|
HC REMOVE URETER STENT, PERCUT
|
Facility
|
OP
|
$8,943.00
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
909081851
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,788.60 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,544.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,544.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,365.80
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$2,544.87
|
| Rate for Payer: Cash Price |
$4,024.35
|
| Rate for Payer: Cash Price |
$4,024.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,154.40
|
| Rate for Payer: Cigna of CA PPO |
$6,617.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Dignity Health Media |
$2,544.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,799.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,435.57
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,544.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,544.87
|
| Rate for Payer: Galaxy Health WC |
$7,601.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,365.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,048.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,707.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,173.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,199.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,544.87
|
| Rate for Payer: InnovAge PACE Commercial |
$3,817.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,964.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,503.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,544.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,788.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,410.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,410.13
|
| Rate for Payer: Multiplan Commercial |
$6,707.25
|
| Rate for Payer: Networks By Design Commercial |
$5,812.95
|
| Rate for Payer: Prime Health Services Commercial |
$7,601.55
|
| Rate for Payer: Prime Health Services Medicare |
$2,697.56
|
| Rate for Payer: Riverside University Health System MISP |
$2,799.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,365.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,817.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,799.36
|
| Rate for Payer: Vantage Medical Group Senior |
$2,544.87
|
|
|
HC REMOVE URETER STENT, PERCUT
|
Facility
|
IP
|
$8,943.00
|
|
|
Service Code
|
CPT 50384
|
| Hospital Charge Code |
909081851
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,788.60 |
| Max. Negotiated Rate |
$8,048.70 |
| Rate for Payer: Cash Price |
$4,024.35
|
| Rate for Payer: Central Health Plan Commercial |
$7,154.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,577.20
|
| Rate for Payer: Galaxy Health WC |
$7,601.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,365.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,048.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,964.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,407.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,788.60
|
| Rate for Payer: Multiplan Commercial |
$6,707.25
|
| Rate for Payer: Networks By Design Commercial |
$5,812.95
|
| Rate for Payer: Prime Health Services Commercial |
$7,601.55
|
|
|
HC REMOVE VAD DIFF SESSION
|
Facility
|
OP
|
$7,597.00
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
906820233
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$315.50 |
| Max. Negotiated Rate |
$8,958.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,068.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,457.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,178.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,178.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,558.20
|
| Rate for Payer: Blue Shield of California Commercial |
$8,958.72
|
| Rate for Payer: Blue Shield of California EPN |
$6,434.55
|
| Rate for Payer: Cash Price |
$3,418.65
|
| Rate for Payer: Cash Price |
$3,418.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,077.60
|
| Rate for Payer: Cigna of CA PPO |
$5,621.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,457.45
|
| Rate for Payer: Dignity Health Media |
$6,457.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,457.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,038.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,038.80
|
| Rate for Payer: Galaxy Health WC |
$6,457.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,558.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,837.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,697.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,658.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$315.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,519.40
|
| Rate for Payer: Multiplan Commercial |
$5,697.75
|
| Rate for Payer: Networks By Design Commercial |
$4,938.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,457.45
|
| Rate for Payer: Riverside University Health System MISP |
$3,038.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,558.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,558.20
|
| 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 Medi-Cal |
$6,457.45
|
| Rate for Payer: Vantage Medical Group Senior |
$6,457.45
|
|
|
HC REMOVE VAD DIFF SESSION
|
Facility
|
OP
|
$7,597.00
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
906811430
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$315.50 |
| Max. Negotiated Rate |
$8,958.72 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,068.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,457.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,178.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,178.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,017.00
|
| Rate for Payer: Blue Distinction Transplant |
$4,558.20
|
| Rate for Payer: Blue Shield of California Commercial |
$8,958.72
|
| Rate for Payer: Blue Shield of California EPN |
$6,434.55
|
| Rate for Payer: Cash Price |
$3,418.65
|
| Rate for Payer: Cash Price |
$3,418.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,077.60
|
| Rate for Payer: Cigna of CA PPO |
$5,621.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,457.45
|
| Rate for Payer: Dignity Health Media |
$6,457.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,457.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,038.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,038.80
|
| Rate for Payer: Galaxy Health WC |
$6,457.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,558.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,837.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$5,697.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,658.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$315.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,519.40
