|
HC ATHERECTOMY W CORO STENT ADD'L
|
Facility
IP
|
$22,729.00
|
|
|
Service Code
|
CPT 92934
|
| Hospital Charge Code |
906820242
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,113.95 |
| Max. Negotiated Rate |
$17,046.75 |
| Rate for Payer: Adventist Health Commercial |
$4,545.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,614.82
|
| Rate for Payer: Cash Price |
$10,228.05
|
| Rate for Payer: Cash Price |
$10,228.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,113.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,682.25
|
| Rate for Payer: Multiplan Commercial |
$17,046.75
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
IP
|
$22,354.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906811434
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,046.07 |
| Max. Negotiated Rate |
$16,765.50 |
| Rate for Payer: Adventist Health Commercial |
$4,470.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,357.20
|
| Rate for Payer: Cash Price |
$10,059.30
|
| Rate for Payer: Cash Price |
$10,059.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,046.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,588.50
|
| Rate for Payer: Multiplan Commercial |
$16,765.50
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
OP
|
$22,354.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906811434
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$806.93 |
| Max. Negotiated Rate |
$26,115.92 |
| Rate for Payer: Adventist Health Commercial |
$4,470.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,407.72
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,357.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,496.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,562.15
|
| Rate for Payer: Blue Shield of California EPN |
$6,499.32
|
| Rate for Payer: Cash Price |
$10,059.30
|
| Rate for Payer: Cash Price |
$10,059.30
|
| Rate for Payer: Cash Price |
$10,059.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: Dignity Health Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,745.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,837.13
|
| Rate for Payer: Heritage Provider Network Senior |
$16,906.62
|
| Rate for Payer: Humana Medicare |
$13,745.22
|
| Rate for Payer: IEHP Medi-Cal |
$806.93
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$26,115.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,046.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,219.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,588.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,318.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,318.98
|
| Rate for Payer: Multiplan Commercial |
$16,765.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,119.74
|
| Rate for Payer: TriValley Medical Group Senior |
$13,745.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
OP
|
$26,744.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906820237
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$806.93 |
| Max. Negotiated Rate |
$26,115.92 |
| Rate for Payer: Adventist Health Commercial |
$5,348.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,407.72
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,373.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,496.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,562.15
|
| Rate for Payer: Blue Shield of California EPN |
$6,499.32
|
| Rate for Payer: Cash Price |
$12,034.80
|
| Rate for Payer: Cash Price |
$12,034.80
|
| Rate for Payer: Cash Price |
$12,034.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: Dignity Health Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,745.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,554.54
|
| Rate for Payer: Heritage Provider Network Senior |
$16,906.62
|
| Rate for Payer: Humana Medicare |
$13,745.22
|
| Rate for Payer: IEHP Medi-Cal |
$806.93
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$26,115.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,840.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,219.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,686.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,318.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,318.98
|
| Rate for Payer: Multiplan Commercial |
$20,058.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,119.74
|
| Rate for Payer: TriValley Medical Group Senior |
$13,745.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC ATHERECTOMY W PTCA
|
Facility
IP
|
$26,744.00
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
906820237
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,840.66 |
| Max. Negotiated Rate |
$20,058.00 |
| Rate for Payer: Adventist Health Commercial |
$5,348.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,373.13
|
| Rate for Payer: Cash Price |
$12,034.80
|
| Rate for Payer: Cash Price |
$12,034.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,840.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,686.00
|
| Rate for Payer: Multiplan Commercial |
$20,058.00
|
|
|
HC ATHERECTOMY W PTCA ADD'L VESSEL
|
Facility
IP
|
$23,303.00
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
906811435
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,217.84 |
| Max. Negotiated Rate |
$17,477.25 |
| Rate for Payer: Adventist Health Commercial |
$4,660.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,009.16
|
| Rate for Payer: Cash Price |
$10,486.35
|
| Rate for Payer: Cash Price |
$10,486.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,217.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,825.75
|
| Rate for Payer: Multiplan Commercial |
$17,477.25
|
|
|
HC ATHERECTOMY W PTCA ADD'L VESSEL
|
Facility
OP
|
$23,303.00
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
906811435
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$729.69 |
| Max. Negotiated Rate |
$19,807.55 |
| Rate for Payer: Adventist Health Commercial |
$4,660.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$729.69
