|
HC PLCMT PERIPH INSRT CV DEVC W/P
|
Facility
|
OP
|
$10,655.00
|
|
|
Service Code
|
CPT 36571
|
| Hospital Charge Code |
909080016
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$577.03 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| 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 |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,393.00
|
| 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 |
$3,982.55
|
| Rate for Payer: Cash Price |
$4,794.75
|
| Rate for Payer: Cash Price |
$4,794.75
|
| Rate for Payer: Central Health Plan Commercial |
$8,524.00
|
| Rate for Payer: Cigna of CA PPO |
$7,884.70
|
| 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 |
$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: Health Plan of Nevada (Sierra) Other |
$7,991.25
|
| 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 |
$7,106.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$577.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,131.00
|
| 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 |
$7,991.25
|
| Rate for Payer: Networks By Design Commercial |
$6,925.75
|
| Rate for Payer: Prime Health Services Commercial |
$9,056.75
|
| 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 |
$6,393.00
|
| 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 PERIPH INSRT CV DVC W/PO
|
Facility
|
IP
|
$10,655.00
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
909080015
|
|
Hospital Revenue Code
|
450
|
| 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
|
|
|
HC PLCMT PERIPH INSRT CV DVC W/PO
|
Facility
|
OP
|
$10,655.00
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
909080015
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$9,589.50 |
| 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 |
$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 |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,393.00
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$4,794.75
|
| Rate for Payer: Cash Price |
$4,794.75
|
| Rate for Payer: Cash Price |
$4,794.75
|
| Rate for Payer: Cash Price |
$4,794.75
|
| Rate for Payer: Central Health Plan Commercial |
$8,524.00
|
| Rate for Payer: Cigna of CA PPO |
$7,884.70
|
| 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 |
$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: Health Plan of Nevada (Sierra) Other |
$7,991.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,531.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| 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 |
$7,106.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$643.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,131.00
|
| 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 |
$7,991.25
|
| Rate for Payer: Networks By Design Commercial |
$6,925.75
|
| Rate for Payer: Prime Health Services Commercial |
$9,056.75
|
| 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 |
$6,393.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,327.50
|
| Rate for Payer: United Healthcare All Other HMO |
$5,327.50
|
| Rate for Payer: United Healthcare HMO Rider |
$5,327.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,327.50
|
| 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 PERIPH INSRT CV DVC W/PO
|
Facility
|
IP
|
$10,655.00
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
909080015
|
|
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
|
|
|
HC PLCMT PERIPH INSRT CV DVC W/PO
|
Facility
|
OP
|
$10,655.00
|
|
|
Service Code
|
CPT 36570
|
| Hospital Charge Code |
909080015
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$643.00 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| 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 |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$6,393.00
|
| 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 |
$3,982.55
|
| Rate for Payer: Cash Price |
$4,794.75
|
| Rate for Payer: Cash Price |
$4,794.75
|
| Rate for Payer: Central Health Plan Commercial |
$8,524.00
|
| Rate for Payer: Cigna of CA PPO |
$7,884.70
|
| 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 |
$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: Health Plan of Nevada (Sierra) Other |
$7,991.25
|
| 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 |
$7,106.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$643.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,131.00
|
| 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 |
$7,991.25
|
| Rate for Payer: Networks By Design Commercial |
$6,925.75
|
| Rate for Payer: Prime Health Services Commercial |
$9,056.75
|
| 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 |
$6,393.00
|
| 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 PLC TUN CNTRL VAD W/SUB PRT LT 5YR
|
Facility
|
OP
|
$12,877.00
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
909080011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$498.35 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
| 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 |
$7,726.20
|
| Rate for Payer: Blue Shield of California Commercial |
$6,621.66
|
| Rate for Payer: Blue Shield of California EPN |
$4,755.97
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$5,794.65
|
| Rate for Payer: Cash Price |
$5,794.65
|
| Rate for Payer: Central Health Plan Commercial |
$10,301.60
|
| Rate for Payer: Cigna of CA PPO |
$9,528.98
|
| 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 |
$10,945.45
|
| Rate for Payer: Global Benefits Group Commercial |
$7,726.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,589.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9,657.75
|
| 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 |
$8,588.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$498.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,575.40
|
| 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 |
$9,657.75
|
| Rate for Payer: Networks By Design Commercial |
$8,370.05
|
| Rate for Payer: Prime Health Services Commercial |
$10,945.45
|
| 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 |
$7,726.20
|
| 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 PLC TUN CNTRL VAD W/SUB PRT LT 5YR
|
Facility
|
IP
|
$12,877.00
|
|
|
Service Code
|
CPT 36560
|
| Hospital Charge Code |
909080011