|
| Rate for Payer: Multiplan Commercial |
$5,697.75
|
| Rate for Payer: Networks By Design Commercial |
$4,938.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,457.45
|
| Rate for Payer: Riverside University Health System MISP |
$3,038.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,558.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,558.20
|
| 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 Medi-Cal |
$6,457.45
|
| Rate for Payer: Vantage Medical Group Senior |
$6,457.45
|
|
|
HC REMOVE VAD DIFF SESSION
|
Facility
|
IP
|
$7,597.00
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
906820233
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,519.40 |
| Max. Negotiated Rate |
$6,837.30 |
| Rate for Payer: Cash Price |
$3,418.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,038.80
|
| Rate for Payer: Galaxy Health WC |
$6,457.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,558.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,837.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,894.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,519.40
|
| Rate for Payer: Multiplan Commercial |
$5,697.75
|
| Rate for Payer: Networks By Design Commercial |
$4,938.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,457.45
|
|
|
HC REMOVE VAD DIFF SESSION
|
Facility
|
IP
|
$7,597.00
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
906811430
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,519.40 |
| Max. Negotiated Rate |
$6,837.30 |
| Rate for Payer: Cash Price |
$3,418.65
|
| Rate for Payer: Central Health Plan Commercial |
$6,077.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,038.80
|
| Rate for Payer: Galaxy Health WC |
$6,457.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,558.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,837.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,067.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,894.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,519.40
|
| Rate for Payer: Multiplan Commercial |
$5,697.75
|
| Rate for Payer: Networks By Design Commercial |
$4,938.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,457.45
|
|
|
HC REMOVE VENTILATING TUBE
|
Facility
|
IP
|
$5,916.00
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
900501512
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,183.20 |
| Max. Negotiated Rate |
$5,324.40 |
| Rate for Payer: Cash Price |
$2,662.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,732.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,366.40
|
| Rate for Payer: Galaxy Health WC |
$5,028.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,549.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,324.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,945.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,254.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,183.20
|
| Rate for Payer: Multiplan Commercial |
$4,437.00
|
| Rate for Payer: Networks By Design Commercial |
$3,845.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,028.60
|
|
|
HC REMOVE VENTILATING TUBE
|
Facility
|
OP
|
$5,916.00
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
900501512
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$120.25 |
| Max. Negotiated Rate |
$6,597.21 |
| 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 |
$6,034.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,424.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,022.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,549.60
|
| Rate for Payer: Caremore Medicare Advantage |
$4,022.69
|
| Rate for Payer: Cash Price |
$2,662.20
|
| Rate for Payer: Cash Price |
$2,662.20
|
| Rate for Payer: Cash Price |
$2,662.20
|
| Rate for Payer: Cash Price |
$2,662.20
|
| Rate for Payer: Central Health Plan Commercial |
$4,732.80
|
| Rate for Payer: Cigna of CA PPO |
$4,377.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,034.04
|
| Rate for Payer: Dignity Health Media |
$4,022.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,424.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,430.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,022.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,022.69
|
| Rate for Payer: Galaxy Health WC |
$5,028.60
|
| Rate for Payer: Global Benefits Group Commercial |
$3,549.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,324.40
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,437.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,597.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,022.69
|
| Rate for Payer: InnovAge PACE Commercial |
$6,034.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,945.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$120.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,022.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,183.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,390.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,390.40
|
| Rate for Payer: Multiplan Commercial |
$4,437.00
|
| Rate for Payer: Networks By Design Commercial |
$3,845.40
|
| Rate for Payer: Prime Health Services Commercial |
$5,028.60
|
| Rate for Payer: Prime Health Services Medicare |
$4,264.05
|
| Rate for Payer: Riverside University Health System MISP |
$4,424.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,549.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,958.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,958.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,958.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,958.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,034.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,424.96
|
| Rate for Payer: Vantage Medical Group Senior |
$4,022.69
|
|
|
HC REMVL TUN CVP ACCESS W SUBCU
|
Facility
|
OP
|
$6,501.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
909081361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$304.17 |
| Max. Negotiated Rate |
$7,027.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,001.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| 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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,900.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
| Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$2,925.45
|
| Rate for Payer: Cash Price |
$2,925.45
|
| Rate for Payer: Central Health Plan Commercial |
$5,200.80
|
| Rate for Payer: Cigna of CA PPO |
$4,810.74
|
| 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 |
$5,525.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,900.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,850.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,875.75
