|
HC PERC PULM ART STENT ABN BI
|
Facility
|
IP
|
$31,065.00
|
|
|
Service Code
|
CPT 33903
|
| Hospital Charge Code |
906811903
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,213.00 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Central Health Plan Commercial |
$24,852.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,426.00
|
| Rate for Payer: Galaxy Health WC |
$26,405.25
|
| Rate for Payer: Global Benefits Group Commercial |
$18,639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,958.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,720.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,835.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,213.00
|
| Rate for Payer: Multiplan Commercial |
$23,298.75
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$26,405.25
|
|
|
HC PERC PULM ART STENT ABN BI
|
Facility
|
IP
|
$31,065.00
|
|
|
Service Code
|
CPT 33903
|
| Hospital Charge Code |
906820326
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,213.00 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Central Health Plan Commercial |
$24,852.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,426.00
|
| Rate for Payer: Galaxy Health WC |
$26,405.25
|
| Rate for Payer: Global Benefits Group Commercial |
$18,639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,958.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,720.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,835.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,213.00
|
| Rate for Payer: Multiplan Commercial |
$23,298.75
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$26,405.25
|
|
|
HC PERC PULM ART STENT ABN BI
|
Facility
|
OP
|
$31,065.00
|
|
|
Service Code
|
CPT 33903
|
| Hospital Charge Code |
906811903
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: Blue Distinction Transplant |
$18,639.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Central Health Plan Commercial |
$24,852.00
|
| Rate for Payer: Cigna of CA PPO |
$22,988.10
|
| 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 |
$26,405.25
|
| Rate for Payer: Global Benefits Group Commercial |
$18,639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,958.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$23,298.75
|
| 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 |
$20,720.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,213.00
|
| 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 |
$23,298.75
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$20,192.25
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$26,405.25
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,639.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| 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 PERC PULM ART STENT ABN UNI
|
Facility
|
IP
|
$47,756.00
|
|
|
Service Code
|
CPT 33902
|
| Hospital Charge Code |
906811902
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,551.20 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$21,490.20
|
| Rate for Payer: Cash Price |
$21,490.20
|
| Rate for Payer: Central Health Plan Commercial |
$38,204.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,102.40
|
| Rate for Payer: Galaxy Health WC |
$40,592.60
|
| Rate for Payer: Global Benefits Group Commercial |
$28,653.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,980.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,853.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,195.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,551.20
|
| Rate for Payer: Multiplan Commercial |
$35,817.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$40,592.60
|
|
|
HC PERC PULM ART STENT ABN UNI
|
Facility
|
OP
|
$47,756.00
|
|
|
Service Code
|
CPT 33902
|
| Hospital Charge Code |
906820322
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$29,952.68
|
| Rate for Payer: Blue Distinction Transplant |
$28,653.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$21,490.20
|
| Rate for Payer: Cash Price |
$21,490.20
|
| Rate for Payer: Cash Price |
$21,490.20
|
| Rate for Payer: Central Health Plan Commercial |
$38,204.80
|
| Rate for Payer: Cigna of CA PPO |
$35,339.44
|
| 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 |
$40,592.60
|
| Rate for Payer: Global Benefits Group Commercial |
$28,653.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,980.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$35,817.00
|
| 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 |
$31,853.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,551.20
|
| 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 |
$35,817.00
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: Networks By Design Commercial |
$31,041.40
|
| Rate for Payer: Preferred Health Network WC |
$30,563.96
|
| Rate for Payer: Prime Health Services Commercial |
$40,592.60
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Prime Health Services WC |
$29,647.04
|
| Rate for Payer: Riverside University Health System MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28,653.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| 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 PERC PULM ART STENT ABN UNI
|
Facility
|
OP
|
$47,756.00
|
|
|
Service Code
|
CPT 33902
|
| Hospital Charge Code |
906811902
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,908.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12,913.00
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$29,952.68