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,575.40 |
| Max. Negotiated Rate |
$11,589.30 |
| Rate for Payer: Cash Price |
$5,794.65
|
| Rate for Payer: Central Health Plan Commercial |
$10,301.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,150.80
|
| Rate for Payer: Galaxy Health WC |
$10,945.45
|
| Rate for Payer: Global Benefits Group Commercial |
$7,726.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,589.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,588.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,906.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,575.40
|
| Rate for Payer: Multiplan Commercial |
$9,657.75
|
| Rate for Payer: Networks By Design Commercial |
$8,370.05
|
| Rate for Payer: Prime Health Services Commercial |
$10,945.45
|
|
|
HC PLEURA BIOPSY, PERCUTANEOUS
|
Facility
|
IP
|
$3,003.00
|
|
|
Service Code
|
CPT 32400
|
| Hospital Charge Code |
909000123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$600.60 |
| Max. Negotiated Rate |
$2,702.70 |
| Rate for Payer: Cash Price |
$1,351.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,402.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,201.20
|
| Rate for Payer: Galaxy Health WC |
$2,552.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,801.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,702.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,003.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,144.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$600.60
|
| Rate for Payer: Multiplan Commercial |
$2,252.25
|
| Rate for Payer: Networks By Design Commercial |
$1,951.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,552.55
|
|
|
HC PLEURA BIOPSY, PERCUTANEOUS
|
Facility
|
OP
|
$3,003.00
|
|
|
Service Code
|
CPT 32400
|
| Hospital Charge Code |
909000123
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$254.66 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
| 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 |
$1,801.80
|
| 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 |
$2,025.69
|
| Rate for Payer: Cash Price |
$1,351.35
|
| Rate for Payer: Cash Price |
$1,351.35
|
| Rate for Payer: Central Health Plan Commercial |
$2,402.40
|
| Rate for Payer: Cigna of CA PPO |
$2,222.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Dignity Health Media |
$2,025.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
| Rate for Payer: Galaxy Health WC |
$2,552.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1,801.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,702.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,252.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
| Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,003.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$254.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$600.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
| Rate for Payer: Multiplan Commercial |
$2,252.25
|
| Rate for Payer: Networks By Design Commercial |
$1,951.95
|
| Rate for Payer: Prime Health Services Commercial |
$2,552.55
|
| Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
| Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,801.80
|
| 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 Commercial/Exchange |
$3,038.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
|
HC PLEURAL DRAIN PERC CATH WO IMAGE
|
Facility
|
OP
|
$2,290.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
909032556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$175.43 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,377.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,377.45
|
| 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 |
$1,374.00
|
| 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 |
$2,377.45
|
| Rate for Payer: Cash Price |
$1,030.50
|
| Rate for Payer: Cash Price |
$1,030.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,832.00
|
| Rate for Payer: Cigna of CA PPO |
$1,694.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Dignity Health Media |
$2,377.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,615.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,209.56
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,377.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,377.45
|
| Rate for Payer: Galaxy Health WC |
$1,946.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,374.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,061.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,717.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,899.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,922.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,377.45
|
| Rate for Payer: InnovAge PACE Commercial |
$3,566.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,527.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,377.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$458.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,185.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,185.78
|
| Rate for Payer: Multiplan Commercial |
$1,717.50
|
| Rate for Payer: Networks By Design Commercial |
$1,488.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,946.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,520.10
|
| Rate for Payer: Riverside University Health System MISP |
$2,615.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,374.00
|
| 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 Commercial/Exchange |
$3,566.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,615.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,377.45
|
|
|
HC PLEURAL DRAIN PERC CATH WO IMAGE
|
Facility
|
IP
|
$2,290.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
909032556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$458.00 |
| Max. Negotiated Rate |
$2,061.00 |
| Rate for Payer: Cash Price |
$1,030.50
|
| Rate for Payer: Central Health Plan Commercial |
$1,832.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$916.00
|
| Rate for Payer: Galaxy Health WC |
$1,946.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1,374.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,061.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,527.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$872.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$458.00
