|
HC ANTI-XA APIXABAN
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
900912042
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.58 |
| Max. Negotiated Rate |
$48.00 |
| Rate for Payer: Adventist Health Commercial |
$12.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$41.22
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$43.33
|
| Rate for Payer: Heritage Provider Network Senior |
$43.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.00
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
|
|
HC ANTI-XA UNFRACTIONATED HEPARIN
|
Facility
|
OP
|
$123.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
900912030
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$105.60 |
| Rate for Payer: Adventist Health Commercial |
$24.60
|
| Rate for Payer: Adventist Health Commercial |
$23.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$73.54
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$76.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$105.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$105.60
|
| Rate for Payer: Blue Shield of California Commercial |
$105.35
|
| Rate for Payer: Blue Shield of California Commercial |
$105.35
|
| Rate for Payer: Blue Shield of California EPN |
$84.50
|
| Rate for Payer: Blue Shield of California EPN |
$84.50
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Cash Price |
$53.55
|
| Rate for Payer: Cash Price |
$53.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$77.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$79.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.21
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.09
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$73.66
|
| Rate for Payer: Heritage Provider Network Commercial |
$76.14
|
| Rate for Payer: Heritage Provider Network Senior |
$73.66
|
| Rate for Payer: Heritage Provider Network Senior |
$76.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$56.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$58.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.54
|
| Rate for Payer: Multiplan Commercial |
$89.25
|
| Rate for Payer: Multiplan Commercial |
$92.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.09
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.09
|
| Rate for Payer: TriValley Medical Group Senior |
$13.09
|
| Rate for Payer: TriValley Medical Group Senior |
$13.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.14
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.40
|
| Rate for Payer: Vantage Medical Group Senior |
$13.09
|
| Rate for Payer: Vantage Medical Group Senior |
$13.09
|
|
|
HC ANTI-XA UNFRACTIONATED HEPARIN
|
Facility
|
IP
|
$123.00
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
900912030
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.26 |
| Max. Negotiated Rate |
$92.25 |
| Rate for Payer: Adventist Health Commercial |
$24.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$79.21
|
| Rate for Payer: Cash Price |
$55.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$83.27
|
| Rate for Payer: Heritage Provider Network Senior |
$83.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.75
|
| Rate for Payer: Multiplan Commercial |
$92.25
|
|
|
HC AORTA CATHETER (FEMORAL/AX
|
Facility
|
OP
|
$1,384.00
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
909081318
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$250.50 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$276.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$855.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,176.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$761.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,038.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$622.80
|
| Rate for Payer: Cash Price |
$622.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$899.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,176.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,176.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,176.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$856.70
|
| Rate for Payer: Heritage Provider Network Senior |
$856.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$660.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$250.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$346.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$968.80
|
| Rate for Payer: Multiplan Commercial |
$1,038.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,176.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,176.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,176.40
|
|
|
HC AORTA CATHETER (FEMORAL/AX
|
Facility
|
IP
|
$1,384.00
|
|
|
Service Code
|
CPT 36200
|
| Hospital Charge Code |
909081318
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$250.50 |
| Max. Negotiated Rate |
$1,038.00 |
| Rate for Payer: Adventist Health Commercial |
$276.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$891.30
|
| Rate for Payer: Cash Price |
$622.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$936.97
|
| Rate for Payer: Heritage Provider Network Senior |
$936.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$250.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$346.00
|
| Rate for Payer: Multiplan Commercial |
$1,038.00
|
|
|
HC AORTOGRAM/SUPRAVALVULAR
|
Facility
|
OP
|
$2,160.00
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
906811416
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$390.96 |
| Max. Negotiated Rate |
$8,962.13 |
| Rate for Payer: Adventist Health Commercial |
$432.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,334.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,836.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,188.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,620.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,836.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,836.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,836.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,274.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,337.04
|
| Rate for Payer: Heritage Provider Network Senior |
$1,337.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,030.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$390.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$540.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,512.00
|
| Rate for Payer: Multiplan Commercial |
$1,620.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,836.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,836.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,836.00
|
|
|
HC AORTOGRAM/SUPRAVALVULAR
|
Facility
|
IP
|
$2,160.00
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
906811416
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$390.96 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$432.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,391.04
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Cash Price |
$972.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$390.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$540.00
|
| Rate for Payer: Multiplan Commercial |
$1,620.00
|
|
|
HC AORTOGRAPH ABDOMINAL
|
Facility
|
OP
|
$5,961.00
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
909081602
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,078.94 |
| Max. Negotiated Rate |
$6,091.57 |