|
| Rate for Payer: Blue Distinction Transplant |
$28,653.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$21,908.96
|
| Rate for Payer: Cash Price |
$21,490.20
|
| Rate for Payer: Cash Price |
$21,490.20
|
| Rate for Payer: Cash Price |
$21,490.20
|
| Rate for Payer: Central Health Plan Commercial |
$38,204.80
|
| Rate for Payer: Cigna of CA PPO |
$35,339.44
|
| 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 |
$40,592.60
|
| Rate for Payer: Global Benefits Group Commercial |
$28,653.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,980.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$35,817.00
|
| 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 |
$31,853.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21,908.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,551.20
|
| 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 |
$35,817.00
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: Networks By Design Commercial |
$31,041.40
|
| Rate for Payer: Preferred Health Network WC |
$30,563.96
|
| Rate for Payer: Prime Health Services Commercial |
$40,592.60
|
| Rate for Payer: Prime Health Services Medicare |
$23,223.50
|
| Rate for Payer: Prime Health Services WC |
$29,647.04
|
| Rate for Payer: Riverside University Health System MISP |
$24,099.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28,653.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| 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 PERC PULM ART STENT ABN UNI
|
Facility
|
IP
|
$47,756.00
|
|
|
Service Code
|
CPT 33902
|
| Hospital Charge Code |
906820322
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$9,551.20 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$21,490.20
|
| Rate for Payer: Cash Price |
$21,490.20
|
| Rate for Payer: Central Health Plan Commercial |
$38,204.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,102.40
|
| Rate for Payer: Galaxy Health WC |
$40,592.60
|
| Rate for Payer: Global Benefits Group Commercial |
$28,653.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$42,980.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31,853.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,195.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,551.20
|
| Rate for Payer: Multiplan Commercial |
$35,817.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$40,592.60
|
|
|
HC PERC PULM ART STENT EA ADD ABN OR NRM
|
Facility
|
OP
|
$15,532.00
|
|
|
Service Code
|
CPT 33904
|
| Hospital Charge Code |
906811904
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$13,978.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,202.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,542.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,542.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,520.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,176.31
|
| Rate for Payer: Blue Distinction Transplant |
$9,319.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$6,989.40
|
| Rate for Payer: Cash Price |
$6,989.40
|
| Rate for Payer: Cash Price |
$6,989.40
|
| Rate for Payer: Central Health Plan Commercial |
$12,425.60
|
| Rate for Payer: Cigna of CA PPO |
$11,493.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,202.20
|
| Rate for Payer: Dignity Health Media |
$13,202.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,202.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,212.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,212.80
|
| Rate for Payer: Galaxy Health WC |
$13,202.20
|
| Rate for Payer: Global Benefits Group Commercial |
$9,319.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,978.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,649.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,436.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,359.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,106.40
|
| Rate for Payer: Multiplan Commercial |
$11,649.00
|
| Rate for Payer: Networks By Design Commercial |
$10,095.80
|
| Rate for Payer: Prime Health Services Commercial |
$13,202.20
|
| Rate for Payer: Riverside University Health System MISP |
$6,212.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,319.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,202.20
|
| Rate for Payer: Vantage Medical Group Senior |
$13,202.20
|
|
|
HC PERC PULM ART STENT EA ADD ABN OR NRM
|
Facility
|
IP
|
$15,532.00
|
|
|
Service Code
|
CPT 33904
|
| Hospital Charge Code |
906820327
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,106.40 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$6,989.40
|
| Rate for Payer: Cash Price |
$6,989.40
|
| Rate for Payer: Central Health Plan Commercial |
$12,425.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,212.80
|
| Rate for Payer: Galaxy Health WC |
$13,202.20
|
| Rate for Payer: Global Benefits Group Commercial |
$9,319.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,978.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,359.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,917.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,106.40
|
| Rate for Payer: Multiplan Commercial |
$11,649.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$13,202.20
|
|
|
HC PERC PULM ART STENT EA ADD ABN OR NRM
|
Facility
|
IP
|
$15,532.00
|
|
|
Service Code
|
CPT 33904
|
| Hospital Charge Code |
906811904
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,106.40 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$6,989.40
