|
HC ANGIOGRAPH ADRENAL UNILAT
|
Facility
OP
|
$7,502.00
|
|
|
Service Code
|
CPT 75731
|
| Hospital Charge Code |
909081574
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$217.57 |
| Max. Negotiated Rate |
$7,566.84 |
| Rate for Payer: Adventist Health Commercial |
$1,500.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$395.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,153.87
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,000.97
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$3,375.90
|
| Rate for Payer: Cash Price |
$3,375.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,876.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,876.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,643.74
|
| Rate for Payer: Heritage Provider Network Senior |
$4,643.74
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$217.57
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,357.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,875.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$5,626.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| 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 ANGIOGRAPH EXT CAROTID UNILAT
|
Facility
IP
|
$21,162.00
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
909081608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,830.32 |
| Max. Negotiated Rate |
$15,871.50 |
| Rate for Payer: Adventist Health Commercial |
$4,232.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,538.29
|
| Rate for Payer: Cash Price |
$9,522.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,326.67
|
| Rate for Payer: Heritage Provider Network Senior |
$14,326.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,830.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,290.50
|
| Rate for Payer: Multiplan Commercial |
$15,871.50
|
|
|
HC ANGIOGRAPH EXT CAROTID UNILAT
|
Facility
OP
|
$21,162.00
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
909081608
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$138.23 |
| Max. Negotiated Rate |
$17,987.70 |
| Rate for Payer: Adventist Health Commercial |
$4,232.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,538.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17,987.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11,639.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15,871.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,517.28
|
| Rate for Payer: Blue Shield of California EPN |
$3,022.94
|
| Rate for Payer: Cash Price |
$9,522.90
|
| Rate for Payer: Cash Price |
$9,522.90
|
| Rate for Payer: Cash Price |
$9,522.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13,755.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,987.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$17,987.70
|
| Rate for Payer: Dignity Health Senior |
$17,987.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,099.28
|
| Rate for Payer: Heritage Provider Network Senior |
$13,099.28
|
| Rate for Payer: IEHP Medi-Cal |
$138.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$10,200.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,830.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,290.50
|
| Rate for Payer: Multiplan Commercial |
$15,871.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,987.70
|
| Rate for Payer: Vantage Medical Group Senior |
$17,987.70
|
|
|
HC ANGIOGRAPH EXTREMITY BILAT
|
Facility
OP
|
$13,136.00
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
906820191
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$229.30 |
| Max. Negotiated Rate |
$9,852.00 |
| Rate for Payer: Adventist Health Commercial |
$2,627.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$454.74
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,024.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,017.48
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$5,911.20
|
| Rate for Payer: Cash Price |
$5,911.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$8,538.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,538.40
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,131.18
|
| Rate for Payer: Heritage Provider Network Senior |
$8,131.18
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$229.30
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,377.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,284.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$9,852.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| 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 ANGIOGRAPH EXTREMITY BILAT
|
Facility
IP
|
$13,136.00
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
906820191
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,377.62 |
| Max. Negotiated Rate |
$9,852.00 |
| Rate for Payer: Adventist Health Commercial |
$2,627.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,024.43
|
| Rate for Payer: Cash Price |
$5,911.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,893.07
|
| Rate for Payer: Heritage Provider Network Senior |
$8,893.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,377.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,284.00
|
| Rate for Payer: Multiplan Commercial |
$9,852.00
|
|
|
HC ANGIOGRAPH EXTREMITY BILAT
|
Facility
IP
|
$7,509.00
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
909081619
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,359.13 |
| Max. Negotiated Rate |
$5,631.75 |
| Rate for Payer: Adventist Health Commercial |
$1,501.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,158.68
|
| Rate for Payer: Cash Price |
$3,379.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,083.59
|
| Rate for Payer: Heritage Provider Network Senior |
$5,083.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,359.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,877.25
|
| Rate for Payer: Multiplan Commercial |
$5,631.75
|
|
|
HC ANGIOGRAPH EXTREMITY BILAT
|
Facility
OP
|
$7,509.00
|
|
|
Service Code
|
CPT 75716
|
| Hospital Charge Code |
909081619
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$229.30 |
| Max. Negotiated Rate |
$7,566.84 |
| Rate for Payer: Adventist Health Commercial |
$1,501.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$454.74
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,158.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,017.48
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$3,379.05
|
| Rate for Payer: Cash Price |
$3,379.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,880.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,880.85
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,648.07
|
| Rate for Payer: Heritage Provider Network Senior |
$4,648.07
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$229.30
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,359.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,877.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$5,631.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| 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 ANGIOGRAPH EXTREMITY UNILAT
|
Facility
OP
|
$7,509.00
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
909081572
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$212.38 |
| Max. Negotiated Rate |
$7,566.84 |
| Rate for Payer: Adventist Health Commercial |
$1,501.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$395.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,158.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,000.97
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$3,379.05
|
| Rate for Payer: Cash Price |
$3,379.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,880.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,880.85
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,648.07
|
| Rate for Payer: Heritage Provider Network Senior |
$4,648.07
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$212.38