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,009.16
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19,807.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12,816.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17,477.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,562.15
|
| Rate for Payer: Blue Shield of California EPN |
$6,499.32
|
| Rate for Payer: Cash Price |
$10,486.35
|
| Rate for Payer: Cash Price |
$10,486.35
|
| Rate for Payer: Cash Price |
$10,486.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19,807.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$19,807.55
|
| Rate for Payer: Dignity Health Senior |
$19,807.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,424.56
|
| Rate for Payer: Heritage Provider Network Senior |
$14,424.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11,232.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,217.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,825.75
|
| Rate for Payer: Multiplan Commercial |
$17,477.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19,807.55
|
| Rate for Payer: Vantage Medical Group Senior |
$19,807.55
|
|
|
HC ATHERECTOMY W PTCA ADD'L VESSEL
|
Facility
OP
|
$10,699.00
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
906820238
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$729.69 |
| Max. Negotiated Rate |
$17,002.00 |
| Rate for Payer: Adventist Health Commercial |
$2,139.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$729.69
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,350.21
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9,094.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5,884.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8,024.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,562.15
|
| Rate for Payer: Blue Shield of California EPN |
$6,499.32
|
| Rate for Payer: Cash Price |
$4,814.55
|
| Rate for Payer: Cash Price |
$4,814.55
|
| Rate for Payer: Cash Price |
$4,814.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,094.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$9,094.15
|
| Rate for Payer: Dignity Health Senior |
$9,094.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,622.68
|
| Rate for Payer: Heritage Provider Network Senior |
$6,622.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5,156.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,936.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,674.75
|
| Rate for Payer: Multiplan Commercial |
$8,024.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,094.15
|
| Rate for Payer: Vantage Medical Group Senior |
$9,094.15
|
|
|
HC ATHERECTOMY W PTCA ADD'L VESSEL
|
Facility
IP
|
$10,699.00
|
|
|
Service Code
|
CPT 92925
|
| Hospital Charge Code |
906820238
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,936.52 |
| Max. Negotiated Rate |
$8,024.25 |
| Rate for Payer: Adventist Health Commercial |
$2,139.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,350.21
|
| Rate for Payer: Cash Price |
$4,814.55
|
| Rate for Payer: Cash Price |
$4,814.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,936.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,674.75
|
| Rate for Payer: Multiplan Commercial |
$8,024.25
|
|
|
HC ATHRECTOMY AORTA
|
Facility
IP
|
$38,541.00
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
909020080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,975.92 |
| Max. Negotiated Rate |
$28,905.75 |
| Rate for Payer: Adventist Health Commercial |
$7,708.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$26,477.67
|
| Rate for Payer: Cash Price |
$17,343.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$26,092.26
|
| Rate for Payer: Heritage Provider Network Senior |
$26,092.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,975.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,635.25
|
| Rate for Payer: Multiplan Commercial |
$28,905.75
|
|
|
HC ATHRECTOMY AORTA
|
Facility
OP
|
$38,541.00
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
909020080
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,728.00 |
| Max. Negotiated Rate |
$28,905.75 |
| Rate for Payer: Adventist Health Commercial |
$7,708.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$26,477.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,500.11
|
| Rate for Payer: Blue Shield of California EPN |
$9,024.37
|
| Rate for Payer: Cash Price |
$17,343.45
|
| Rate for Payer: Cash Price |
$17,343.45
|
| Rate for Payer: Cash Price |
$17,343.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$25,051.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: Dignity Health Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,124.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,745.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,856.88
|
| Rate for Payer: Heritage Provider Network Senior |
$16,906.62
|
| Rate for Payer: Humana Medicare |
$13,745.22
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$26,115.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,975.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,219.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,635.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,318.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,318.98
|
| Rate for Payer: Multiplan Commercial |
$28,905.75
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,119.74
|
| Rate for Payer: TriValley Medical Group Senior |
$15,119.74
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC ATHRECTOMY AORTA
|
Facility
OP
|
$32,366.00
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
906820163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,728.00 |
| Max. Negotiated Rate |
$26,115.92 |
| Rate for Payer: Adventist Health Commercial |
$6,473.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$22,235.44
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,500.11
|
