|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
IP
|
$7,704.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
900501636
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,540.80 |
| Max. Negotiated Rate |
$6,933.60 |
| Rate for Payer: Adventist Health Commercial |
$1,540.80
|
| Rate for Payer: Cash Price |
$4,237.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,163.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,081.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,081.60
|
| Rate for Payer: Galaxy Health WC |
$6,548.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,622.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,933.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,138.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,935.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,768.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,540.80
|
| Rate for Payer: Multiplan Commercial |
$5,778.00
|
| Rate for Payer: Networks By Design Commercial |
$5,007.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,548.40
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
OP
|
$7,704.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
909080021
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$233.73 |
| Max. Negotiated Rate |
$6,933.60 |
| Rate for Payer: Adventist Health Commercial |
$1,540.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$785.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$785.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$4,237.20
|
| Rate for Payer: Cash Price |
$4,237.20
|
| Rate for Payer: Cash Price |
$4,237.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,163.20
|
| Rate for Payer: Cigna of CA HMO |
$4,930.56
|
| Rate for Payer: Cigna of CA PPO |
$5,700.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$864.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$785.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,060.51
|
| Rate for Payer: EPIC Health Plan Senior |
$785.56
|
| Rate for Payer: Galaxy Health WC |
$6,548.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,622.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,933.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,288.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$233.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$785.56
|
| Rate for Payer: InnovAge PACE Commercial |
$1,178.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,138.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$785.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,540.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,052.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,052.65
|
| Rate for Payer: Multiplan Commercial |
$5,778.00
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$5,007.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$785.56
|
| Rate for Payer: Preferred Health Network WC |
$1,277.20
|
| Rate for Payer: Prime Health Services Commercial |
$6,548.40
|
| Rate for Payer: Prime Health Services Medicare |
$832.69
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Riverside University Health System MISP |
$864.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,622.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$785.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Vantage Medical Group Senior |
$785.56
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
IP
|
$7,704.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
900501636
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,540.80 |
| Max. Negotiated Rate |
$6,933.60 |
| Rate for Payer: Adventist Health Commercial |
$1,540.80
|
| Rate for Payer: Cash Price |
$4,237.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,163.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,081.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,081.60
|
| Rate for Payer: Galaxy Health WC |
$6,548.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,622.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,933.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,138.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,935.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,768.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,540.80
|
| Rate for Payer: Multiplan Commercial |
$5,778.00
|
| Rate for Payer: Networks By Design Commercial |
$5,007.60
|
| Rate for Payer: Prime Health Services Commercial |
$6,548.40
|
|
|
HC REMOVE TUN CV CATH WO PORT
|
Facility
|
OP
|
$7,704.00
|
|
|
Service Code
|
CPT 36589
|
| Hospital Charge Code |
900501636
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$258.19 |
| Max. Negotiated Rate |
$6,933.60 |
| Rate for Payer: Adventist Health Commercial |
$1,540.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$785.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Cash Price |
$4,237.20
|
| Rate for Payer: Cash Price |
$4,237.20
|
| Rate for Payer: Cash Price |
$4,237.20
|
| Rate for Payer: Cash Price |
$4,237.20
|
| Rate for Payer: Central Health Plan Commercial |
$6,163.20
|
| Rate for Payer: Cigna of CA HMO |
$4,930.56
|
| Rate for Payer: Cigna of CA PPO |
$5,700.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$864.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$785.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,060.51
|
| Rate for Payer: EPIC Health Plan Senior |
$785.56
|
| Rate for Payer: Galaxy Health WC |
$6,548.40
|
| Rate for Payer: Global Benefits Group Commercial |
$4,622.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,933.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,288.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$785.56
|
| Rate for Payer: InnovAge PACE Commercial |
$1,178.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,138.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$258.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$785.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,540.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,052.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,052.65
|
| Rate for Payer: Multiplan Commercial |
$5,778.00
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$5,007.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$785.56
