|
HC PCI BYPASS GRAFT, ADDN'L
|
Facility
|
OP
|
$7,831.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
906820244
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,566.20 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,147.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,656.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,307.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,307.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,698.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$3,523.95
|
| Rate for Payer: Cash Price |
$3,523.95
|
| Rate for Payer: Central Health Plan Commercial |
$6,264.80
|
| Rate for Payer: Cigna of CA PPO |
$5,794.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,656.35
|
| Rate for Payer: Dignity Health Media |
$6,656.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,656.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,132.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,132.40
|
| Rate for Payer: Galaxy Health WC |
$6,656.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,698.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,047.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,873.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,740.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,223.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,566.20
|
| Rate for Payer: Multiplan Commercial |
$5,873.25
|
| Rate for Payer: Networks By Design Commercial |
$5,090.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,656.35
|
| Rate for Payer: Riverside University Health System MISP |
$3,132.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,698.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,698.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,656.35
|
| Rate for Payer: Vantage Medical Group Senior |
$6,656.35
|
|
|
HC PCI BYPASS GRAFT, ADDN'L
|
Facility
|
IP
|
$7,831.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
906820244
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,566.20 |
| Max. Negotiated Rate |
$7,047.90 |
| Rate for Payer: Cash Price |
$3,523.95
|
| Rate for Payer: Central Health Plan Commercial |
$6,264.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,132.40
|
| Rate for Payer: Galaxy Health WC |
$6,656.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,698.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,047.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,223.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,983.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,566.20
|
| Rate for Payer: Multiplan Commercial |
$5,873.25
|
| Rate for Payer: Networks By Design Commercial |
$5,090.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,656.35
|
|
|
HC PCI BYPASS GRAFT, ADDN'L
|
Facility
|
OP
|
$7,831.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
906811441
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,566.20 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,147.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,656.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,307.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,307.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,698.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$3,523.95
|
| Rate for Payer: Cash Price |
$3,523.95
|
| Rate for Payer: Central Health Plan Commercial |
$6,264.80
|
| Rate for Payer: Cigna of CA PPO |
$5,794.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,656.35
|
| Rate for Payer: Dignity Health Media |
$6,656.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,656.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,132.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,132.40
|
| Rate for Payer: Galaxy Health WC |
$6,656.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,698.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,047.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,873.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,740.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,223.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,566.20
|
| Rate for Payer: Multiplan Commercial |
$5,873.25
|
| Rate for Payer: Networks By Design Commercial |
$5,090.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,656.35
|
| Rate for Payer: Riverside University Health System MISP |
$3,132.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,698.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,698.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,656.35
|
| Rate for Payer: Vantage Medical Group Senior |
$6,656.35
|
|
|
HC PCI BYPASS GRAFT, ADDN'L
|
Facility
|
IP
|
$7,831.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
906811441
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,566.20 |
| Max. Negotiated Rate |
$7,047.90 |
| Rate for Payer: Cash Price |
$3,523.95
|
| Rate for Payer: Central Health Plan Commercial |
$6,264.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,132.40
|
| Rate for Payer: Galaxy Health WC |
$6,656.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,698.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,047.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,223.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,983.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,566.20
|
| Rate for Payer: Multiplan Commercial |
$5,873.25
|
| Rate for Payer: Networks By Design Commercial |
$5,090.15
|
| Rate for Payer: Prime Health Services Commercial |
$6,656.35
|
|
|
HC PCI CORO/BYPASS CHRONIC 1 VESL
|
Facility
|
OP
|
$18,795.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
906820246
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,028.24 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,715.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$11,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$8,457.75
|
| Rate for Payer: Cash Price |
$8,457.75
|
| Rate for Payer: Central Health Plan Commercial |
$15,036.00
|
| Rate for Payer: Cigna of CA PPO |
$13,908.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$15,975.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11,277.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,915.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14,096.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,679.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: InnovAge PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,536.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,028.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,759.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$14,096.25
|
| Rate for Payer: Networks By Design Commercial |
$12,216.75
|
| Rate for Payer: Prime Health Services Commercial |
$15,975.75
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,277.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,277.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC PCI CORO/BYPASS CHRONIC 1 VESL
|
Facility
|
OP
|
$18,795.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
906811443
