|
HC PLATELET NEUTRALIZATION
|
Facility
|
IP
|
$382.00
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
900912007
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$76.40 |
| Max. Negotiated Rate |
$343.80 |
| Rate for Payer: Cash Price |
$171.90
|
| Rate for Payer: Central Health Plan Commercial |
$305.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$152.80
|
| Rate for Payer: Galaxy Health WC |
$324.70
|
| Rate for Payer: Global Benefits Group Commercial |
$229.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$343.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$254.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$145.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.40
|
| Rate for Payer: Multiplan Commercial |
$286.50
|
| Rate for Payer: Networks By Design Commercial |
$248.30
|
| Rate for Payer: Prime Health Services Commercial |
$324.70
|
|
|
HC PLATELET NEUTRALIZATION
|
Facility
|
OP
|
$55.00
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
900912007
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$135.49 |
| Rate for Payer: Adventist Health Medi-Cal |
$17.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$131.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$111.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$135.49
|
| Rate for Payer: Blue Distinction Transplant |
$33.00
|
| Rate for Payer: Blue Shield of California Commercial |
$33.99
|
| Rate for Payer: Blue Shield of California EPN |
$26.73
|
| Rate for Payer: Caremore Medicare Advantage |
$17.98
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Cash Price |
$24.75
|
| Rate for Payer: Central Health Plan Commercial |
$44.00
|
| Rate for Payer: Cigna of CA HMO |
$35.20
|
| Rate for Payer: Cigna of CA PPO |
$40.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.97
|
| Rate for Payer: Dignity Health Media |
$17.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.27
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$17.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.98
|
| Rate for Payer: Galaxy Health WC |
$46.75
|
| Rate for Payer: Global Benefits Group Commercial |
$33.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$41.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$29.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.98
|
| Rate for Payer: InnovAge PACE Commercial |
$26.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.09
|
| Rate for Payer: Multiplan Commercial |
$41.25
|
| Rate for Payer: Networks By Design Commercial |
$35.75
|
| Rate for Payer: Prime Health Services Commercial |
$46.75
|
| Rate for Payer: Prime Health Services Medicare |
$19.06
|
| Rate for Payer: Riverside University Health System MISP |
$19.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.56
|
| Rate for Payer: United Healthcare All Other HMO |
$14.56
|
| Rate for Payer: United Healthcare HMO Rider |
$14.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.78
|
| Rate for Payer: Vantage Medical Group Senior |
$17.98
|
|
|
HC PLATELET PED PAK ALIQUOT
|
Facility
|
OP
|
$1,151.00
|
|
|
Service Code
|
CPT P9011
|
| Hospital Charge Code |
900904532
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$195.48 |
| Max. Negotiated Rate |
$1,035.90 |
| Rate for Payer: Adventist Health Medi-Cal |
$195.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$338.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$293.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$215.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$195.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$557.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$680.01
|
| Rate for Payer: Blue Distinction Transplant |
$690.60
|
| Rate for Payer: Blue Shield of California Commercial |
$723.98
|
| Rate for Payer: Blue Shield of California EPN |
$562.84
|
| Rate for Payer: Caremore Medicare Advantage |
$195.48
|
| Rate for Payer: Cash Price |
$517.95
|
| Rate for Payer: Cash Price |
$517.95
|
| Rate for Payer: Cash Price |
$517.95
|
| Rate for Payer: Central Health Plan Commercial |
$920.80
|
| Rate for Payer: Cigna of CA HMO |
$736.64
|
| Rate for Payer: Cigna of CA PPO |
$851.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$293.22
|
| Rate for Payer: Dignity Health Media |
$195.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$215.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.90
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$195.48
|
| Rate for Payer: EPIC Health Plan Transplant |
$195.48
|
| Rate for Payer: Galaxy Health WC |
$978.35
|
| Rate for Payer: Global Benefits Group Commercial |
$690.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,035.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$863.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$320.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$322.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$195.48
|
| Rate for Payer: InnovAge PACE Commercial |
$293.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$767.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$283.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$195.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.94
|
| Rate for Payer: Multiplan Commercial |
$863.25
|
| Rate for Payer: Networks By Design Commercial |
$748.15
|
| Rate for Payer: Prime Health Services Commercial |
$978.35
|
| Rate for Payer: Prime Health Services Medicare |
$207.21
|
| Rate for Payer: Riverside University Health System MISP |
$215.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$690.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$690.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$293.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$215.03