|
| 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 |
$4,336.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$304.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,300.20
|
| 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 |
$4,875.75
|
| Rate for Payer: Networks By Design Commercial |
$4,225.65
|
| Rate for Payer: Prime Health Services Commercial |
$5,525.85
|
| 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 |
$3,900.60
|
| 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 |
$3,001.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,201.11
|
| Rate for Payer: Vantage Medical Group Senior |
$2,001.01
|
|
|
HC REMVL TUN CVP ACCESS W SUBCU
|
Facility
|
IP
|
$6,501.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
909081361
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,300.20 |
| Max. Negotiated Rate |
$5,850.90 |
| Rate for Payer: Cash Price |
$2,925.45
|
| Rate for Payer: Central Health Plan Commercial |
$5,200.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,600.40
|
| Rate for Payer: Galaxy Health WC |
$5,525.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,900.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,850.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,336.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,476.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,300.20
|
| Rate for Payer: Multiplan Commercial |
$4,875.75
|
| Rate for Payer: Networks By Design Commercial |
$4,225.65
|
| Rate for Payer: Prime Health Services Commercial |
$5,525.85
|
|
|
HC REMVL TUN CVP ACCESS W SUBCU
|
Facility
|
IP
|
$6,501.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
900501752
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,300.20 |
| Max. Negotiated Rate |
$5,850.90 |
| Rate for Payer: Cash Price |
$2,925.45
|
| Rate for Payer: Central Health Plan Commercial |
$5,200.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,600.40
|
| Rate for Payer: Galaxy Health WC |
$5,525.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,900.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,850.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,336.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,476.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,300.20
|
| Rate for Payer: Multiplan Commercial |
$4,875.75
|
| Rate for Payer: Networks By Design Commercial |
$4,225.65
|
| Rate for Payer: Prime Health Services Commercial |
$5,525.85
|
|
|
HC REMVL TUN CVP ACCESS W SUBCU
|
Facility
|
OP
|
$6,501.00
|
|
|
Service Code
|
CPT 36590
|
| Hospital Charge Code |
900501752
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$304.17 |
| Max. Negotiated Rate |
$5,850.90 |
| 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 |
$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 |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Distinction Transplant |
$3,900.60
|
| Rate for Payer: Caremore Medicare Advantage |
$2,001.01
|
| Rate for Payer: Cash Price |
$2,925.45
|
| Rate for Payer: Cash Price |
$2,925.45
|
| Rate for Payer: Cash Price |
$2,925.45
|
| Rate for Payer: Cash Price |
$2,925.45
|
| Rate for Payer: Central Health Plan Commercial |
$5,200.80
|
| Rate for Payer: Cigna of CA PPO |
$4,810.74
|
| 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 |
$5,525.85
|
| Rate for Payer: Global Benefits Group Commercial |
$3,900.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,850.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,875.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,281.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$936.00
|
| 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 |
$4,336.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$304.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,001.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,300.20
|
| 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 |
$4,875.75
|
| Rate for Payer: Networks By Design Commercial |
$4,225.65
|
| Rate for Payer: Prime Health Services Commercial |
$5,525.85
|
| 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 |
$3,900.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,250.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,250.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,250.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,250.50
|
| 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 RENAL ANGIO CARDIAC CATH
|
Facility
|
IP
|
$2,852.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$570.40 |
| Max. Negotiated Rate |
$2,566.80 |
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,281.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,140.80
|
| Rate for Payer: Galaxy Health WC |
$2,424.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,711.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,566.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,902.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,086.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$570.40
|
| Rate for Payer: Multiplan Commercial |
$2,139.00
|
| Rate for Payer: Networks By Design Commercial |
$1,853.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,424.20
|
|
|
HC RENAL ANGIO CARDIAC CATH
|
Facility
|
OP
|
$2,852.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906811386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$68.29 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,424.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,568.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,568.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,684.96
|
| Rate for Payer: Blue Distinction Transplant |
$1,711.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,281.60
|
| Rate for Payer: Cigna of CA PPO |
$2,110.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,424.20
|
| Rate for Payer: Dignity Health Media |
$2,424.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,424.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,140.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,140.80
|
| Rate for Payer: Galaxy Health WC |
$2,424.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,711.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,566.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,139.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$998.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,902.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,086.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$570.40
|
| Rate for Payer: Multiplan Commercial |
$2,139.00
|
| Rate for Payer: Networks By Design Commercial |
$1,853.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,424.20