|
| Rate for Payer: Multiplan Commercial |
$1,717.50
|
| Rate for Payer: Networks By Design Commercial |
$1,488.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,946.50
|
|
|
HC PLEURAL DRAIN PLCMNT NO TUNN
|
Facility
|
OP
|
$5,150.00
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
909020159
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$192.41 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,001.01
|
| 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 |
$3,090.00
|
| 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 |
$2,001.01
|
| Rate for Payer: Cash Price |
$2,317.50
|
| Rate for Payer: Cash Price |
$2,317.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,120.00
|
| Rate for Payer: Cigna of CA PPO |
$3,811.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Dignity Health Media |
$2,001.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,201.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,701.36
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,001.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,001.01
|
| Rate for Payer: Galaxy Health WC |
$4,377.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,090.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,635.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,862.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,301.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,001.01
|
| Rate for Payer: InnovAge PACE Commercial |
$3,001.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,435.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$192.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,030.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,681.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,681.35
|
| Rate for Payer: Multiplan Commercial |
$3,862.50
|
| Rate for Payer: Networks By Design Commercial |
$3,347.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,377.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,121.07
|
| Rate for Payer: Riverside University Health System MISP |
$2,201.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,090.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC PLEURAL DRAIN PLCMNT NO TUNN
|
Facility
|
IP
|
$5,150.00
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
909020159
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,030.00 |
| Max. Negotiated Rate |
$4,635.00 |
| Rate for Payer: Cash Price |
$2,317.50
|
| Rate for Payer: Central Health Plan Commercial |
$4,120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,060.00
|
| Rate for Payer: Galaxy Health WC |
$4,377.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,090.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,635.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,435.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,962.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,030.00
|
| Rate for Payer: Multiplan Commercial |
$3,862.50
|
| Rate for Payer: Networks By Design Commercial |
$3,347.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,377.50
|
|
|
HC PLEURA VAC
|
Facility
|
OP
|
$265.00
|
|
| Hospital Charge Code |
909081710
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.00 |
| Max. Negotiated Rate |
$238.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$160.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$225.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$145.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$145.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$128.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$156.56
|
| Rate for Payer: Blue Distinction Transplant |
$159.00
|
| Rate for Payer: Blue Shield of California Commercial |
$166.68
|
| Rate for Payer: Blue Shield of California EPN |
$129.58
|
| Rate for Payer: Cash Price |
$119.25
|
| Rate for Payer: Central Health Plan Commercial |
$212.00
|
| Rate for Payer: Cigna of CA HMO |
$169.60
|
| Rate for Payer: Cigna of CA PPO |
$196.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.25
|
| Rate for Payer: Dignity Health Media |
$225.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$225.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$106.00
|
| Rate for Payer: Galaxy Health WC |
$225.25
|
| Rate for Payer: Global Benefits Group Commercial |
$159.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$198.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$92.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$176.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.00
|
| Rate for Payer: Multiplan Commercial |
$198.75
|
| Rate for Payer: Networks By Design Commercial |
$172.25
|
| Rate for Payer: Prime Health Services Commercial |
$225.25
|
| Rate for Payer: Riverside University Health System MISP |
$106.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$159.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$159.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.50
|
| Rate for Payer: United Healthcare All Other HMO |
$132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$132.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$132.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$225.25
|
| Rate for Payer: Vantage Medical Group Senior |
$225.25
|
|
|
HC PLEURA VAC
|
Facility
|
IP
|
$265.00
|
|
| Hospital Charge Code |
909081710
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.00 |
| Max. Negotiated Rate |
$238.50 |
| Rate for Payer: Cash Price |
$119.25
|
| Rate for Payer: Central Health Plan Commercial |
$212.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.00
|
| Rate for Payer: Galaxy Health WC |
$225.25
|
| Rate for Payer: Global Benefits Group Commercial |
$159.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$176.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.00
|
| Rate for Payer: Multiplan Commercial |
$198.75
|
| Rate for Payer: Networks By Design Commercial |
$172.25
|
| Rate for Payer: Prime Health Services Commercial |
$225.25
|
|
|
HC PLEURODESIS
|
Facility
|
IP
|
$2,149.00
|
|
|
Service Code
|
CPT 32560
|
| Hospital Charge Code |
909000202
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$429.80 |
| Max. Negotiated Rate |
$1,934.10 |