|
| Rate for Payer: Cash Price |
$6,989.40
|
| Rate for Payer: Central Health Plan Commercial |
$12,425.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,212.80
|
| Rate for Payer: Galaxy Health WC |
$13,202.20
|
| Rate for Payer: Global Benefits Group Commercial |
$9,319.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,978.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,359.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,917.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,106.40
|
| Rate for Payer: Multiplan Commercial |
$11,649.00
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$13,202.20
|
|
|
HC PERC PULM ART STENT EA ADD ABN OR NRM
|
Facility
|
OP
|
$15,532.00
|
|
|
Service Code
|
CPT 33904
|
| Hospital Charge Code |
906820327
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$13,978.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,202.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,542.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,542.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7,520.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,176.31
|
| Rate for Payer: Blue Distinction Transplant |
$9,319.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$6,989.40
|
| Rate for Payer: Cash Price |
$6,989.40
|
| Rate for Payer: Cash Price |
$6,989.40
|
| Rate for Payer: Central Health Plan Commercial |
$12,425.60
|
| Rate for Payer: Cigna of CA PPO |
$11,493.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,202.20
|
| Rate for Payer: Dignity Health Media |
$13,202.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,202.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,212.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,212.80
|
| Rate for Payer: Galaxy Health WC |
$13,202.20
|
| Rate for Payer: Global Benefits Group Commercial |
$9,319.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,978.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11,649.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,436.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,359.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,106.40
|
| Rate for Payer: Multiplan Commercial |
$11,649.00
|
| Rate for Payer: Networks By Design Commercial |
$10,095.80
|
| Rate for Payer: Prime Health Services Commercial |
$13,202.20
|
| Rate for Payer: Riverside University Health System MISP |
$6,212.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,319.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,202.20
|
| Rate for Payer: Vantage Medical Group Senior |
$13,202.20
|
|
|
HC PERC PULM ART STENT NRM BI
|
Facility
|
IP
|
$31,065.00
|
|
|
Service Code
|
CPT 33901
|
| Hospital Charge Code |
906820325
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,213.00 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Central Health Plan Commercial |
$24,852.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,426.00
|
| Rate for Payer: Galaxy Health WC |
$26,405.25
|
| Rate for Payer: Global Benefits Group Commercial |
$18,639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,958.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,720.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,835.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,213.00
|
| Rate for Payer: Multiplan Commercial |
$23,298.75
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$26,405.25
|
|
|
HC PERC PULM ART STENT NRM BI
|
Facility
|
OP
|
$31,065.00
|
|
|
Service Code
|
CPT 33901
|
| Hospital Charge Code |
906811901
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: Blue Distinction Transplant |
$18,639.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Central Health Plan Commercial |
$24,852.00
|
| Rate for Payer: Cigna of CA PPO |
$22,988.10
|
| 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 |
$26,405.25
|
| Rate for Payer: Global Benefits Group Commercial |
$18,639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,958.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$23,298.75
|
| 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 |
$20,720.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,213.00
|
| 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 |
$23,298.75
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$20,192.25
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$26,405.25
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,639.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| 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 PERC PULM ART STENT NRM BI
|
Facility
|
IP
|
$31,065.00
|
|
|
Service Code
|
CPT 33901
|
| Hospital Charge Code |
906811901
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,213.00 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Central Health Plan Commercial |
$24,852.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,426.00
|
| Rate for Payer: Galaxy Health WC |
$26,405.25
|
| Rate for Payer: Global Benefits Group Commercial |
$18,639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,958.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,720.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,835.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,213.00
|
| Rate for Payer: Multiplan Commercial |
$23,298.75
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$26,405.25
|
|
|
HC PERC PULM ART STENT NRM BI
|
Facility
|
OP
|