| Rate for Payer: Adventist Health Commercial |
$1,192.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,683.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,404.17
|
| Rate for Payer: Blue Shield of California Commercial |
$2,647.15
|
| Rate for Payer: Blue Shield of California EPN |
$2,128.75
|
| Rate for Payer: Cash Price |
$2,682.45
|
| Rate for Payer: Cash Price |
$2,682.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,874.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,516.99
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,061.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,689.86
|
| Rate for Payer: Heritage Provider Network Senior |
$3,689.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,843.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,078.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,670.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,490.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$4,470.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,061.05
|
| Rate for Payer: TriValley Medical Group Senior |
$4,061.05
|
| 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 |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC AORTOGRAPH ABDOMINAL
|
Facility
|
IP
|
$5,961.00
|
|
|
Service Code
|
CPT 75625
|
| Hospital Charge Code |
909081602
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,078.94 |
| Max. Negotiated Rate |
$4,470.75 |
| Rate for Payer: Adventist Health Commercial |
$1,192.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,838.88
|
| Rate for Payer: Cash Price |
$2,682.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,035.60
|
| Rate for Payer: Heritage Provider Network Senior |
$4,035.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,078.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,490.25
|
| Rate for Payer: Multiplan Commercial |
$4,470.75
|
|
|
HC AORTOGRAPH ABDOMINAL AIF
|
Facility
|
IP
|
$5,961.00
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
909081603
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,078.94 |
| Max. Negotiated Rate |
$4,470.75 |
| Rate for Payer: Adventist Health Commercial |
$1,192.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,838.88
|
| Rate for Payer: Cash Price |
$2,682.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,035.60
|
| Rate for Payer: Heritage Provider Network Senior |
$4,035.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,078.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,490.25
|
| Rate for Payer: Multiplan Commercial |
$4,470.75
|
|
|
HC AORTOGRAPH ABDOMINAL AIF
|
Facility
|
OP
|
$5,961.00
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
909081603
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,078.94 |
| Max. Negotiated Rate |
$6,091.57 |
| Rate for Payer: Adventist Health Commercial |
$1,192.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,683.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,547.86
|
| Rate for Payer: Blue Shield of California Commercial |
$2,759.95
|
| Rate for Payer: Blue Shield of California EPN |
$2,219.46
|
| Rate for Payer: Cash Price |
$2,682.45
|
| Rate for Payer: Cash Price |
$2,682.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,874.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,516.99
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,061.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,689.86
|
| Rate for Payer: Heritage Provider Network Senior |
$3,689.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,843.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,078.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,670.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,490.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$4,470.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,061.05
|
| Rate for Payer: TriValley Medical Group Senior |
$4,061.05
|
| 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 |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC AORTOGRAPH THORACIC
|
Facility
|
OP
|
$8,940.00
|
|
|
Service Code
|
CPT 75605
|
| Hospital Charge Code |
909081600
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,618.14 |
| Max. Negotiated Rate |
$10,735.29 |
| Rate for Payer: Adventist Health Commercial |
$1,788.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,524.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,156.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,404.17
|
| Rate for Payer: Blue Shield of California Commercial |
$2,647.15
|
| Rate for Payer: Blue Shield of California EPN |
$2,128.75
|
| Rate for Payer: Cash Price |
$4,023.00
|
| Rate for Payer: Cash Price |
$4,023.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5,811.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,872.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,156.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,274.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,156.86
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,533.86
|
| Rate for Payer: Heritage Provider Network Senior |
$5,533.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$4,264.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,618.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,230.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,235.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,590.19
|
| Rate for Payer: Multiplan Commercial |
$6,705.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,156.86
|
| Rate for Payer: TriValley Medical Group Senior |
$7,156.86
|
| 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 |
$10,735.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,156.86
|
|
|
HC AORTOGRAPH THORACIC
|
Facility
|
IP
|
$8,940.00
|
|
|
Service Code
|
CPT 75605
|
| Hospital Charge Code |
909081600
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$1,618.14 |
| Max. Negotiated Rate |
$6,705.00 |
| Rate for Payer: Adventist Health Commercial |
$1,788.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,757.36
|
| Rate for Payer: Cash Price |
$4,023.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,052.38
|
| Rate for Payer: Heritage Provider Network Senior |
$6,052.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,618.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,235.00
|
| Rate for Payer: Multiplan Commercial |
$6,705.00
|
|
|
HC AORTO TRNSLMBR NEEDL/CATH
|
Facility
|
IP
|
$687.00
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
909081317
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$124.35 |
| Max. Negotiated Rate |
$515.25 |
| Rate for Payer: Adventist Health Commercial |
$137.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$442.43
|
| Rate for Payer: Cash Price |
$309.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$465.10
|
| Rate for Payer: Heritage Provider Network Senior |
$465.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$124.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.75
|
| Rate for Payer: Multiplan Commercial |
$515.25
|
|
|
HC AORTO TRNSLMBR NEEDL/CATH
|
Facility
|
OP
|
$687.00
|
|
|
Service Code
|
CPT 36160
|
| Hospital Charge Code |
909081317