| Rate for Payer: Cash Price |
$967.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,719.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$859.60
|
| Rate for Payer: Galaxy Health WC |
$1,826.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,289.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,934.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,433.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$818.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.80
|
| Rate for Payer: Multiplan Commercial |
$1,611.75
|
| Rate for Payer: Networks By Design Commercial |
$1,396.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,826.65
|
|
|
HC PLEURODESIS
|
Facility
|
OP
|
$2,149.00
|
|
|
Service Code
|
CPT 32560
|
| Hospital Charge Code |
909000202
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$429.38 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$784.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$784.90
|
| 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 |
$1,289.40
|
| 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 |
$784.90
|
| Rate for Payer: Cash Price |
$967.05
|
| Rate for Payer: Cash Price |
$967.05
|
| Rate for Payer: Central Health Plan Commercial |
$1,719.20
|
| Rate for Payer: Cigna of CA PPO |
$1,590.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Dignity Health Media |
$784.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$863.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,059.62
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$784.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$784.90
|
| Rate for Payer: Galaxy Health WC |
$1,826.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1,289.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,934.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,611.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,287.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,295.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$784.90
|
| Rate for Payer: InnovAge PACE Commercial |
$1,177.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,433.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$429.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$784.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$429.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,051.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,051.77
|
| Rate for Payer: Multiplan Commercial |
$1,611.75
|
| Rate for Payer: Networks By Design Commercial |
$1,396.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,826.65
|
| Rate for Payer: Prime Health Services Medicare |
$831.99
|
| Rate for Payer: Riverside University Health System MISP |
$863.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,289.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,177.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$863.39
|
| Rate for Payer: Vantage Medical Group Senior |
$784.90
|
|
|
HC PLEURX CHEST DRAIN
|
Facility
|
OP
|
$1,205.20
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909020015
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.04 |
| Max. Negotiated Rate |
$1,084.68 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,024.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$662.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$662.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$550.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$671.30
|
| Rate for Payer: Blue Distinction Transplant |
$723.12
|
| Rate for Payer: Blue Shield of California Commercial |
$903.90
|
| Rate for Payer: Blue Shield of California EPN |
$655.63
|
| Rate for Payer: Cash Price |
$542.34
|
| Rate for Payer: Central Health Plan Commercial |
$964.16
|
| Rate for Payer: Cigna of CA HMO |
$843.64
|
| Rate for Payer: Cigna of CA PPO |
$843.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,024.42
|
| Rate for Payer: Dignity Health Media |
$1,024.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,024.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$482.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$482.08
|
| Rate for Payer: Galaxy Health WC |
$1,024.42
|
| Rate for Payer: Global Benefits Group Commercial |
$723.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,084.68
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$903.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$421.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$803.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$459.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.04
|
| Rate for Payer: Multiplan Commercial |
$903.90
|
| Rate for Payer: Networks By Design Commercial |
$602.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,024.42
|
| Rate for Payer: Riverside University Health System MISP |
$482.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$723.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$723.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$602.60
|
| Rate for Payer: United Healthcare All Other HMO |
$602.60
|
| Rate for Payer: United Healthcare HMO Rider |
$602.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$602.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,024.42
|
| Rate for Payer: Vantage Medical Group Senior |
$1,024.42
|
|
|
HC PLEURX CHEST DRAIN
|
Facility
|
IP
|
$1,205.20
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909020015
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.04 |
| Max. Negotiated Rate |
$1,084.68 |
| Rate for Payer: Blue Shield of California EPN |
$643.58
|
| Rate for Payer: Cash Price |
$542.34
|
| Rate for Payer: Central Health Plan Commercial |
$964.16
|
| Rate for Payer: Cigna of CA HMO |
$843.64
|
| Rate for Payer: Cigna of CA PPO |
$843.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$482.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$482.08
|
| Rate for Payer: Galaxy Health WC |
$1,024.42
|
| Rate for Payer: Global Benefits Group Commercial |
$723.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,084.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$803.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$459.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$241.04
|
| Rate for Payer: Multiplan Commercial |