|
| Rate for Payer: Riverside University Health System MISP |
$1,140.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,711.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,426.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,426.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,426.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,426.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,424.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,424.20
|
|
|
HC RENAL ANGIO CARDIAC CATH
|
Facility
|
OP
|
$2,852.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906820130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$68.29 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,424.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,568.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,568.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$68.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,684.96
|
| Rate for Payer: Blue Distinction Transplant |
$1,711.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,281.60
|
| Rate for Payer: Cigna of CA PPO |
$2,110.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,424.20
|
| Rate for Payer: Dignity Health Media |
$2,424.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,424.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,140.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,140.80
|
| Rate for Payer: Galaxy Health WC |
$2,424.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,711.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,566.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,139.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$998.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,902.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,086.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$570.40
|
| Rate for Payer: Multiplan Commercial |
$2,139.00
|
| Rate for Payer: Networks By Design Commercial |
$1,853.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,424.20
|
| Rate for Payer: Riverside University Health System MISP |
$1,140.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,711.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,426.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,426.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,426.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,426.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,424.20
|
| Rate for Payer: Vantage Medical Group Senior |
$2,424.20
|
|
|
HC RENAL ANGIO CARDIAC CATH
|
Facility
|
IP
|
$2,852.00
|
|
|
Service Code
|
CPT G0278
|
| Hospital Charge Code |
906820130
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$570.40 |
| Max. Negotiated Rate |
$2,566.80 |
| Rate for Payer: Cash Price |
$1,283.40
|
| Rate for Payer: Central Health Plan Commercial |
$2,281.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,140.80
|
| Rate for Payer: Galaxy Health WC |
$2,424.20
|
| Rate for Payer: Global Benefits Group Commercial |
$1,711.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,566.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,902.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,086.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$570.40
|
| Rate for Payer: Multiplan Commercial |
$2,139.00
|
| Rate for Payer: Networks By Design Commercial |
$1,853.80
|
| Rate for Payer: Prime Health Services Commercial |
$2,424.20
|
|
|
HC RENAL BILAT 2ND ORDER
|
Facility
|
IP
|
$8,641.00
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
909036254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,728.20 |
| Max. Negotiated Rate |
$7,776.90 |
| Rate for Payer: Cash Price |
$3,888.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,912.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,456.40
|
| Rate for Payer: Galaxy Health WC |
$7,344.85
|
| Rate for Payer: Global Benefits Group Commercial |
$5,184.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,776.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,763.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,292.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,728.20
|
| Rate for Payer: Multiplan Commercial |
$6,480.75
|
| Rate for Payer: Networks By Design Commercial |
$5,616.65
|
| Rate for Payer: Prime Health Services Commercial |
$7,344.85
|
|
|
HC RENAL BILAT 2ND ORDER
|
Facility
|
OP
|
$8,641.00
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
909036254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$648.26 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,184.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$3,888.45
|
| Rate for Payer: Cash Price |
$3,888.45
|
| Rate for Payer: Cash Price |
$3,888.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,912.80
|
| Rate for Payer: Cigna of CA PPO |
$6,394.34
|
| 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 |
$7,344.85
|
| Rate for Payer: Global Benefits Group Commercial |
$5,184.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,776.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,480.75
|
| 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 |
$5,763.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$648.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,728.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$6,480.75
|
| Rate for Payer: Networks By Design Commercial |
$5,616.65
|
| Rate for Payer: Prime Health Services Commercial |
$7,344.85
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,184.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC RENAL BILAT 2ND ORDER
|
Facility
|
OP
|
$8,641.00
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
906820208
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$648.26 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,184.60
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$3,888.45
|
| Rate for Payer: Cash Price |
$3,888.45
|
| Rate for Payer: Cash Price |
$3,888.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,912.80
|
| Rate for Payer: Cigna of CA PPO |
$6,394.34
|
| 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 |
$7,344.85
|
| Rate for Payer: Global Benefits Group Commercial |
$5,184.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,776.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,480.75
|
| 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 |
$5,763.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$648.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,728.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,336.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,336.62
|
| Rate for Payer: Multiplan Commercial |
$6,480.75
|
| Rate for Payer: Networks By Design Commercial |