|
| Rate for Payer: Vantage Medical Group Senior |
$195.48
|
|
|
HC PLATELET PED PAK ALIQUOT
|
Facility
|
IP
|
$1,151.00
|
|
|
Service Code
|
CPT P9011
|
| Hospital Charge Code |
900904532
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$230.20 |
| Max. Negotiated Rate |
$1,035.90 |
| Rate for Payer: Cash Price |
$517.95
|
| Rate for Payer: Central Health Plan Commercial |
$920.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$460.40
|
| Rate for Payer: Galaxy Health WC |
$978.35
|
| Rate for Payer: Global Benefits Group Commercial |
$690.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,035.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$767.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$438.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.20
|
| Rate for Payer: Multiplan Commercial |
$863.25
|
| Rate for Payer: Networks By Design Commercial |
$748.15
|
| Rate for Payer: Prime Health Services Commercial |
$978.35
|
|
|
HC PLATELET SURVIVAL
|
Facility
|
IP
|
$948.00
|
|
|
Service Code
|
CPT 78191
|
| Hospital Charge Code |
909301642
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$189.60 |
| Max. Negotiated Rate |
$853.20 |
| Rate for Payer: Cash Price |
$426.60
|
| Rate for Payer: Central Health Plan Commercial |
$758.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$379.20
|
| Rate for Payer: Galaxy Health WC |
$805.80
|
| Rate for Payer: Global Benefits Group Commercial |
$568.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$853.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$632.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$361.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.60
|
| Rate for Payer: Multiplan Commercial |
$711.00
|
| Rate for Payer: Networks By Design Commercial |
$616.20
|
| Rate for Payer: Prime Health Services Commercial |
$805.80
|
|
|
HC PLATELET SURVIVAL
|
Facility
|
OP
|
$948.00
|
|
|
Service Code
|
CPT 78191
|
| Hospital Charge Code |
909301642
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$189.60 |
| Max. Negotiated Rate |
$1,526.91 |
| Rate for Payer: Adventist Health Medi-Cal |
$515.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$821.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$515.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,526.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$560.08
|
| Rate for Payer: Blue Distinction Transplant |
$568.80
|
| Rate for Payer: Blue Shield of California Commercial |
$585.86
|
| Rate for Payer: Blue Shield of California EPN |
$460.73
|
| Rate for Payer: Caremore Medicare Advantage |
$515.32
|
| Rate for Payer: Cash Price |
$426.60
|
| Rate for Payer: Cash Price |
$426.60
|
| Rate for Payer: Central Health Plan Commercial |
$758.40
|
| Rate for Payer: Cigna of CA HMO |
$606.72
|
| Rate for Payer: Cigna of CA PPO |
$701.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$772.98
|
| Rate for Payer: Dignity Health Media |
$515.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$566.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$695.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$515.32
|
| Rate for Payer: EPIC Health Plan Transplant |
$515.32
|
| Rate for Payer: Galaxy Health WC |
$805.80
|
| Rate for Payer: Global Benefits Group Commercial |
$568.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$853.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$711.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$845.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$850.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$515.32
|
| Rate for Payer: InnovAge PACE Commercial |
$772.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$632.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$515.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$690.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$690.53
|
| Rate for Payer: Multiplan Commercial |
$711.00
|
| Rate for Payer: Networks By Design Commercial |
$616.20
|
| Rate for Payer: Prime Health Services Commercial |
$805.80
|
| Rate for Payer: Prime Health Services Medicare |
$546.24
|
| Rate for Payer: Riverside University Health System MISP |
$566.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$568.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$568.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$409.89
|
| Rate for Payer: United Healthcare All Other HMO |
$409.89
|
| Rate for Payer: United Healthcare HMO Rider |
$409.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$409.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$772.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.85
|
| Rate for Payer: Vantage Medical Group Senior |
$515.32
|
|
|
HC PLCMNT ACC BILIARY TREE PERCU
|
Facility
|
OP
|
$11,134.00
|
|
|
Service Code
|
CPT 47541
|
| Hospital Charge Code |
909047541
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,054.91 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$9,452.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14,179.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10,397.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9,452.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$12,923.16
|
| Rate for Payer: Blue Distinction Transplant |
$6,680.40
|
| Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
| Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
| Rate for Payer: Caremore Medicare Advantage |
$9,452.68
|
| Rate for Payer: Cash Price |
$5,010.30
|
| Rate for Payer: Cash Price |
$5,010.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,907.20
|
| Rate for Payer: Cigna of CA PPO |
$8,239.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14,179.02
|