$903.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,024.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$455.08
|
| Rate for Payer: United Healthcare All Other HMO |
$444.48
|
| Rate for Payer: United Healthcare HMO Rider |
$434.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$397.72
|
|
|
HC PLEURX PERITONEAL DRAIN
|
Facility
|
IP
|
$1,973.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909020016
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$394.60 |
| Max. Negotiated Rate |
$1,775.70 |
| Rate for Payer: Blue Shield of California EPN |
$1,053.58
|
| Rate for Payer: Cash Price |
$887.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,578.40
|
| Rate for Payer: Cigna of CA HMO |
$1,381.10
|
| Rate for Payer: Cigna of CA PPO |
$1,381.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$789.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$789.20
|
| Rate for Payer: Galaxy Health WC |
$1,677.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,183.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,775.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,315.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$751.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$394.60
|
| Rate for Payer: Multiplan Commercial |
$1,479.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,677.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$745.00
|
| Rate for Payer: United Healthcare All Other HMO |
$727.64
|
| Rate for Payer: United Healthcare HMO Rider |
$711.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$651.09
|
|
|
HC PLEURX PERITONEAL DRAIN
|
Facility
|
OP
|
$1,973.00
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
909020016
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$394.60 |
| Max. Negotiated Rate |
$1,775.70 |
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,677.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,085.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,085.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$900.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,098.96
|
| Rate for Payer: Blue Distinction Transplant |
$1,183.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,479.75
|
| Rate for Payer: Blue Shield of California EPN |
$1,073.31
|
| Rate for Payer: Cash Price |
$887.85
|
| Rate for Payer: Central Health Plan Commercial |
$1,578.40
|
| Rate for Payer: Cigna of CA HMO |
$1,381.10
|
| Rate for Payer: Cigna of CA PPO |
$1,381.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,677.05
|
| Rate for Payer: Dignity Health Media |
$1,677.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,677.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$789.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$789.20
|
| Rate for Payer: Galaxy Health WC |
$1,677.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,183.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,775.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1,479.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$690.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,315.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$751.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$394.60
|
| Rate for Payer: Multiplan Commercial |
$1,479.75
|
| Rate for Payer: Networks By Design Commercial |
$986.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,677.05
|
| Rate for Payer: Riverside University Health System MISP |
$789.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,183.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,183.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$986.50
|
| Rate for Payer: United Healthcare All Other HMO |
$986.50
|
| Rate for Payer: United Healthcare HMO Rider |
$986.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$986.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,677.05
|
| Rate for Payer: Vantage Medical Group Senior |
$1,677.05
|
|
|
HC PLUG DECANNULATION 10.0
|
Facility
|
IP
|
$38.62
|
|
| Hospital Charge Code |
900800861
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
|
|
HC PLUG DECANNULATION 10.0
|
Facility
|
OP
|
$38.62
|
|
| Hospital Charge Code |
900800861
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.82
|
| Rate for Payer: Blue Distinction Transplant |
$23.17
|
| Rate for Payer: Blue Shield of California Commercial |
$24.29
|
| Rate for Payer: Blue Shield of California EPN |
$18.89
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: Cigna of CA HMO |
$24.72
|
| Rate for Payer: Cigna of CA PPO |
$28.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.83
|
| Rate for Payer: Dignity Health Media |
$32.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$28.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
| Rate for Payer: Riverside University Health System MISP |
$15.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.31
|
| Rate for Payer: United Healthcare All Other HMO |
$19.31
|
| Rate for Payer: United Healthcare HMO Rider |
$19.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.83
|
| Rate for Payer: Vantage Medical Group Senior |
$32.83
|
|
|
HC PLUG DECANNULATION 4.0
|
Facility
|
OP
|
$38.62
|
|
| Hospital Charge Code |
900800858
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.82
|
| Rate for Payer: Blue Distinction Transplant |
$23.17
|
| Rate for Payer: Blue Shield of California Commercial |
$24.29
|
| Rate for Payer: Blue Shield of California EPN |
$18.89
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: Cigna of CA HMO |
$24.72
|
| Rate for Payer: Cigna of CA PPO |
$28.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.83
|
| Rate for Payer: Dignity Health Media |
$32.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$28.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
| Rate for Payer: Riverside University Health System MISP |
$15.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.31
|
| Rate for Payer: United Healthcare All Other HMO |
$19.31
|
| Rate for Payer: United Healthcare HMO Rider |
$19.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.83
|
| Rate for Payer: Vantage Medical Group Senior |
$32.83
|
|
|
HC PLUG DECANNULATION 4.0
|
Facility
|
IP
|
$38.62
|
|
| Hospital Charge Code |
900800858
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
|