|
| Rate for Payer: Preferred Health Network WC |
$1,277.20
|
| Rate for Payer: Prime Health Services Commercial |
$6,548.40
|
| Rate for Payer: Prime Health Services Medicare |
$832.69
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Riverside University Health System MISP |
$864.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,622.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,852.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,852.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,852.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,852.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$785.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Vantage Medical Group Senior |
$785.56
|
|
|
HC REMOVE TUNNEL PLEURAL CATH
|
Facility
|
IP
|
$3,802.00
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
902100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$760.40 |
| Max. Negotiated Rate |
$3,421.80 |
| Rate for Payer: Adventist Health Commercial |
$760.40
|
| Rate for Payer: Cash Price |
$2,091.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,041.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,520.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,520.80
|
| Rate for Payer: Galaxy Health WC |
$3,231.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,421.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,535.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,448.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,353.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.40
|
| Rate for Payer: Multiplan Commercial |
$2,851.50
|
| Rate for Payer: Networks By Design Commercial |
$2,471.30
|
| Rate for Payer: Prime Health Services Commercial |
$3,231.70
|
|
|
HC REMOVE TUNNEL PLEURAL CATH
|
Facility
|
OP
|
$3,802.00
|
|
|
Service Code
|
CPT 32552
|
| Hospital Charge Code |
902100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$262.54 |
| Max. Negotiated Rate |
$4,460.00 |
| Rate for Payer: Adventist Health Commercial |
$760.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$785.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$785.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,840.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,232.91
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$1,251.66
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$2,091.10
|
| Rate for Payer: Cash Price |
$2,091.10
|
| Rate for Payer: Cash Price |
$2,091.10
|
| Rate for Payer: Central Health Plan Commercial |
$3,041.60
|
| Rate for Payer: Cigna of CA HMO |
$2,433.28
|
| Rate for Payer: Cigna of CA PPO |
$2,813.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$864.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$785.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,060.51
|
| Rate for Payer: EPIC Health Plan Senior |
$785.56
|
| Rate for Payer: Galaxy Health WC |
$3,231.70
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,421.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,288.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$262.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$785.56
|
| Rate for Payer: InnovAge PACE Commercial |
$1,178.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,535.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$290.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$785.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$760.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,052.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,052.65
|
| Rate for Payer: Multiplan Commercial |
$2,851.50
|
| Rate for Payer: Multiplan WC |
$1,251.66
|
| Rate for Payer: Networks By Design Commercial |
$2,471.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$785.56
|
| Rate for Payer: Preferred Health Network WC |
$1,277.20
|
| Rate for Payer: Prime Health Services Commercial |
$3,231.70
|
| Rate for Payer: Prime Health Services Medicare |
$832.69
|
| Rate for Payer: Prime Health Services WC |
$1,238.88
|
| Rate for Payer: Riverside University Health System MISP |
$864.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,281.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$785.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,178.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$864.12
|
| Rate for Payer: Vantage Medical Group Senior |
$785.56
|
|
|
HC REMOVE URETER STENT, PERCUT
|
Facility
|
OP
|
$9,770.00
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
909081851
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,954.00 |
| Max. Negotiated Rate |
$16,122.00 |
| Rate for Payer: Adventist Health Commercial |
$1,954.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,602.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,863.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,602.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,333.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$4,147.14
|
| Rate for Payer: Blue Shield of California Commercial |
$4,245.30
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Cash Price |
$5,373.50
|
| Rate for Payer: Cash Price |
$5,373.50
|
| Rate for Payer: Cash Price |
$5,373.50
|
| Rate for Payer: Central Health Plan Commercial |
$7,816.00
|
| Rate for Payer: Cigna of CA HMO |
$6,252.80
|
| Rate for Payer: Cigna of CA PPO |
$7,229.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,863.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,602.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,513.83
|
| Rate for Payer: EPIC Health Plan Senior |
$2,602.84
|
| Rate for Payer: Galaxy Health WC |
$8,304.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,862.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,793.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,268.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,266.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,602.84
|
| Rate for Payer: InnovAge PACE Commercial |
$3,904.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,516.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,503.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,602.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,954.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,487.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,487.81