| Rate for Payer: Dignity Health Media |
$9,452.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$10,397.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,761.12
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$9,452.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$9,452.68
|
| Rate for Payer: Galaxy Health WC |
$9,463.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,680.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,020.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8,350.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$15,502.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15,596.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,452.68
|
| Rate for Payer: InnovAge PACE Commercial |
$14,179.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,426.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,054.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,452.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,226.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12,666.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12,666.59
|
| Rate for Payer: Multiplan Commercial |
$8,350.50
|
| Rate for Payer: Multiplan WC |
$12,923.16
|
| Rate for Payer: Networks By Design Commercial |
$7,237.10
|
| Rate for Payer: Preferred Health Network WC |
$13,186.90
|
| Rate for Payer: Prime Health Services Commercial |
$9,463.90
|
| Rate for Payer: Prime Health Services Medicare |
$10,019.84
|
| Rate for Payer: Prime Health Services WC |
$12,791.29
|
| Rate for Payer: Riverside University Health System MISP |
$10,397.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,680.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14,179.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10,397.95
|
| Rate for Payer: Vantage Medical Group Senior |
$9,452.68
|
|
|
HC PLCMNT ACC BILIARY TREE PERCU
|
Facility
|
IP
|
$11,134.00
|
|
|
Service Code
|
CPT 47541
|
| Hospital Charge Code |
909047541
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,226.80 |
| Max. Negotiated Rate |
$10,020.60 |
| Rate for Payer: Cash Price |
$5,010.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,907.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,453.60
|
| Rate for Payer: Galaxy Health WC |
$9,463.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,680.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$10,020.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,426.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,242.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,226.80
|
| Rate for Payer: Multiplan Commercial |
$8,350.50
|
| Rate for Payer: Networks By Design Commercial |
$7,237.10
|
| Rate for Payer: Prime Health Services Commercial |
$9,463.90
|
|
|
HC PLCMNT LCL DVC PERC 1ST LESION
|
Facility
|
OP
|
$1,796.00
|
|
|
Service Code
|
CPT 10035
|
| Hospital Charge Code |
909010035
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$359.20 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,077.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,109.93
|
| Rate for Payer: Blue Shield of California EPN |
$872.86
|
| Rate for Payer: Caremore Medicare Advantage |
$879.07
|
| Rate for Payer: Cash Price |
$808.20
|
| Rate for Payer: Cash Price |
$808.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,436.80
|
| Rate for Payer: Cigna of CA HMO |
$1,149.44
|
| Rate for Payer: Cigna of CA PPO |
$1,329.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Dignity Health Media |
$879.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
| Rate for Payer: Galaxy Health WC |
$1,526.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,077.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,616.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,347.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,450.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
| Rate for Payer: InnovAge PACE Commercial |
$1,318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,197.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$935.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$359.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
| Rate for Payer: Multiplan Commercial |
$1,347.00
|
| Rate for Payer: Networks By Design Commercial |
$1,167.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,526.60
|
| Rate for Payer: Prime Health Services Medicare |
$931.81
|
| Rate for Payer: Riverside University Health System MISP |
$966.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,077.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,077.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$898.00
|
| Rate for Payer: United Healthcare All Other HMO |
$898.00
|
| Rate for Payer: United Healthcare HMO Rider |
$898.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$898.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
| Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
|
HC PLCMNT LCL DVC PERC 1ST LESION
|
Facility
|
IP
|
$1,796.00
|
|
|
Service Code
|
CPT 10035
|
| Hospital Charge Code |
909010035
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$359.20 |
| Max. Negotiated Rate |
$1,616.40 |
| Rate for Payer: Cash Price |
$808.20
|
| Rate for Payer: Central Health Plan Commercial |
$1,436.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$718.40
|
| Rate for Payer: Galaxy Health WC |
$1,526.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1,077.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,616.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,197.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$684.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$359.20
|
| Rate for Payer: Multiplan Commercial |
$1,347.00
|