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,359.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,877.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$5,631.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| 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 ANGIOGRAPH EXTREMITY UNILAT
|
Facility
OP
|
$11,282.00
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
906820184
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$212.38 |
| Max. Negotiated Rate |
$8,461.50 |
| Rate for Payer: Adventist Health Commercial |
$2,256.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$395.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,750.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,000.97
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$5,076.90
|
| Rate for Payer: Cash Price |
$5,076.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,333.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,333.30
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,983.56
|
| Rate for Payer: Heritage Provider Network Senior |
$6,983.56
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$212.38
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,042.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,820.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$8,461.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| 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 ANGIOGRAPH EXTREMITY UNILAT
|
Facility
IP
|
$11,282.00
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
906820184
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,042.04 |
| Max. Negotiated Rate |
$8,461.50 |
| Rate for Payer: Adventist Health Commercial |
$2,256.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,750.73
|
| Rate for Payer: Cash Price |
$5,076.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,637.91
|
| Rate for Payer: Heritage Provider Network Senior |
$7,637.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,042.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,820.50
|
| Rate for Payer: Multiplan Commercial |
$8,461.50
|
|
|
HC ANGIOGRAPH EXTREMITY UNILAT
|
Facility
IP
|
$7,509.00
|
|
|
Service Code
|
CPT 75710
|
| Hospital Charge Code |
909081572
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,359.13 |
| Max. Negotiated Rate |
$5,631.75 |
| Rate for Payer: Adventist Health Commercial |
$1,501.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,158.68
|
| Rate for Payer: Cash Price |
$3,379.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,083.59
|
| Rate for Payer: Heritage Provider Network Senior |
$5,083.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,359.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,877.25
|
| Rate for Payer: Multiplan Commercial |
$5,631.75
|
|
|
HC ANGIOGRAPH INTERNAL MAMMARY
|
Facility
IP
|
$11,948.00
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
906820186
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,162.59 |
| Max. Negotiated Rate |
$8,961.00 |
| Rate for Payer: Adventist Health Commercial |
$2,389.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,208.28
|
| Rate for Payer: Cash Price |
$5,376.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$8,088.80
|
| Rate for Payer: Heritage Provider Network Senior |
$8,088.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,162.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,987.00
|
| Rate for Payer: Multiplan Commercial |
$8,961.00
|
|
|
HC ANGIOGRAPH INTERNAL MAMMARY
|
Facility
IP
|
$4,223.00
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
909081576
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$764.36 |
| Max. Negotiated Rate |
$3,167.25 |
| Rate for Payer: Adventist Health Commercial |
$844.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,901.20
|
| Rate for Payer: Cash Price |
$1,900.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,858.97
|
| Rate for Payer: Heritage Provider Network Senior |
$2,858.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$764.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,055.75
|
| Rate for Payer: Multiplan Commercial |
$3,167.25
|
|
|
HC ANGIOGRAPH INTERNAL MAMMARY
|
Facility
OP
|
$4,223.00
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
909081576
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$226.81 |
| Max. Negotiated Rate |
$7,566.84 |
| Rate for Payer: Adventist Health Commercial |
$844.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$396.42
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2,901.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,000.97
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$1,900.35
|
| Rate for Payer: Cash Price |
$1,900.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,744.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,744.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,614.04
|
| Rate for Payer: Heritage Provider Network Senior |
$2,614.04
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$226.81
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$764.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,055.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$3,167.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,055.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,055.15
|
| 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 ANGIOGRAPH INTERNAL MAMMARY
|
Facility
OP
|
$11,948.00
|
|
|
Service Code
|
CPT 75756
|
| Hospital Charge Code |
906820186
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$226.81 |
| Max. Negotiated Rate |
$8,961.00 |
| Rate for Payer: Adventist Health Commercial |
$2,389.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$396.42
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,208.28
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,000.97
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$5,376.60
|
| Rate for Payer: Cash Price |
$5,376.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,766.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,766.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,395.81
|
| Rate for Payer: Heritage Provider Network Senior |
$7,395.81
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$226.81
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,162.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,987.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$8,961.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,055.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,055.15
|
| 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 ANGIOGRAPH PULMONARY BILAT
|
Facility
OP
|
$11,597.00
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
906820194
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$209.88 |
| Max. Negotiated Rate |
$8,697.75 |
| Rate for Payer: Adventist Health Commercial |
$2,319.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$361.59
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,967.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,017.48
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$5,218.65
|
| Rate for Payer: Cash Price |
$5,218.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,538.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$7,538.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,178.54
|
| Rate for Payer: Heritage Provider Network Senior |
$7,178.54
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$209.88
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,099.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,899.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$8,697.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| 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 ANGIOGRAPH PULMONARY BILAT
|
Facility
IP
|
$7,509.00
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
909081627
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,359.13 |
| Max. Negotiated Rate |
$5,631.75 |
| Rate for Payer: Adventist Health Commercial |
$1,501.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,158.68