$31,065.00
|
|
|
Service Code
|
CPT 33901
|
| Hospital Charge Code |
906820325
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: Blue Distinction Transplant |
$18,639.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Central Health Plan Commercial |
$24,852.00
|
| Rate for Payer: Cigna of CA PPO |
$22,988.10
|
| 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 |
$26,405.25
|
| Rate for Payer: Global Benefits Group Commercial |
$18,639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,958.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$23,298.75
|
| 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 |
$20,720.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,213.00
|
| 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 |
$23,298.75
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$20,192.25
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$26,405.25
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,639.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| 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 PERC PULM ART STENT NRM UNI
|
Facility
|
IP
|
$31,065.00
|
|
|
Service Code
|
CPT 33900
|
| Hospital Charge Code |
906811900
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,213.00 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Central Health Plan Commercial |
$24,852.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,426.00
|
| Rate for Payer: Galaxy Health WC |
$26,405.25
|
| Rate for Payer: Global Benefits Group Commercial |
$18,639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,958.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,720.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,835.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,213.00
|
| Rate for Payer: Multiplan Commercial |
$23,298.75
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$26,405.25
|
|
|
HC PERC PULM ART STENT NRM UNI
|
Facility
|
OP
|
$31,065.00
|
|
|
Service Code
|
CPT 33900
|
| Hospital Charge Code |
906811900
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: Blue Distinction Transplant |
$18,639.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Central Health Plan Commercial |
$24,852.00
|
| Rate for Payer: Cigna of CA PPO |
$22,988.10
|
| 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 |
$26,405.25
|
| Rate for Payer: Global Benefits Group Commercial |
$18,639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,958.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$23,298.75
|
| 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 |
$20,720.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,213.00
|
| 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 |
$23,298.75
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$20,192.25
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$26,405.25
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,639.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| 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 PERC PULM ART STENT NRM UNI
|
Facility
|
IP
|
$31,065.00
|
|
|
Service Code
|
CPT 33900
|
| Hospital Charge Code |
906820324
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,213.00 |
| Max. Negotiated Rate |
$120,000.00 |
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Central Health Plan Commercial |
$24,852.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,426.00
|
| Rate for Payer: Galaxy Health WC |
$26,405.25
|
| Rate for Payer: Global Benefits Group Commercial |
$18,639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,958.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20,720.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,835.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,213.00
|
| Rate for Payer: Multiplan Commercial |
$23,298.75
|
| Rate for Payer: Networks By Design Commercial |
$120,000.00
|
| Rate for Payer: Prime Health Services Commercial |
$26,405.25
|
|
|
HC PERC PULM ART STENT NRM UNI
|
Facility
|
OP
|
$31,065.00
|
|
|
Service Code
|
CPT 33900
|
| Hospital Charge Code |
906820324
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$5,465.14 |
| Max. Negotiated Rate |
$48,045.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,745.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9,620.00
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$18,791.68
|
| Rate for Payer: Blue Distinction Transplant |
$18,639.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$13,745.22
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Cash Price |
$13,979.25
|
| Rate for Payer: Central Health Plan Commercial |
$24,852.00
|
| Rate for Payer: Cigna of CA PPO |
$22,988.10
|
| 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 |
$26,405.25
|
| Rate for Payer: Global Benefits Group Commercial |
$18,639.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27,958.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$23,298.75
|
| 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 |
$20,720.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13,745.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,213.00
|
| 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 |
$23,298.75
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: Networks By Design Commercial |
$20,192.25
|
| Rate for Payer: Preferred Health Network WC |
$19,175.18
|
| Rate for Payer: Prime Health Services Commercial |
$26,405.25
|
| Rate for Payer: Prime Health Services Medicare |