| Rate for Payer: Networks By Design Commercial |
$1,167.40
|
| Rate for Payer: Prime Health Services Commercial |
$1,526.60
|
|
|
HC PLCMNT LCL DVC PERC ADD LESION
|
Facility
|
OP
|
$898.00
|
|
|
Service Code
|
CPT 10036
|
| Hospital Charge Code |
909010036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$179.60 |
| Max. Negotiated Rate |
$4,846.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$763.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$493.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$538.80
|
| Rate for Payer: Blue Shield of California Commercial |
$554.96
|
| Rate for Payer: Blue Shield of California EPN |
$436.43
|
| Rate for Payer: Cash Price |
$404.10
|
| Rate for Payer: Cash Price |
$404.10
|
| Rate for Payer: Central Health Plan Commercial |
$718.40
|
| Rate for Payer: Cigna of CA HMO |
$574.72
|
| Rate for Payer: Cigna of CA PPO |
$664.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$763.30
|
| Rate for Payer: Dignity Health Media |
$763.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$763.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$359.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$359.20
|
| Rate for Payer: Galaxy Health WC |
$763.30
|
| Rate for Payer: Global Benefits Group Commercial |
$538.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$808.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$673.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$314.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$598.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$818.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.60
|
| Rate for Payer: Multiplan Commercial |
$673.50
|
| Rate for Payer: Networks By Design Commercial |
$583.70
|
| Rate for Payer: Prime Health Services Commercial |
$763.30
|
| Rate for Payer: Riverside University Health System MISP |
$359.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$538.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$538.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$449.00
|
| Rate for Payer: United Healthcare All Other HMO |
$449.00
|
| Rate for Payer: United Healthcare HMO Rider |
$449.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$449.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$763.30
|
| Rate for Payer: Vantage Medical Group Senior |
$763.30
|
|
|
HC PLCMNT LCL DVC PERC ADD LESION
|
Facility
|
IP
|
$898.00
|
|
|
Service Code
|
CPT 10036
|
| Hospital Charge Code |
909010036
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$179.60 |
| Max. Negotiated Rate |
$808.20 |
| Rate for Payer: Cash Price |
$404.10
|
| Rate for Payer: Central Health Plan Commercial |
$718.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$359.20
|
| Rate for Payer: Galaxy Health WC |
$763.30
|
| Rate for Payer: Global Benefits Group Commercial |
$538.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$808.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$598.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$342.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.60
|
| Rate for Payer: Multiplan Commercial |
$673.50
|
| Rate for Payer: Networks By Design Commercial |
$583.70
|
| Rate for Payer: Prime Health Services Commercial |
$763.30
|
|
|
HC PLCMNT NEPH CATH PERCU
|
Facility
|
IP
|
$13,406.00
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
909050432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,681.20 |
| Max. Negotiated Rate |
$12,065.40 |
| Rate for Payer: Cash Price |
$6,032.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,724.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,362.40
|
| Rate for Payer: Galaxy Health WC |
$11,395.10
|
| Rate for Payer: Global Benefits Group Commercial |
$8,043.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,065.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,941.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,107.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,681.20
|
| Rate for Payer: Multiplan Commercial |
$10,054.50
|
| Rate for Payer: Networks By Design Commercial |
$8,713.90
|
| Rate for Payer: Prime Health Services Commercial |
$11,395.10
|
|
|
HC PLCMNT NEPH CATH PERCU
|
Facility
|
OP
|
$13,406.00
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
909050432
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,469.92 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,544.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,544.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$8,043.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,544.87
|
| Rate for Payer: Cash Price |
$6,032.70
|
| Rate for Payer: Cash Price |
$6,032.70
|
| Rate for Payer: Central Health Plan Commercial |
$10,724.80
|
| Rate for Payer: Cigna of CA PPO |
$9,920.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Dignity Health Media |
$2,544.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,799.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,435.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,544.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,544.87
|
| Rate for Payer: Galaxy Health WC |
$11,395.10
|
| Rate for Payer: Global Benefits Group Commercial |
$8,043.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$12,065.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10,054.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,173.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,199.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,544.87
|
| Rate for Payer: InnovAge PACE Commercial |