|
| Rate for Payer: Multiplan Commercial |
$7,327.50
|
| Rate for Payer: Multiplan WC |
$4,147.14
|
| Rate for Payer: Networks By Design Commercial |
$6,350.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,602.84
|
| Rate for Payer: Preferred Health Network WC |
$4,231.78
|
| Rate for Payer: Prime Health Services Commercial |
$8,304.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,759.01
|
| Rate for Payer: Prime Health Services WC |
$4,104.83
|
| Rate for Payer: Riverside University Health System MISP |
$2,863.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,862.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,984.00
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,602.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,904.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,863.12
|
| Rate for Payer: Vantage Medical Group Senior |
$2,602.84
|
|
|
HC REMOVE URETER STENT, PERCUT
|
Facility
|
IP
|
$9,770.00
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
909081851
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,954.00 |
| Max. Negotiated Rate |
$8,793.00 |
| Rate for Payer: Adventist Health Commercial |
$1,954.00
|
| Rate for Payer: Cash Price |
$5,373.50
|
| Rate for Payer: Central Health Plan Commercial |
$7,816.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,908.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,908.00
|
| Rate for Payer: Galaxy Health WC |
$8,304.50
|
| Rate for Payer: Global Benefits Group Commercial |
$5,862.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,793.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,516.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,722.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,047.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,954.00
|
| Rate for Payer: Multiplan Commercial |
$7,327.50
|
| Rate for Payer: Networks By Design Commercial |
$6,350.50
|
| Rate for Payer: Prime Health Services Commercial |
$8,304.50
|
|
|
HC REMOVE VAD DIFF SESSION
|
Facility
|
IP
|
$7,217.00
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
906820233
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,443.40 |
| Max. Negotiated Rate |
$6,495.30 |
| Rate for Payer: Adventist Health Commercial |
$1,443.40
|
| Rate for Payer: Cash Price |
$3,969.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,773.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,886.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,886.80
|
| Rate for Payer: Galaxy Health WC |
$6,134.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,330.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,495.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,813.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,749.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,467.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,443.40
|
| Rate for Payer: Multiplan Commercial |
$5,412.75
|
| Rate for Payer: Networks By Design Commercial |
$4,691.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,134.45
|
|
|
HC REMOVE VAD DIFF SESSION
|
Facility
|
OP
|
$6,134.00
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
906811430
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$285.61 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,226.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,213.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,373.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,600.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,320.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,227.69
|
| Rate for Payer: Blue Shield of California EPN |
$6,020.76
|
| Rate for Payer: Cash Price |
$3,373.70
|
| Rate for Payer: Cash Price |
$3,373.70
|
| Rate for Payer: Cash Price |
$3,373.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,907.20
|
| Rate for Payer: Cigna of CA HMO |
$3,987.10
|
| Rate for Payer: Cigna of CA PPO |
$4,539.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,213.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,213.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,213.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,453.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,453.60
|
| Rate for Payer: Galaxy Health WC |
$5,213.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,680.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,520.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$285.61
|
| Rate for Payer: InnovAge PACE Commercial |
$3,067.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,091.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$315.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,796.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,226.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,293.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,293.80
|
| Rate for Payer: Multiplan Commercial |
$4,600.50
|
| Rate for Payer: Networks By Design Commercial |
$3,987.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,213.90
|
| Rate for Payer: Riverside University Health System MISP |
$2,453.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,680.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,680.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,213.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,213.90
|
| Rate for Payer: Vantage Medical Group Senior |
$5,213.90
|
|
|
HC REMOVE VAD DIFF SESSION
|
Facility
|
OP
|
$7,217.00
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
906820233
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$285.61 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$1,443.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,134.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,969.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,412.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,320.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9,227.69
|
| Rate for Payer: Blue Shield of California EPN |
$6,020.76
|
| Rate for Payer: Cash Price |
$3,969.35
|
| Rate for Payer: Cash Price |
$3,969.35
|
| Rate for Payer: Cash Price |
$3,969.35
|