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,028.24 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,715.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$11,277.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$8,457.75
|
| Rate for Payer: Cash Price |
$8,457.75
|
| Rate for Payer: Central Health Plan Commercial |
$15,036.00
|
| Rate for Payer: Cigna of CA PPO |
$13,908.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Media |
$13,745.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,556.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$13,745.22
|
| Rate for Payer: Galaxy Health WC |
$15,975.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11,277.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,915.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14,096.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$22,542.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,679.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,745.22
|
| Rate for Payer: InnovAge PACE Commercial |
$20,617.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,536.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,028.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,759.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18,418.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18,418.59
|
| Rate for Payer: Multiplan Commercial |
$14,096.25
|
| Rate for Payer: Networks By Design Commercial |
$12,216.75
|
| Rate for Payer: Prime Health Services Commercial |
$15,975.75
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,277.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11,277.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC PCI CORO/BYPASS CHRONIC 1 VESL
|
Facility
|
IP
|
$18,795.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
906811443
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,759.00 |
| Max. Negotiated Rate |
$16,915.50 |
| Rate for Payer: Cash Price |
$8,457.75
|
| Rate for Payer: Central Health Plan Commercial |
$15,036.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,518.00
|
| Rate for Payer: Galaxy Health WC |
$15,975.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11,277.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,915.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,536.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,160.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,759.00
|
| Rate for Payer: Multiplan Commercial |
$14,096.25
|
| Rate for Payer: Networks By Design Commercial |
$12,216.75
|
| Rate for Payer: Prime Health Services Commercial |
$15,975.75
|
|
|
HC PCI CORO/BYPASS CHRONIC 1 VESL
|
Facility
|
IP
|
$18,795.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
906820246
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,759.00 |
| Max. Negotiated Rate |
$16,915.50 |
| Rate for Payer: Cash Price |
$8,457.75
|
| Rate for Payer: Central Health Plan Commercial |
$15,036.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,518.00
|
| Rate for Payer: Galaxy Health WC |
$15,975.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11,277.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$16,915.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,536.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,160.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,759.00
|
| Rate for Payer: Multiplan Commercial |
$14,096.25
|
| Rate for Payer: Networks By Design Commercial |
$12,216.75
|
| Rate for Payer: Prime Health Services Commercial |
$15,975.75
|
|
|
HC PCI CORO BYPASS CHRONIC 1 VSL
|
Facility
|
OP
|
$38,826.00
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
906820264
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$36,149.78 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,035.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$23,295.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Central Health Plan Commercial |
$31,060.80
|
| Rate for Payer: Cigna of CA HMO |
$24,848.64
|
| Rate for Payer: Cigna of CA PPO |
$28,731.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Dignity Health Media |
$21,908.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,099.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,577.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,908.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$21,908.96
|
| Rate for Payer: Galaxy Health WC |
$33,002.10
|
| Rate for Payer: Global Benefits Group Commercial |
$23,295.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,943.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$29,119.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35,930.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36,149.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,908.96
|
| Rate for Payer: InnovAge PACE Commercial |
$32,863.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,896.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,792.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,765.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,358.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,358.01
|
| Rate for Payer: Multiplan Commercial |
$29,119.50
|
| Rate for Payer: Networks By Design Commercial |
$25,236.90
|
| Rate for Payer: Prime Health Services Commercial |
$33,002.10
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Riverside University Health System MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,295.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23,295.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Vantage Medical Group Senior |
$21,908.96
|
|
|
HC PCI CORO BYPASS CHRONIC 1 VSL
|
Facility
|
IP
|
$38,826.00
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
906811466
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7,765.20 |
| Max. Negotiated Rate |
$34,943.40 |
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Central Health Plan Commercial |
$31,060.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,530.40
|
| Rate for Payer: Galaxy Health WC |
$33,002.10
|
| Rate for Payer: Global Benefits Group Commercial |
$23,295.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,943.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,896.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,792.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,765.20
|
| Rate for Payer: Multiplan Commercial |
$29,119.50
|
| Rate for Payer: Networks By Design Commercial |
$25,236.90
|
| Rate for Payer: Prime Health Services Commercial |
$33,002.10
|
|
|
HC PCI CORO BYPASS CHRONIC 1 VSL
|
Facility
|
OP
|
$38,826.00
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
906811466
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$36,149.78 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7,035.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$23,295.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Central Health Plan Commercial |
$31,060.80
|
| Rate for Payer: Cigna of CA HMO |
$24,848.64
|
| Rate for Payer: Cigna of CA PPO |