$3,817.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,941.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,469.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,544.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,681.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,410.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,410.13
|
| Rate for Payer: Multiplan Commercial |
$10,054.50
|
| Rate for Payer: Networks By Design Commercial |
$8,713.90
|
| Rate for Payer: Prime Health Services Commercial |
$11,395.10
|
| Rate for Payer: Prime Health Services Medicare |
$2,697.56
|
| Rate for Payer: Riverside University Health System MISP |
$2,799.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8,043.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Vantage Medical Group Senior |
$2,544.87
|
|
|
HC PLCMNT NEPHU CATH PERCU
|
Facility
|
IP
|
$7,705.00
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
909050433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,541.00 |
| Max. Negotiated Rate |
$6,934.50 |
| Rate for Payer: Cash Price |
$3,467.25
|
| Rate for Payer: Central Health Plan Commercial |
$6,164.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,082.00
|
| Rate for Payer: Galaxy Health WC |
$6,549.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,623.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,934.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,139.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,935.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,541.00
|
| Rate for Payer: Multiplan Commercial |
$5,778.75
|
| Rate for Payer: Networks By Design Commercial |
$5,008.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,549.25
|
|
|
HC PLCMNT NEPHU CATH PERCU
|
Facility
|
OP
|
$7,705.00
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
909050433
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,541.00 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,355.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,533.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,791.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,355.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,623.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$4,355.72
|
| Rate for Payer: Cash Price |
$3,467.25
|
| Rate for Payer: Cash Price |
$3,467.25
|
| Rate for Payer: Central Health Plan Commercial |
$6,164.00
|
| Rate for Payer: Cigna of CA PPO |
$5,701.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,533.58
|
| Rate for Payer: Dignity Health Media |
$4,355.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,791.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,880.22
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,355.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,355.72
|
| Rate for Payer: Galaxy Health WC |
$6,549.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4,623.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,934.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,778.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7,143.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,186.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,355.72
|
| Rate for Payer: InnovAge PACE Commercial |
$6,533.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,139.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,982.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,355.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,541.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,836.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,836.66
|
| Rate for Payer: Multiplan Commercial |
$5,778.75
|
| Rate for Payer: Networks By Design Commercial |
$5,008.25
|
| Rate for Payer: Prime Health Services Commercial |
$6,549.25
|
| Rate for Payer: Prime Health Services Medicare |
$4,617.06
|
| Rate for Payer: Riverside University Health System MISP |
$4,791.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,623.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,533.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,791.29
|
| Rate for Payer: Vantage Medical Group Senior |
$4,355.72
|
|
|
HC PLCMNT TRANSESOPHEAGEAL PROBE
|
Facility
|
IP
|
$2,419.00
|
|
|
Service Code
|
CPT 93316
|
| Hospital Charge Code |
900501593
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$483.80 |
| Max. Negotiated Rate |
$2,177.10 |
| Rate for Payer: Cash Price |
$1,088.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,935.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$967.60
|
| Rate for Payer: Galaxy Health WC |
$2,056.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,451.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,177.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,613.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$921.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$483.80
|
| Rate for Payer: Multiplan Commercial |
$1,814.25
|
| Rate for Payer: Networks By Design Commercial |
$1,572.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,056.15
|
|
|
HC PLCMNT TRANSESOPHEAGEAL PROBE
|
Facility
|
OP
|
$2,419.00
|
|
|
Service Code
|
CPT 93316
|
| Hospital Charge Code |
900501593
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$254.45 |
| Max. Negotiated Rate |
$2,356.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$254.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$758.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$689.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$1,451.40
|
| Rate for Payer: Caremore Medicare Advantage |
$689.28
|
| Rate for Payer: Cash Price |
$1,088.55
|
| Rate for Payer: Cash Price |
$1,088.55
|
| Rate for Payer: Cash Price |
$1,088.55
|
| Rate for Payer: Cash Price |
$1,088.55
|
| Rate for Payer: Central Health Plan Commercial |
$1,935.20
|
| Rate for Payer: Cigna of CA PPO |