| Rate for Payer: Central Health Plan Commercial |
$5,773.60
|
| Rate for Payer: Cigna of CA HMO |
$4,691.05
|
| Rate for Payer: Cigna of CA PPO |
$5,340.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,134.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,134.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,134.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,886.80
|
| Rate for Payer: EPIC Health Plan Senior |
$2,886.80
|
| Rate for Payer: Galaxy Health WC |
$6,134.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,330.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,495.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$285.61
|
| Rate for Payer: InnovAge PACE Commercial |
$3,608.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,813.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$315.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,467.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,443.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,051.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,051.90
|
| Rate for Payer: Multiplan Commercial |
$5,412.75
|
| Rate for Payer: Networks By Design Commercial |
$4,691.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,134.45
|
| Rate for Payer: Riverside University Health System MISP |
$2,886.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,330.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,330.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,134.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,134.45
|
| Rate for Payer: Vantage Medical Group Senior |
$6,134.45
|
|
|
HC REMOVE VAD DIFF SESSION
|
Facility
|
IP
|
$6,134.00
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
906811430
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,226.80 |
| Max. Negotiated Rate |
$5,520.60 |
| Rate for Payer: Adventist Health Commercial |
$1,226.80
|
| Rate for Payer: Cash Price |
$3,373.70
|
| Rate for Payer: Central Health Plan Commercial |
$4,907.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,453.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,453.60
|
| Rate for Payer: Galaxy Health WC |
$5,213.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,680.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,520.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,091.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,337.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,796.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,226.80
|
| Rate for Payer: Multiplan Commercial |
$4,600.50
|
| Rate for Payer: Networks By Design Commercial |
$3,987.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,213.90
|
|
|
HC REMOVE VENTILATING TUBE
|
Facility
|
IP
|
$7,823.00
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
900501512
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,564.60 |
| Max. Negotiated Rate |
$7,040.70 |
| Rate for Payer: Adventist Health Commercial |
$1,564.60
|
| Rate for Payer: Cash Price |
$4,302.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,258.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,129.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,129.20
|
| Rate for Payer: Galaxy Health WC |
$6,649.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,693.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,040.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,217.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,980.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,842.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,564.60
|
| Rate for Payer: Multiplan Commercial |
$5,867.25
|
| Rate for Payer: Networks By Design Commercial |
$5,084.95
|
| Rate for Payer: Prime Health Services Commercial |
$6,649.55
|
|
|
HC REMOVE VENTILATING TUBE
|
Facility
|
OP
|
$7,823.00
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
900501512
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$120.25 |
| Max. Negotiated Rate |
$7,040.70 |
| Rate for Payer: Adventist Health Commercial |
$1,564.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,120.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,565.51
|
| Rate for Payer: Cash Price |
$4,302.65
|
| Rate for Payer: Cash Price |
$4,302.65
|
| Rate for Payer: Cash Price |
$4,302.65
|
| Rate for Payer: Cash Price |
$4,302.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,258.40
|
| Rate for Payer: Cigna of CA HMO |
$5,006.72
|
| Rate for Payer: Cigna of CA PPO |
$5,789.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,532.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,120.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,562.86
|
| Rate for Payer: EPIC Health Plan Senior |
$4,120.64
|
| Rate for Payer: Galaxy Health WC |
$6,649.55
|
| Rate for Payer: Global Benefits Group Commercial |
$4,693.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,040.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,757.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,120.64
|
| Rate for Payer: InnovAge PACE Commercial |
$6,180.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,217.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,120.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,564.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,521.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,521.66
|
| Rate for Payer: Multiplan Commercial |
$5,867.25
|
| Rate for Payer: Multiplan WC |
$6,565.51
|
| Rate for Payer: Networks By Design Commercial |
$5,084.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,120.64
|
| Rate for Payer: Preferred Health Network WC |
$6,699.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,649.55
|
| Rate for Payer: Prime Health Services Medicare |
$4,367.88
|
| Rate for Payer: Prime Health Services WC |
$6,498.52
|
| Rate for Payer: Riverside University Health System MISP |
$4,532.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,693.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,911.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,911.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,911.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,911.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,120.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,180.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,532.70