$28,731.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Dignity Health Media |
$21,908.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,099.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$29,577.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$21,908.96
|
| Rate for Payer: EPIC Health Plan Transplant |
$21,908.96
|
| Rate for Payer: Galaxy Health WC |
$33,002.10
|
| Rate for Payer: Global Benefits Group Commercial |
$23,295.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,943.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$29,119.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$35,930.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$36,149.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,908.96
|
| Rate for Payer: InnovAge PACE Commercial |
$32,863.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,896.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,792.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,765.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29,358.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29,358.01
|
| Rate for Payer: Multiplan Commercial |
$29,119.50
|
| Rate for Payer: Networks By Design Commercial |
$25,236.90
|
| Rate for Payer: Prime Health Services Commercial |
$33,002.10
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Riverside University Health System MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,295.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23,295.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Vantage Medical Group Senior |
$21,908.96
|
|
|
HC PCI CORO BYPASS CHRONIC 1 VSL
|
Facility
|
IP
|
$38,826.00
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
906820264
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7,765.20 |
| Max. Negotiated Rate |
$34,943.40 |
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Central Health Plan Commercial |
$31,060.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,530.40
|
| Rate for Payer: Galaxy Health WC |
$33,002.10
|
| Rate for Payer: Global Benefits Group Commercial |
$23,295.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,943.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,896.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,792.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,765.20
|
| Rate for Payer: Multiplan Commercial |
$29,119.50
|
| Rate for Payer: Networks By Design Commercial |
$25,236.90
|
| Rate for Payer: Prime Health Services Commercial |
$33,002.10
|
|
|
HC PCI CORO BYPASS CHRONIC ADD
|
Facility
|
OP
|
$36,977.00
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
906820265
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$33,279.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,456.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31,430.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20,337.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,337.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$22,186.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$16,639.65
|
| Rate for Payer: Cash Price |
$16,639.65
|
| Rate for Payer: Cash Price |
$16,639.65
|
| Rate for Payer: Central Health Plan Commercial |
$29,581.60
|
| Rate for Payer: Cigna of CA HMO |
$23,665.28
|
| Rate for Payer: Cigna of CA PPO |
$27,362.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31,430.45
|
| Rate for Payer: Dignity Health Media |
$31,430.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,430.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,790.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$14,790.80
|
| Rate for Payer: Galaxy Health WC |
$31,430.45
|
| Rate for Payer: Global Benefits Group Commercial |
$22,186.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$33,279.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$27,732.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12,941.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,663.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,088.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,395.40
|
| Rate for Payer: Multiplan Commercial |
$27,732.75
|
| Rate for Payer: Networks By Design Commercial |
$24,035.05
|
| Rate for Payer: Prime Health Services Commercial |
$31,430.45
|
| Rate for Payer: Riverside University Health System MISP |
$14,790.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22,186.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22,186.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,430.45
|
| Rate for Payer: Vantage Medical Group Senior |
$31,430.45
|
|
|
HC PCI CORO BYPASS CHRONIC ADD
|
Facility
|
OP
|
$36,977.00
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
906811467
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$33,279.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,456.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31,430.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20,337.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,337.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$22,186.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$16,639.65
|
| Rate for Payer: Cash Price |
$16,639.65
|
| Rate for Payer: Cash Price |
$16,639.65
|
| Rate for Payer: Central Health Plan Commercial |
$29,581.60
|
| Rate for Payer: Cigna of CA HMO |
$23,665.28
|
| Rate for Payer: Cigna of CA PPO |
$27,362.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31,430.45
|
| Rate for Payer: Dignity Health Media |
$31,430.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$31,430.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,790.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$14,790.80
|
| Rate for Payer: Galaxy Health WC |
$31,430.45
|
| Rate for Payer: Global Benefits Group Commercial |
$22,186.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$33,279.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$27,732.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12,941.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,663.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,088.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,395.40
|
| Rate for Payer: Multiplan Commercial |
$27,732.75
|
| Rate for Payer: Networks By Design Commercial |
$24,035.05
|
| Rate for Payer: Prime Health Services Commercial |
$31,430.45
|
| Rate for Payer: Riverside University Health System MISP |
$14,790.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22,186.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22,186.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31,430.45
|
| Rate for Payer: Vantage Medical Group Senior |
$31,430.45
|
|
|
HC PCI CORO BYPASS CHRONIC ADD
|
Facility
|
IP
|
$36,977.00
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
906811467
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7,395.40 |
| Max. Negotiated Rate |
$33,279.30 |
| Rate for Payer: Cash Price |
$16,639.65
|
| Rate for Payer: Central Health Plan Commercial |
$29,581.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,790.80
|
| Rate for Payer: Galaxy Health WC |