$1,790.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Dignity Health Media |
$689.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$758.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$930.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$689.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$689.28
|
| Rate for Payer: Galaxy Health WC |
$2,056.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1,451.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,177.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,814.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,130.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$689.28
|
| Rate for Payer: InnovAge PACE Commercial |
$1,033.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,613.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$921.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$689.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$483.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$923.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$923.64
|
| Rate for Payer: Multiplan Commercial |
$1,814.25
|
| Rate for Payer: Networks By Design Commercial |
$1,572.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,056.15
|
| Rate for Payer: Prime Health Services Medicare |
$730.64
|
| Rate for Payer: Riverside University Health System MISP |
$758.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,451.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,209.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,209.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,209.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,209.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,033.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$758.21
|
| Rate for Payer: Vantage Medical Group Senior |
$689.28
|
|
|
HC PLCMT CENTRLY INSERT TUN CVP GT 5YR
|
Facility
|
OP
|
$12,581.00
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
909080010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$257.70 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$7,548.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$5,661.45
|
| Rate for Payer: Cash Price |
$5,661.45
|
| Rate for Payer: Central Health Plan Commercial |
$10,064.80
|
| Rate for Payer: Cigna of CA PPO |
$9,309.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Media |
$3,982.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,376.44
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,982.55
|
| Rate for Payer: Galaxy Health WC |
$10,693.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7,548.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,322.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,435.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,571.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,982.55
|
| Rate for Payer: InnovAge PACE Commercial |
$5,973.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,391.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$257.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,516.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$9,435.75
|
| Rate for Payer: Networks By Design Commercial |
$8,177.65
|
| Rate for Payer: Prime Health Services Commercial |
$10,693.85
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,548.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC PLCMT CENTRLY INSERT TUN CVP GT 5YR
|
Facility
|
IP
|
$12,581.00
|
|
|
Service Code
|
CPT 36558
|
| Hospital Charge Code |
909080010
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,516.20 |
| Max. Negotiated Rate |
$11,322.90 |
| Rate for Payer: Cash Price |
$5,661.45
|
| Rate for Payer: Central Health Plan Commercial |
$10,064.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,032.40
|
| Rate for Payer: Galaxy Health WC |
$10,693.85
|
| Rate for Payer: Global Benefits Group Commercial |
$7,548.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,322.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,391.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,793.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,516.20
|
| Rate for Payer: Multiplan Commercial |
$9,435.75
|
| Rate for Payer: Networks By Design Commercial |
$8,177.65
|
| Rate for Payer: Prime Health Services Commercial |
$10,693.85
|
|
|
HC PLCMT CENTRLY INSERT TUN CVP LT 5YR
|
Facility
|
OP
|
$10,034.00
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
909081359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$262.98 |
| Max. Negotiated Rate |
$27,445.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,866.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,866.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,020.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$6,866.07
|
| Rate for Payer: Cash Price |
$4,515.30
|
| Rate for Payer: Cash Price |
$4,515.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,027.20
|
| Rate for Payer: Cigna of CA PPO |
$7,425.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,299.10
|
| Rate for Payer: Dignity Health Media |
$6,866.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,552.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,269.19
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$6,866.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$6,866.07
|
| Rate for Payer: Galaxy Health WC |
$8,528.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,020.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,030.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$7,525.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,260.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,329.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,866.07