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$124.35 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$137.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$424.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$583.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$377.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$515.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,672.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$309.15
|
| Rate for Payer: Cash Price |
$309.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$446.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$583.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$583.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$583.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$425.25
|
| Rate for Payer: Heritage Provider Network Senior |
$425.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$327.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$124.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$171.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$480.90
|
| Rate for Payer: Multiplan Commercial |
$515.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$583.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$583.95
|
| Rate for Payer: Vantage Medical Group Senior |
$583.95
|
|
|
HC API M 10 (HONEY BEE), IGE
|
Facility
|
OP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913746
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$157.06 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Adventist Health Commercial |
$3.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.12
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.06
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.66
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.17
|
| Rate for Payer: Heritage Provider Network Senior |
$10.14
|
| Rate for Payer: Heritage Provider Network Senior |
$12.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$9.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$12.29
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC API M 10 (HONEY BEE), IGE
|
Facility
|
IP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913746
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$14.74 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.66
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.31
|
| Rate for Payer: Heritage Provider Network Senior |
$13.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.92
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
|
|
HC API M 1 (HONEY BEE), IGE
|
Facility
|
OP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913742
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$157.06 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Adventist Health Commercial |
$3.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.12
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.06
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.66
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.17
|
| Rate for Payer: Heritage Provider Network Senior |
$10.14
|
| Rate for Payer: Heritage Provider Network Senior |
$12.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$9.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$12.29
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC API M 1 (HONEY BEE), IGE
|
Facility
|
IP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913742
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$14.74 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.66
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.31
|
| Rate for Payer: Heritage Provider Network Senior |
$13.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.92
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
|
|
HC API M 2 (HONEY BEE), IGE
|
Facility
|
IP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913743
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$14.74 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.66
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.31
|
| Rate for Payer: Heritage Provider Network Senior |
$13.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.92
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
|
|
HC API M 2 (HONEY BEE), IGE
|
Facility
|
OP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913743
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$157.06 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Adventist Health Commercial |
$3.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.12
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.06
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.66
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.17
|
| Rate for Payer: Heritage Provider Network Senior |
$10.14
|
| Rate for Payer: Heritage Provider Network Senior |
$12.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$9.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$12.29
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC API M 3 (HONEY BEE), IGE
|
Facility
|
OP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913744
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$157.06 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Adventist Health Commercial |
$3.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.12
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.06
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.66
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.17
|
| Rate for Payer: Heritage Provider Network Senior |
$10.14
|
| Rate for Payer: Heritage Provider Network Senior |
$12.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$9.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$12.29
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC API M 3 (HONEY BEE), IGE
|
Facility
|
IP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913744
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$14.74 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.66
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.31
|
| Rate for Payer: Heritage Provider Network Senior |
$13.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.92
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
|
|
HC API M 5 (HONEY BEE), IGE
|
Facility
|
IP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913745
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$14.74 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.66
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.31
|
| Rate for Payer: Heritage Provider Network Senior |
$13.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.92
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
|
|
HC API M 5 (HONEY BEE), IGE
|
Facility
|
OP
|
$19.66
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913745
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$157.06 |
| Rate for Payer: Adventist Health Commercial |
$3.93
|
| Rate for Payer: Adventist Health Commercial |
$3.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.12
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.06
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$8.85
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.66
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.17
|
| Rate for Payer: Heritage Provider Network Senior |
$10.14
|
| Rate for Payer: Heritage Provider Network Senior |
$12.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$9.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.03
|
| Rate for Payer: Multiplan Commercial |
$12.29
|
| Rate for Payer: Multiplan Commercial |
$14.74
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