|
| Rate for Payer: Cash Price |
$3,379.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,083.59
|
| Rate for Payer: Heritage Provider Network Senior |
$5,083.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,359.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,877.25
|
| Rate for Payer: Multiplan Commercial |
$5,631.75
|
|
|
HC ANGIOGRAPH PULMONARY BILAT
|
Facility
OP
|
$7,509.00
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
909081627
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$209.88 |
| Max. Negotiated Rate |
$7,566.84 |
| Rate for Payer: Adventist Health Commercial |
$1,501.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$361.59
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,158.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,017.48
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$3,379.05
|
| Rate for Payer: Cash Price |
$3,379.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,880.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,880.85
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,648.07
|
| Rate for Payer: Heritage Provider Network Senior |
$4,648.07
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$209.88
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,359.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,877.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$5,631.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| 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 ANGIOGRAPH PULMONARY BILAT
|
Facility
IP
|
$11,597.00
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
906820194
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,099.06 |
| Max. Negotiated Rate |
$8,697.75 |
| Rate for Payer: Adventist Health Commercial |
$2,319.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,967.14
|
| Rate for Payer: Cash Price |
$5,218.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,851.17
|
| Rate for Payer: Heritage Provider Network Senior |
$7,851.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,099.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,899.25
|
| Rate for Payer: Multiplan Commercial |
$8,697.75
|
|
|
HC ANGIOGRAPH PULMONARY UNILAT
|
Facility
IP
|
$7,731.00
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
906820185
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,399.31 |
| Max. Negotiated Rate |
$5,798.25 |
| Rate for Payer: Adventist Health Commercial |
$1,546.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,311.20
|
| Rate for Payer: Cash Price |
$3,478.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,233.89
|
| Rate for Payer: Heritage Provider Network Senior |
$5,233.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,399.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,932.75
|
| Rate for Payer: Multiplan Commercial |
$5,798.25
|
|
|
HC ANGIOGRAPH PULMONARY UNILAT
|
Facility
OP
|
$7,731.00
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
906820185
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$185.69 |
| Max. Negotiated Rate |
$7,566.84 |
| Rate for Payer: Adventist Health Commercial |
$1,546.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$342.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,311.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,000.92
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$3,478.95
|
| Rate for Payer: Cash Price |
$3,478.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,025.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,025.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,785.49
|
| Rate for Payer: Heritage Provider Network Senior |
$4,785.49
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$185.69
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,399.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,932.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$5,798.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| 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 ANGIOGRAPH PULMONARY UNILAT
|
Facility
OP
|
$7,509.00
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
909081575
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$185.69 |
| Max. Negotiated Rate |
$7,566.84 |
| Rate for Payer: Adventist Health Commercial |
$1,501.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$342.66
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,158.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,000.92
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$3,379.05
|
| Rate for Payer: Cash Price |
$3,379.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,880.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,880.85
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,648.07
|
| Rate for Payer: Heritage Provider Network Senior |
$4,648.07
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$185.69
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,359.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,877.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$5,631.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,338.61
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,338.61
|
| 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 ANGIOGRAPH PULMONARY UNILAT
|
Facility
IP
|
$7,509.00
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
909081575
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,359.13 |
| Max. Negotiated Rate |
$5,631.75 |
| Rate for Payer: Adventist Health Commercial |
$1,501.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,158.68
|
| Rate for Payer: Cash Price |
$3,379.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,083.59
|
| Rate for Payer: Heritage Provider Network Senior |
$5,083.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,359.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,877.25
|
| Rate for Payer: Multiplan Commercial |
$5,631.75
|
|
|
HC ANGIOGRAPH PULMONARY VENOUS INJ
|
Facility
OP
|
$2,601.00
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
909081628
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$191.52 |
| Max. Negotiated Rate |
$7,566.84 |
| Rate for Payer: Adventist Health Commercial |
$520.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$372.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,786.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,017.54
|
| Rate for Payer: Blue Shield of California Commercial |
$2,569.94
|
| Rate for Payer: Blue Shield of California EPN |
$1,461.45
|
| Rate for Payer: Cash Price |
$1,170.45
|
| Rate for Payer: Cash Price |
$1,170.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,690.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,690.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,610.02
|
| Rate for Payer: Heritage Provider Network Senior |
$1,610.02
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$191.52
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$470.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$650.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$1,950.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,982.55
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,055.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,055.15
|
| 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 ANGIOGRAPH PULMONARY VENOUS INJ
|
Facility
IP
|
$2,601.00
|
|
|
Service Code
|
CPT 75746
|
| Hospital Charge Code |
909081628
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$470.78 |
| Max. Negotiated Rate |
$1,950.75 |
| Rate for Payer: Adventist Health Commercial |
$520.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,786.89
|
| Rate for Payer: Cash Price |
$1,170.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,760.88
|
| Rate for Payer: Heritage Provider Network Senior |
$1,760.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$470.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$650.25
|
| Rate for Payer: Multiplan Commercial |
$1,950.75
|
|