$5,616.65
|
| Rate for Payer: Prime Health Services Commercial |
$7,344.85
|
| Rate for Payer: Prime Health Services Medicare |
$4,221.50
|
| Rate for Payer: Riverside University Health System MISP |
$4,380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,184.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
| Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC RENAL BILAT 2ND ORDER
|
Facility
|
IP
|
$8,641.00
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
906820208
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,728.20 |
| Max. Negotiated Rate |
$7,776.90 |
| Rate for Payer: Cash Price |
$3,888.45
|
| Rate for Payer: Central Health Plan Commercial |
$6,912.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,456.40
|
| Rate for Payer: Galaxy Health WC |
$7,344.85
|
| Rate for Payer: Global Benefits Group Commercial |
$5,184.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,776.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,763.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,292.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,728.20
|
| Rate for Payer: Multiplan Commercial |
$6,480.75
|
| Rate for Payer: Networks By Design Commercial |
$5,616.65
|
| Rate for Payer: Prime Health Services Commercial |
$7,344.85
|
|
|
HC RENAL BILAT SELECTIVE INC AO
|
Facility
|
IP
|
$9,075.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
906820207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,815.00 |
| Max. Negotiated Rate |
$8,167.50 |
| Rate for Payer: Cash Price |
$4,083.75
|
| Rate for Payer: Central Health Plan Commercial |
$7,260.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,630.00
|
| Rate for Payer: Galaxy Health WC |
$7,713.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,445.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,167.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,053.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,457.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,815.00
|
| Rate for Payer: Multiplan Commercial |
$6,806.25
|
| Rate for Payer: Networks By Design Commercial |
$5,898.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,713.75
|
|
|
HC RENAL BILAT SELECTIVE INC AO
|
Facility
|
OP
|
$9,075.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
909036252
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$563.43 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,445.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$4,083.75
|
| Rate for Payer: Cash Price |
$4,083.75
|
| Rate for Payer: Cash Price |
$4,083.75
|
| Rate for Payer: Central Health Plan Commercial |
$7,260.00
|
| Rate for Payer: Cigna of CA PPO |
$6,715.50
|
| 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 |
$7,713.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,445.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,167.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,806.25
|
| 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 |
$6,053.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$563.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,815.00
|
| 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 |
$6,806.25
|
| Rate for Payer: Networks By Design Commercial |
$5,898.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,713.75
|
| 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 |
$5,445.00
|
| 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 RENAL BILAT SELECTIVE INC AO
|
Facility
|
IP
|
$9,075.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
909036252
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,815.00 |
| Max. Negotiated Rate |
$8,167.50 |
| Rate for Payer: Cash Price |
$4,083.75
|
| Rate for Payer: Central Health Plan Commercial |
$7,260.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,630.00
|
| Rate for Payer: Galaxy Health WC |
$7,713.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,445.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,167.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,053.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,457.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,815.00
|
| Rate for Payer: Multiplan Commercial |
$6,806.25
|
| Rate for Payer: Networks By Design Commercial |
$5,898.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,713.75
|
|
|
HC RENAL BILAT SELECTIVE INC AO
|
Facility
|
OP
|
$9,075.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
906820207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$563.43 |
| Max. Negotiated Rate |
$19,907.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,982.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: Blue Distinction Transplant |
$5,445.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$3,982.55
|
| Rate for Payer: Cash Price |
$4,083.75
|
| Rate for Payer: Cash Price |
$4,083.75
|
| Rate for Payer: Cash Price |
$4,083.75
|
| Rate for Payer: Central Health Plan Commercial |
$7,260.00
|
| Rate for Payer: Cigna of CA PPO |
$6,715.50
|
| 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 |
$7,713.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5,445.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$8,167.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$6,806.25
|
| 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 |
$6,053.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$563.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,982.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,815.00
|
| 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 |
$6,806.25
|
| Rate for Payer: Networks By Design Commercial |
$5,898.75
|
| Rate for Payer: Prime Health Services Commercial |
$7,713.75
|
| 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 |
$5,445.00
|
| 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 RENAL BIOP PERCUT BY NEEDLE
|
Facility
|
IP
|
$4,891.00
|
|
|
Service Code
|
CPT 50200
|
| Hospital Charge Code |
903800069
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$978.20 |
| Max. Negotiated Rate |
$4,401.90 |
| Rate for Payer: Cash Price |
$2,200.95
|
| Rate for Payer: Central Health Plan Commercial |
$3,912.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,956.40
|
| Rate for Payer: Galaxy Health WC |
$4,157.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2,934.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,401.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,262.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,863.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$978.20
|
| Rate for Payer: Multiplan Commercial |
$3,668.25
|
| Rate for Payer: Networks By Design Commercial |
$3,179.15
|
| Rate for Payer: Prime Health Services Commercial |
$4,157.35
|
|
