|
| Rate for Payer: Cash Price |
$17,301.35
|
| Rate for Payer: Cash Price |
$17,301.35
|
| Rate for Payer: Central Health Plan Commercial |
$25,165.60
|
| Rate for Payer: Cigna of CA HMO |
$20,447.05
|
| Rate for Payer: Cigna of CA PPO |
$23,278.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$26,738.45
|
| Rate for Payer: Global Benefits Group Commercial |
$18,874.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$28,311.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,730.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: InnovAge PACE Commercial |
$34,223.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,981.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,911.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,291.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,573.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$23,592.75
|
| Rate for Payer: Networks By Design Commercial |
$20,447.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Prime Health Services Commercial |
$26,738.45
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,874.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18,874.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,866.00
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC PERQ TRANSCATH CLSRE MITRAL
|
Facility
|
IP
|
$37,008.00
|
|
|
Service Code
|
CPT 93590
|
| Hospital Charge Code |
906820301
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,401.60 |
| Max. Negotiated Rate |
$33,307.20 |
| Rate for Payer: Adventist Health Commercial |
$7,401.60
|
| Rate for Payer: Cash Price |
$20,354.40
|
| Rate for Payer: Central Health Plan Commercial |
$29,606.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,803.20
|
| Rate for Payer: EPIC Health Plan Senior |
$14,803.20
|
| Rate for Payer: Galaxy Health WC |
$31,456.80
|
| Rate for Payer: Global Benefits Group Commercial |
$22,204.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$33,307.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,684.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,100.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,907.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,401.60
|
| Rate for Payer: Multiplan Commercial |
$27,756.00
|
| Rate for Payer: Networks By Design Commercial |
$24,055.20
|
| Rate for Payer: Prime Health Services Commercial |
$31,456.80
|
|
|
HC PERQ TRANSCATH CLSRE MITRAL
|
Facility
|
OP
|
$37,008.00
|
|
|
Service Code
|
CPT 93590
|
| Hospital Charge Code |
906820301
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,730.37 |
| Max. Negotiated Rate |
$71,375.00 |
| Rate for Payer: Adventist Health Commercial |
$7,401.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$22,815.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22,815.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,912.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,734.80
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$20,354.40
|
| Rate for Payer: Cash Price |
$20,354.40
|
| Rate for Payer: Cash Price |
$20,354.40
|
| Rate for Payer: Central Health Plan Commercial |
$29,606.40
|
| Rate for Payer: Cigna of CA HMO |
$24,055.20
|
| Rate for Payer: Cigna of CA PPO |
$27,385.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,097.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,815.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$30,801.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22,815.81
|
| Rate for Payer: Galaxy Health WC |
$31,456.80
|
| Rate for Payer: Global Benefits Group Commercial |
$22,204.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$33,307.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$37,417.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,730.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$22,815.81
|
| Rate for Payer: InnovAge PACE Commercial |
$34,223.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,684.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,911.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22,815.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,401.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,573.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,573.19
|
| Rate for Payer: Multiplan Commercial |
$27,756.00
|
| Rate for Payer: Networks By Design Commercial |
$24,055.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$22,815.81
|
| Rate for Payer: Prime Health Services Commercial |
$31,456.80
|
| Rate for Payer: Prime Health Services Medicare |
$24,184.76
|
| Rate for Payer: Riverside University Health System MISP |
$25,097.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22,204.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22,204.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$60,866.00
|
| Rate for Payer: United Healthcare All Other HMO |
$71,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$57,385.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52,575.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$22,815.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34,223.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,097.39
|
| Rate for Payer: Vantage Medical Group Senior |
$22,815.81
|
|
|
HC PERQ TRNSCTH CLSRE EA OCC DVC
|
Facility
|
IP
|
$20,836.00
|
|
|
Service Code
|
CPT 93592
|
| Hospital Charge Code |
906820302
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,167.20 |
| Max. Negotiated Rate |
$18,752.40 |
| Rate for Payer: Adventist Health Commercial |
$4,167.20
|
| Rate for Payer: Cash Price |
$11,459.80
|
| Rate for Payer: Central Health Plan Commercial |
$16,668.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,334.40
|
| Rate for Payer: EPIC Health Plan Senior |
$8,334.40
|
| Rate for Payer: Galaxy Health WC |
$17,710.60
|
| Rate for Payer: Global Benefits Group Commercial |
$12,501.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,752.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,897.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,938.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12,897.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,167.20
|
| Rate for Payer: Multiplan Commercial |
$15,627.00
|
| Rate for Payer: Networks By Design Commercial |
$13,543.40
|
| Rate for Payer: Prime Health Services Commercial |
$17,710.60
|
|
|
HC PERQ TRNSCTH CLSRE EA OCC DVC
|
Facility
|
IP
|
$17,711.00
|
|
|
Service Code
|
CPT 93592
|
| Hospital Charge Code |
906811592
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,542.20 |
| Max. Negotiated Rate |
$15,939.90 |
| Rate for Payer: Adventist Health Commercial |
$3,542.20
|
| Rate for Payer: Cash Price |
$9,741.05
|
| Rate for Payer: Central Health Plan Commercial |
$14,168.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,084.40
|
| Rate for Payer: EPIC Health Plan Senior |
$7,084.40
|
| Rate for Payer: Galaxy Health WC |
$15,054.35
|
| Rate for Payer: Global Benefits Group Commercial |
$10,626.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$15,939.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11,813.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,747.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10,963.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,542.20
|
| Rate for Payer: Multiplan Commercial |
$13,283.25
|
| Rate for Payer: Networks By Design Commercial |
$11,512.15
|
| Rate for Payer: Prime Health Services Commercial |
$15,054.35
|
|