$31,430.45
|
| Rate for Payer: Global Benefits Group Commercial |
$22,186.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$33,279.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,663.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,088.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,395.40
|
| Rate for Payer: Multiplan Commercial |
$27,732.75
|
| Rate for Payer: Networks By Design Commercial |
$24,035.05
|
| Rate for Payer: Prime Health Services Commercial |
$31,430.45
|
|
|
HC PCI CORO BYPASS CHRONIC ADD
|
Facility
|
IP
|
$36,977.00
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
906820265
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7,395.40 |
| Max. Negotiated Rate |
$33,279.30 |
| Rate for Payer: Cash Price |
$16,639.65
|
| Rate for Payer: Central Health Plan Commercial |
$29,581.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,790.80
|
| Rate for Payer: Galaxy Health WC |
$31,430.45
|
| Rate for Payer: Global Benefits Group Commercial |
$22,186.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$33,279.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24,663.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,088.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,395.40
|
| Rate for Payer: Multiplan Commercial |
$27,732.75
|
| Rate for Payer: Networks By Design Commercial |
$24,035.05
|
| Rate for Payer: Prime Health Services Commercial |
$31,430.45
|
|
|
HC PCI CORO/BYPASS CHRONIC, ADD'L
|
Facility
|
IP
|
$9,397.00
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
906811444
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,879.40 |
| Max. Negotiated Rate |
$8,457.30 |
| Rate for Payer: Cash Price |
$4,228.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,517.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,758.80
|
| Rate for Payer: Galaxy Health WC |
$7,987.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,638.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,457.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,267.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,580.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,879.40
|
| Rate for Payer: Multiplan Commercial |
$7,047.75
|
| Rate for Payer: Networks By Design Commercial |
$6,108.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,987.45
|
|
|
HC PCI CORO/BYPASS CHRONIC, ADD'L
|
Facility
|
OP
|
$9,397.00
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
906811444
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,879.40 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,761.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,987.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,168.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,168.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,638.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$4,228.65
|
| Rate for Payer: Cash Price |
$4,228.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,517.60
|
| Rate for Payer: Cigna of CA PPO |
$6,953.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,987.45
|
| Rate for Payer: Dignity Health Media |
$7,987.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,987.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,758.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,758.80
|
| Rate for Payer: Galaxy Health WC |
$7,987.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,638.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,457.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,047.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,288.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,879.40
|
| Rate for Payer: Multiplan Commercial |
$7,047.75
|
| Rate for Payer: Networks By Design Commercial |
$6,108.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,987.45
|
| Rate for Payer: Riverside University Health System MISP |
$3,758.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,638.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,638.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,987.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,987.45
|
|
|
HC PCI CORO/BYPASS CHRONIC, ADD'L
|
Facility
|
IP
|
$9,397.00
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
906820247
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,879.40 |
| Max. Negotiated Rate |
$8,457.30 |
| Rate for Payer: Cash Price |
$4,228.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,517.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,758.80
|
| Rate for Payer: Galaxy Health WC |
$7,987.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,638.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,457.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,267.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,580.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,879.40
|
| Rate for Payer: Multiplan Commercial |
$7,047.75
|
| Rate for Payer: Networks By Design Commercial |
$6,108.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,987.45
|
|
|
HC PCI CORO/BYPASS CHRONIC, ADD'L
|
Facility
|
OP
|
$9,397.00
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
906820247
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,879.40 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,761.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,987.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,168.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,168.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,638.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$4,228.65
|
| Rate for Payer: Cash Price |
$4,228.65
|
| Rate for Payer: Central Health Plan Commercial |
$7,517.60
|
| Rate for Payer: Cigna of CA PPO |
$6,953.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,987.45
|
| Rate for Payer: Dignity Health Media |
$7,987.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,987.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,758.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,758.80
|
| Rate for Payer: Galaxy Health WC |
$7,987.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,638.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,457.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,047.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,288.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,879.40
|
| Rate for Payer: Multiplan Commercial |
$7,047.75
|
| Rate for Payer: Networks By Design Commercial |
$6,108.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,987.45
|
| Rate for Payer: Riverside University Health System MISP |
$3,758.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,638.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,638.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$16,813.00
|
| Rate for Payer: United Healthcare All Other HMO |
$27,445.00
|
| Rate for Payer: United Healthcare HMO Rider |
$17,214.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,742.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,987.45
|
| Rate for Payer: Vantage Medical Group Senior |