|
| Rate for Payer: InnovAge PACE Commercial |
$10,299.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,692.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$262.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,866.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,006.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,200.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,200.53
|
| Rate for Payer: Multiplan Commercial |
$7,525.50
|
| Rate for Payer: Networks By Design Commercial |
$6,522.10
|
| Rate for Payer: Prime Health Services Commercial |
$8,528.90
|
| Rate for Payer: Prime Health Services Medicare |
$7,278.03
|
| Rate for Payer: Riverside University Health System MISP |
$7,552.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,020.40
|
| 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 |
$10,299.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,552.68
|
| Rate for Payer: Vantage Medical Group Senior |
$6,866.07
|
|
|
HC PLCMT CENTRLY INSERT TUN CVP LT 5YR
|
Facility
|
IP
|
$10,034.00
|
|
|
Service Code
|
CPT 36557
|
| Hospital Charge Code |
909081359
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,006.80 |
| Max. Negotiated Rate |
$9,030.60 |
| Rate for Payer: Cash Price |
$4,515.30
|
| Rate for Payer: Central Health Plan Commercial |
$8,027.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,013.60
|
| Rate for Payer: Galaxy Health WC |
$8,528.90
|
| Rate for Payer: Global Benefits Group Commercial |
$6,020.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,030.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,692.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,822.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,006.80
|
| Rate for Payer: Multiplan Commercial |
$7,525.50
|
| Rate for Payer: Networks By Design Commercial |
$6,522.10
|
| Rate for Payer: Prime Health Services Commercial |
$8,528.90
|
|
|
HC PLCMT OF ENTRSTMY OR CECSTMY TUBE
|
Facility
|
IP
|
$4,179.00
|
|
|
Service Code
|
CPT 44300
|
| Hospital Charge Code |
906744300
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$835.80 |
| Max. Negotiated Rate |
$3,761.10 |
| Rate for Payer: Cash Price |
$1,880.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,343.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,671.60
|
| Rate for Payer: Galaxy Health WC |
$3,552.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,507.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,761.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,787.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,592.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$835.80
|
| Rate for Payer: Multiplan Commercial |
$3,134.25
|
| Rate for Payer: Networks By Design Commercial |
$2,716.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,552.15
|
|
|
HC PLCMT OF ENTRSTMY OR CECSTMY TUBE
|
Facility
|
OP
|
$4,179.00
|
|
|
Service Code
|
CPT 44300
|
| Hospital Charge Code |
906744300
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$681.19 |
| Max. Negotiated Rate |
$8,017.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,552.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,298.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,298.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Distinction Transplant |
$2,507.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Cash Price |
$1,880.55
|
| Rate for Payer: Cash Price |
$1,880.55
|
| Rate for Payer: Central Health Plan Commercial |
$3,343.20
|
| Rate for Payer: Cigna of CA PPO |
$3,092.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,552.15
|
| Rate for Payer: Dignity Health Media |
$3,552.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,552.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,671.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,671.60
|
| Rate for Payer: Galaxy Health WC |
$3,552.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2,507.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,761.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,134.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,462.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,787.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$681.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$835.80
|
| Rate for Payer: Multiplan Commercial |
$3,134.25
|
| Rate for Payer: Networks By Design Commercial |
$2,716.35
|
| Rate for Payer: Prime Health Services Commercial |
$3,552.15
|
| Rate for Payer: Riverside University Health System MISP |
$1,671.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,507.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,507.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,552.15
|
| Rate for Payer: Vantage Medical Group Senior |
$3,552.15
|
|
|
HC PLCMT PERIPH INSRT CV DEVC W/P
|
Facility
|
IP
|
$10,655.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
909080016
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,131.00 |
| Max. Negotiated Rate |
$9,589.50 |
| Rate for Payer: Cash Price |
$4,794.75
|
| Rate for Payer: Central Health Plan Commercial |
$8,524.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,262.00
|
| Rate for Payer: Galaxy Health WC |
$9,056.75
|
| Rate for Payer: Global Benefits Group Commercial |
$6,393.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,589.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,106.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,059.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,131.00
|
| Rate for Payer: Multiplan Commercial |
$7,991.25
|
| Rate for Payer: Networks By Design Commercial |
$6,925.75
|
| Rate for Payer: Prime Health Services Commercial |
$9,056.75
|
|