|
| Rate for Payer: Vantage Medical Group Senior |
$4,120.64
|
|
|
HC REMVL TUN CVP ACCESS W SUBCU
|
Facility
|
OP
|
$8,597.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
909081361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$275.35 |
| Max. Negotiated Rate |
$7,737.30 |
| Rate for Payer: Adventist Health Commercial |
$1,719.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,973.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,144.90
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$4,728.35
|
| Rate for Payer: Cash Price |
$4,728.35
|
| Rate for Payer: Cash Price |
$4,728.35
|
| Rate for Payer: Central Health Plan Commercial |
$6,877.60
|
| Rate for Payer: Cigna of CA HMO |
$5,502.08
|
| Rate for Payer: Cigna of CA PPO |
$6,361.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,664.63
|
| Rate for Payer: EPIC Health Plan Senior |
$1,973.80
|
| Rate for Payer: Galaxy Health WC |
$7,307.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,158.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,737.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,237.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$275.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: InnovAge PACE Commercial |
$2,960.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,734.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$304.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,973.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,719.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,644.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,644.89
|
| Rate for Payer: Multiplan Commercial |
$6,447.75
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: Networks By Design Commercial |
$5,588.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Preferred Health Network WC |
$3,209.08
|
| Rate for Payer: Prime Health Services Commercial |
$7,307.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,092.23
|
| Rate for Payer: Prime Health Services WC |
$3,112.81
|
| Rate for Payer: Riverside University Health System MISP |
$2,171.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,158.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,973.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
|
HC REMVL TUN CVP ACCESS W SUBCU
|
Facility
|
IP
|
$8,597.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
909081361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,719.40 |
| Max. Negotiated Rate |
$7,737.30 |
| Rate for Payer: Adventist Health Commercial |
$1,719.40
|
| Rate for Payer: Cash Price |
$4,728.35
|
| Rate for Payer: Central Health Plan Commercial |
$6,877.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,438.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,438.80
|
| Rate for Payer: Galaxy Health WC |
$7,307.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,158.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,737.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,734.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,275.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,321.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,719.40
|
| Rate for Payer: Multiplan Commercial |
$6,447.75
|
| Rate for Payer: Networks By Design Commercial |
$5,588.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,307.45
|
|
|
HC REMVL TUN CVP ACCESS W SUBCU
|
Facility
|
IP
|
$8,597.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
900501752
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,719.40 |
| Max. Negotiated Rate |
$7,737.30 |
| Rate for Payer: Adventist Health Commercial |
$1,719.40
|
| Rate for Payer: Cash Price |
$4,728.35
|
| Rate for Payer: Central Health Plan Commercial |
$6,877.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,438.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,438.80
|
| Rate for Payer: Galaxy Health WC |
$7,307.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,158.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,737.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,734.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,275.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,321.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,719.40
|
| Rate for Payer: Multiplan Commercial |
$6,447.75
|
| Rate for Payer: Networks By Design Commercial |
$5,588.05
|
| Rate for Payer: Prime Health Services Commercial |
$7,307.45
|
|
|
HC REMVL TUN CVP ACCESS W SUBCU
|
Facility
|
OP
|
$8,597.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
900501752
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$304.17 |
| Max. Negotiated Rate |
$7,737.30 |
| Rate for Payer: Adventist Health Commercial |
$1,719.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,973.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,582.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,144.90
|
| Rate for Payer: Cash Price |
$4,728.35
|
| Rate for Payer: Cash Price |
$4,728.35
|
| Rate for Payer: Cash Price |
$4,728.35
|
| Rate for Payer: Cash Price |
$4,728.35
|
| Rate for Payer: Central Health Plan Commercial |
$6,877.60
|
| Rate for Payer: Cigna of CA HMO |
$5,502.08
|
| Rate for Payer: Cigna of CA PPO |
$6,361.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,171.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,973.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,664.63
|
| Rate for Payer: EPIC Health Plan Senior |
$1,973.80
|
| Rate for Payer: Galaxy Health WC |
$7,307.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,158.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,737.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,237.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,973.80
|
| Rate for Payer: InnovAge PACE Commercial |
$2,960.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,734.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$304.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,973.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,719.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,644.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,644.89
|