$14,569.93
|
| Rate for Payer: Prime Health Services WC |
$18,599.92
|
| Rate for Payer: Riverside University Health System MISP |
$15,119.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18,639.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$29,673.00
|
| Rate for Payer: United Healthcare All Other HMO |
$48,045.00
|
| Rate for Payer: United Healthcare HMO Rider |
$31,101.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28,895.00
|
| 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 PERC RF ABLATION, LUNG
|
Facility
|
OP
|
$20,559.00
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
909081840
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,209.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,209.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: Blue Distinction Transplant |
$12,335.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$7,209.21
|
| Rate for Payer: Cash Price |
$9,251.55
|
| Rate for Payer: Cash Price |
$9,251.55
|
| Rate for Payer: Central Health Plan Commercial |
$16,447.20
|
| Rate for Payer: Cigna of CA PPO |
$15,213.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Dignity Health Media |
$7,209.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,930.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,732.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,209.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,209.21
|
| Rate for Payer: Galaxy Health WC |
$17,475.15
|
| Rate for Payer: Global Benefits Group Commercial |
$12,335.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,503.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$15,419.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,823.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,895.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,209.21
|
| Rate for Payer: InnovAge PACE Commercial |
$10,813.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,712.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,920.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,209.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,111.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,660.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,660.34
|
| Rate for Payer: Multiplan Commercial |
$15,419.25
|
| Rate for Payer: Networks By Design Commercial |
$13,363.35
|
| Rate for Payer: Prime Health Services Commercial |
$17,475.15
|
| Rate for Payer: Prime Health Services Medicare |
$7,641.76
|
| Rate for Payer: Riverside University Health System MISP |
$7,930.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,335.40
|
| 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 |
$10,813.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Vantage Medical Group Senior |
$7,209.21
|
|
|
HC PERC RF ABLATION, LUNG
|
Facility
|
IP
|
$20,559.00
|
|
|
Service Code
|
CPT 32998
|
| Hospital Charge Code |
909081840
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,111.80 |
| Max. Negotiated Rate |
$18,503.10 |
| Rate for Payer: Cash Price |
$9,251.55
|
| Rate for Payer: Central Health Plan Commercial |
$16,447.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,223.60
|
| Rate for Payer: Galaxy Health WC |
$17,475.15
|
| Rate for Payer: Global Benefits Group Commercial |
$12,335.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,503.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13,712.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,832.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,111.80
|
| Rate for Payer: Multiplan Commercial |
$15,419.25
|
| Rate for Payer: Networks By Design Commercial |
$13,363.35
|
| Rate for Payer: Prime Health Services Commercial |
$17,475.15
|
|
|
HC PERC RF ABLATION, RENAL TUMOR
|
Facility
|
OP
|
$19,295.00
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
909081854
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,859.00 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,209.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,209.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,877.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,389.00
|
| Rate for Payer: Blue Distinction Transplant |
$11,577.00
|
| 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 |
$7,209.21
|
| Rate for Payer: Cash Price |
$8,682.75
|
| Rate for Payer: Cash Price |
$8,682.75
|
| Rate for Payer: Central Health Plan Commercial |
$15,436.00
|
| Rate for Payer: Cigna of CA PPO |
$14,278.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,813.82
|
| Rate for Payer: Dignity Health Media |
$7,209.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,930.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,732.43
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$7,209.21
|
| Rate for Payer: EPIC Health Plan Transplant |
$7,209.21
|
| Rate for Payer: Galaxy Health WC |
$16,400.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11,577.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,365.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$14,471.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,823.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,895.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,209.21
|
| Rate for Payer: InnovAge PACE Commercial |
$10,813.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,869.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,209.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,859.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,660.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,660.34