$7,987.45
|
|
|
HC PCI CORO BYPASS W MI 1 VESSEL
|
Facility
|
IP
|
$38,826.00
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
906811465
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7,765.20 |
| Max. Negotiated Rate |
$34,943.40 |
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Central Health Plan Commercial |
$31,060.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,530.40
|
| Rate for Payer: Galaxy Health WC |
$33,002.10
|
| Rate for Payer: Global Benefits Group Commercial |
$23,295.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,943.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,896.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,792.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,765.20
|
| Rate for Payer: Multiplan Commercial |
$29,119.50
|
| Rate for Payer: Networks By Design Commercial |
$25,236.90
|
| Rate for Payer: Prime Health Services Commercial |
$33,002.10
|
|
|
HC PCI CORO BYPASS W MI 1 VESSEL
|
Facility
|
IP
|
$38,826.00
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
906820263
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7,765.20 |
| Max. Negotiated Rate |
$34,943.40 |
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Central Health Plan Commercial |
$31,060.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,530.40
|
| Rate for Payer: Galaxy Health WC |
$33,002.10
|
| Rate for Payer: Global Benefits Group Commercial |
$23,295.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,943.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,896.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,792.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,765.20
|
| Rate for Payer: Multiplan Commercial |
$29,119.50
|
| Rate for Payer: Networks By Design Commercial |
$25,236.90
|
| Rate for Payer: Prime Health Services Commercial |
$33,002.10
|
|
|
HC PCI CORO BYPASS W MI 1 VESSEL
|
Facility
|
OP
|
$38,826.00
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
906811465
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$34,943.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4,221.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33,002.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21,354.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,354.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$23,295.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Central Health Plan Commercial |
$31,060.80
|
| Rate for Payer: Cigna of CA HMO |
$24,848.64
|
| Rate for Payer: Cigna of CA PPO |
$28,731.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33,002.10
|
| Rate for Payer: Dignity Health Media |
$33,002.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$33,002.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,530.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$15,530.40
|
| Rate for Payer: Galaxy Health WC |
$33,002.10
|
| Rate for Payer: Global Benefits Group Commercial |
$23,295.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,943.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$29,119.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13,589.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,896.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,792.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,765.20
|
| Rate for Payer: Multiplan Commercial |
$29,119.50
|
| Rate for Payer: Networks By Design Commercial |
$25,236.90
|
| Rate for Payer: Prime Health Services Commercial |
$33,002.10
|
| Rate for Payer: Riverside University Health System MISP |
$15,530.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,295.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23,295.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33,002.10
|
| Rate for Payer: Vantage Medical Group Senior |
$33,002.10
|
|
|
HC PCI CORO BYPASS W MI 1 VESSEL
|
Facility
|
OP
|
$38,826.00
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
906820263
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$34,943.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4,221.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33,002.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21,354.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21,354.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,979.00
|
| Rate for Payer: Blue Distinction Transplant |
$23,295.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Cash Price |
$17,471.70
|
| Rate for Payer: Central Health Plan Commercial |
$31,060.80
|
| Rate for Payer: Cigna of CA HMO |
$24,848.64
|
| Rate for Payer: Cigna of CA PPO |
$28,731.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33,002.10
|
| Rate for Payer: Dignity Health Media |
$33,002.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$33,002.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,530.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$15,530.40
|
| Rate for Payer: Galaxy Health WC |
$33,002.10
|
| Rate for Payer: Global Benefits Group Commercial |
$23,295.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$34,943.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$29,119.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13,589.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25,896.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,792.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,765.20
|
| Rate for Payer: Multiplan Commercial |
$29,119.50
|
| Rate for Payer: Networks By Design Commercial |
$25,236.90
|
| Rate for Payer: Prime Health Services Commercial |
$33,002.10
|
| Rate for Payer: Riverside University Health System MISP |
$15,530.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23,295.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23,295.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,078.00
|
| Rate for Payer: United Healthcare All Other HMO |
$827.00
|
| Rate for Payer: United Healthcare HMO Rider |
$702.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$643.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33,002.10
|
| Rate for Payer: Vantage Medical Group Senior |
$33,002.10
|
|
|
HC PCI CORO/BYPASS W MI, 1 VESSEL
|
Facility
|
IP
|
$23,494.00
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
906811442
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,698.80 |
| Max. Negotiated Rate |
$21,144.60 |
| Rate for Payer: Cash Price |
$10,572.30
|
| Rate for Payer: Central Health Plan Commercial |
$18,795.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,397.60
|
| Rate for Payer: Galaxy Health WC |
$19,969.90
|
| Rate for Payer: Global Benefits Group Commercial |
$14,096.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,144.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15,670.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,951.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,698.80
|
| Rate for Payer: Multiplan Commercial |
$17,620.50
|
| Rate for Payer: Networks By Design Commercial |
$15,271.10
|
| Rate for Payer: Prime Health Services Commercial |
$19,969.90
|
|