| Rate for Payer: Multiplan Commercial |
$6,447.75
|
| Rate for Payer: Multiplan WC |
$3,144.90
|
| Rate for Payer: Networks By Design Commercial |
$5,588.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,973.80
|
| Rate for Payer: Preferred Health Network WC |
$3,209.08
|
| Rate for Payer: Prime Health Services Commercial |
$7,307.45
|
| Rate for Payer: Prime Health Services Medicare |
$2,092.23
|
| Rate for Payer: Prime Health Services WC |
$3,112.81
|
| Rate for Payer: Riverside University Health System MISP |
$2,171.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,158.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,298.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4,298.50
|
| Rate for Payer: United Healthcare HMO Rider |
$4,298.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,298.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,973.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,960.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,171.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1,973.80
|
|
|
HC RENAL ANGIO CARDIAC CATH
|
Facility
|
OP
|
$3,280.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906820130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$68.42 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$656.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,788.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,804.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,460.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,926.34
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,804.00
|
| Rate for Payer: Cash Price |
$1,804.00
|
| Rate for Payer: Cash Price |
$1,804.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,624.00
|
| Rate for Payer: Cigna of CA HMO |
$2,099.20
|
| Rate for Payer: Cigna of CA PPO |
$2,427.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,788.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,788.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,788.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,312.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,312.00
|
| Rate for Payer: Galaxy Health WC |
$2,788.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,968.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,952.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1,640.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,187.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,249.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,030.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$656.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,296.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,296.00
|
| Rate for Payer: Multiplan Commercial |
$2,460.00
|
| Rate for Payer: Networks By Design Commercial |
$2,132.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,788.00
|
| Rate for Payer: Riverside University Health System MISP |
$1,312.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,968.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,640.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,640.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,640.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,640.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,788.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,788.00
|
| Rate for Payer: Vantage Medical Group Senior |
$2,788.00
|
|
|
HC RENAL ANGIO CARDIAC CATH
|
Facility
|
OP
|
$2,788.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$68.42 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$557.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,369.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,533.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,091.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,637.39
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$1,533.40
|
| Rate for Payer: Cash Price |
$1,533.40
|
| Rate for Payer: Cash Price |
$1,533.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,230.40
|
| Rate for Payer: Cigna of CA HMO |
$1,784.32
|
| Rate for Payer: Cigna of CA PPO |
$2,063.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,369.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,369.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,369.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,115.20
|
| Rate for Payer: Galaxy Health WC |
$2,369.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,509.20
|
| Rate for Payer: InnovAge PACE Commercial |
$1,394.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,859.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,062.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,725.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,951.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,951.60
|
| Rate for Payer: Multiplan Commercial |
$2,091.00
|
| Rate for Payer: Networks By Design Commercial |
$1,812.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,369.80
|
| Rate for Payer: Riverside University Health System MISP |
$1,115.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,672.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,394.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,394.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,394.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,394.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,369.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,369.80
|
| Rate for Payer: Vantage Medical Group Senior |
$2,369.80
|
|
|
HC RENAL ANGIO CARDIAC CATH
|
Facility
|
IP
|
$2,788.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$557.60 |
| Max. Negotiated Rate |
$2,509.20 |
| Rate for Payer: Adventist Health Commercial |
$557.60
|
| Rate for Payer: Cash Price |
$1,533.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,230.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,115.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,115.20
|
| Rate for Payer: Galaxy Health WC |
$2,369.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,672.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,509.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,859.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,062.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,725.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$557.60