|
| Rate for Payer: Multiplan Commercial |
$14,471.25
|
| Rate for Payer: Networks By Design Commercial |
$12,541.75
|
| Rate for Payer: Prime Health Services Commercial |
$16,400.75
|
| Rate for Payer: Prime Health Services Medicare |
$7,641.76
|
| Rate for Payer: Riverside University Health System MISP |
$7,930.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11,577.00
|
| 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 |
$10,813.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,930.13
|
| Rate for Payer: Vantage Medical Group Senior |
$7,209.21
|
|
|
HC PERC RF ABLATION, RENAL TUMOR
|
Facility
|
IP
|
$19,295.00
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
909081854
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,859.00 |
| Max. Negotiated Rate |
$17,365.50 |
| Rate for Payer: Cash Price |
$8,682.75
|
| Rate for Payer: Central Health Plan Commercial |
$15,436.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,718.00
|
| Rate for Payer: Galaxy Health WC |
$16,400.75
|
| Rate for Payer: Global Benefits Group Commercial |
$11,577.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$17,365.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12,869.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7,351.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,859.00
|
| Rate for Payer: Multiplan Commercial |
$14,471.25
|
| Rate for Payer: Networks By Design Commercial |
$12,541.75
|
| Rate for Payer: Prime Health Services Commercial |
$16,400.75
|
|
|
HC PERC SKEL FIX OF FEM FRAC
|
Facility
|
OP
|
$9,970.00
|
|
|
Service Code
|
CPT 27509
|
| Hospital Charge Code |
900501086
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$111.06 |
| Max. Negotiated Rate |
$14,659.19 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8,938.53
|
| 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: Anthem Blue Cross of CA Workers' Comp |
$12,220.24
|
| Rate for Payer: Blue Distinction Transplant |
$5,982.00
|
| Rate for Payer: Caremore Medicare Advantage |
$8,938.53
|
| Rate for Payer: Cash Price |
$4,486.50
|
| Rate for Payer: Cash Price |
$4,486.50
|
| Rate for Payer: Cash Price |
$4,486.50
|
| Rate for Payer: Cash Price |
$4,486.50
|
| Rate for Payer: Central Health Plan Commercial |
$7,976.00
|
| Rate for Payer: Cigna of CA PPO |
$7,377.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Dignity Health Media |
$8,938.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,832.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,067.02
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$8,938.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$8,938.53
|
| Rate for Payer: Galaxy Health WC |
$8,474.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,982.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,973.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,477.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14,659.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,938.53
|
| Rate for Payer: InnovAge PACE Commercial |
$13,407.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,649.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$111.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,938.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,994.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11,977.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11,977.63
|
| Rate for Payer: Multiplan Commercial |
$7,477.50
|
| Rate for Payer: Multiplan WC |
$12,220.24
|
| Rate for Payer: Networks By Design Commercial |
$6,480.50
|
| Rate for Payer: Preferred Health Network WC |
$12,469.63
|
| Rate for Payer: Prime Health Services Commercial |
$8,474.50
|
| Rate for Payer: Prime Health Services Medicare |
$9,474.84
|
| Rate for Payer: Prime Health Services WC |
$12,095.54
|
| Rate for Payer: Riverside University Health System MISP |
$9,832.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,982.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,985.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,985.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,985.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,985.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,407.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,832.38
|
| Rate for Payer: Vantage Medical Group Senior |
$8,938.53
|
|
|
HC PERC SKEL FIX OF FEM FRAC
|
Facility
|
IP
|
$9,970.00
|
|
|
Service Code
|
CPT 27509
|
| Hospital Charge Code |
900501086
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,994.00 |
| Max. Negotiated Rate |
$8,973.00 |
| Rate for Payer: Blue Shield of California Commercial |
$7,477.50
|
| Rate for Payer: Cash Price |
$4,486.50
|
| Rate for Payer: Central Health Plan Commercial |
$7,976.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,988.00
|
| Rate for Payer: Galaxy Health WC |
$8,474.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,982.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,973.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,649.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,798.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,994.00
|
| Rate for Payer: Multiplan Commercial |
$7,477.50
|
| Rate for Payer: Networks By Design Commercial |
$6,480.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,474.50
|
|