|
| Rate for Payer: Multiplan Commercial |
$2,091.00
|
| Rate for Payer: Networks By Design Commercial |
$1,812.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,369.80
|
|
|
HC RENAL ANGIO CARDIAC CATH
|
Facility
|
IP
|
$3,280.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906820130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$656.00 |
| Max. Negotiated Rate |
$2,952.00 |
| Rate for Payer: Adventist Health Commercial |
$656.00
|
| Rate for Payer: Cash Price |
$1,804.00
|
| Rate for Payer: Central Health Plan Commercial |
$2,624.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,312.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,312.00
|
| Rate for Payer: Galaxy Health WC |
$2,788.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,968.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,952.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,187.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,249.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,030.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$656.00
|
| Rate for Payer: Multiplan Commercial |
$2,460.00
|
| Rate for Payer: Networks By Design Commercial |
$2,132.00
|
| Rate for Payer: Prime Health Services Commercial |
$2,788.00
|
|
|
HC RENAL BILAT 2ND ORDER
|
Facility
|
OP
|
$9,937.00
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
906820208
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$586.57 |
| Max. Negotiated Rate |
$20,902.00 |
| Rate for Payer: Adventist Health Commercial |
$1,987.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$3,999.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,999.21
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,811.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,836.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,372.03
|
| Rate for Payer: Blue Shield of California Commercial |
$7,837.47
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$5,465.35
|
| Rate for Payer: Cash Price |
$5,465.35
|
| Rate for Payer: Cash Price |
$5,465.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,949.60
|
| Rate for Payer: Cigna of CA HMO |
$6,359.68
|
| Rate for Payer: Cigna of CA PPO |
$7,353.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,399.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,999.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,398.93
|
| Rate for Payer: EPIC Health Plan Senior |
$3,999.21
|
| Rate for Payer: Galaxy Health WC |
$8,446.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,943.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,558.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$586.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,999.21
|
| Rate for Payer: InnovAge PACE Commercial |
$5,998.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,627.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$647.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,999.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,987.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,358.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,358.94
|
| Rate for Payer: Multiplan Commercial |
$7,452.75
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$6,459.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$3,999.21
|
| Rate for Payer: Preferred Health Network WC |
$6,502.07
|
| Rate for Payer: Prime Health Services Commercial |
$8,446.45
|
| Rate for Payer: Prime Health Services Medicare |
$4,239.16
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Riverside University Health System MISP |
$4,399.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,962.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,261.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$3,999.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,998.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,399.13
|
| Rate for Payer: Vantage Medical Group Senior |
$3,999.21
|
|
|
HC RENAL BILAT 2ND ORDER
|
Facility
|
IP
|
$9,937.00
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
906820208
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,987.40 |
| Max. Negotiated Rate |
$8,943.30 |
| Rate for Payer: Adventist Health Commercial |
$1,987.40
|
| Rate for Payer: Cash Price |
$5,465.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,949.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,974.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3,974.80
|
| Rate for Payer: Galaxy Health WC |
$8,446.45
|
| Rate for Payer: Global Benefits Group Commercial |
$5,962.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,943.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,627.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,786.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6,151.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,987.40
|
| Rate for Payer: Multiplan Commercial |
$7,452.75
|
| Rate for Payer: Networks By Design Commercial |
$6,459.05
|
| Rate for Payer: Prime Health Services Commercial |
$8,446.45
|
|
|
HC RENAL BILAT 2ND ORDER
|
Facility
|
IP
|
$8,446.00
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
909036254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,689.20 |
| Max. Negotiated Rate |
$7,601.40 |
| Rate for Payer: Adventist Health Commercial |
$1,689.20
|
| Rate for Payer: Cash Price |
$4,645.30
|
| Rate for Payer: Central Health Plan Commercial |
$6,756.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,378.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3,378.40
|
| Rate for Payer: Galaxy Health WC |
$7,179.10
|
| Rate for Payer: Global Benefits Group Commercial |
$5,067.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,601.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,633.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,217.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,228.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,689.20
|
| Rate for Payer: Multiplan Commercial |
$6,334.50
|
| Rate for Payer: Networks By Design Commercial |
$5,489.90
|
| Rate for Payer: Prime Health Services Commercial |
$7,179.10
|
|