| Rate for Payer: Blue Shield of California EPN |
$9,024.37
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$21,037.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: Dignity Health Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,419.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,745.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,034.55
|
| Rate for Payer: Heritage Provider Network Senior |
$16,906.62
|
| Rate for Payer: Humana Medicare |
$13,745.22
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$26,115.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,858.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,219.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,091.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,318.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,318.98
|
| Rate for Payer: Multiplan Commercial |
$24,274.50
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,119.74
|
| Rate for Payer: TriValley Medical Group Senior |
$15,119.74
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC ATHRECTOMY AORTA
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0236T
|
| Hospital Charge Code |
906820163
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,858.25 |
| Max. Negotiated Rate |
$24,274.50 |
| Rate for Payer: Adventist Health Commercial |
$6,473.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$22,235.44
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,911.78
|
| Rate for Payer: Heritage Provider Network Senior |
$21,911.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,858.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,091.50
|
| Rate for Payer: Multiplan Commercial |
$24,274.50
|
|
|
HC ATHRECTOMY BRACHIOCEPHALIC
|
Facility
OP
|
$33,595.00
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
909020079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,728.00 |
| Max. Negotiated Rate |
$26,115.92 |
| Rate for Payer: Adventist Health Commercial |
$6,719.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$23,079.76
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,500.11
|
| Rate for Payer: Blue Shield of California EPN |
$9,024.37
|
| Rate for Payer: Cash Price |
$15,117.75
|
| Rate for Payer: Cash Price |
$15,117.75
|
| Rate for Payer: Cash Price |
$15,117.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$21,836.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: Dignity Health Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$20,157.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,745.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,795.30
|
| Rate for Payer: Heritage Provider Network Senior |
$16,906.62
|
| Rate for Payer: Humana Medicare |
$13,745.22
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$26,115.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,080.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,219.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,398.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,318.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,318.98
|
| Rate for Payer: Multiplan Commercial |
$25,196.25
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,119.74
|
| Rate for Payer: TriValley Medical Group Senior |
$15,119.74
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC ATHRECTOMY BRACHIOCEPHALIC
|
Facility
OP
|
$32,366.00
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
906820162
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,728.00 |
| Max. Negotiated Rate |
$26,115.92 |
| Rate for Payer: Adventist Health Commercial |
$6,473.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$22,235.44
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13,745.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,500.11
|
| Rate for Payer: Blue Shield of California EPN |
$9,024.37
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$21,037.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$15,119.74
|
| Rate for Payer: Dignity Health Senior |
$13,745.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,419.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$13,745.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,034.55
|
| Rate for Payer: Heritage Provider Network Senior |
$16,906.62
|
| Rate for Payer: Humana Medicare |
$13,745.22
|
| Rate for Payer: IEHP Medicare Advantage |
$13,745.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$26,115.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,858.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16,219.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,091.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17,318.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17,318.98
|
| Rate for Payer: Multiplan Commercial |
$24,274.50
|
| Rate for Payer: Multiplan WC |
$18,791.68
|
| Rate for Payer: TriValley Medical Group Commercial |
$15,119.74
|
| Rate for Payer: TriValley Medical Group Senior |
$15,119.74
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20,617.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15,119.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13,745.22
|
|
|
HC ATHRECTOMY BRACHIOCEPHALIC
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
906820162
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,858.25 |
| Max. Negotiated Rate |
$24,274.50 |
| Rate for Payer: Adventist Health Commercial |
$6,473.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$22,235.44
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,911.78
|
| Rate for Payer: Heritage Provider Network Senior |
$21,911.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,858.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,091.50
|
| Rate for Payer: Multiplan Commercial |
$24,274.50
|
|
|
HC ATHRECTOMY BRACHIOCEPHALIC
|
Facility
IP
|
$33,595.00
|
|
|
Service Code
|
CPT 0237T
|
| Hospital Charge Code |
909020079
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,080.70 |
| Max. Negotiated Rate |
$25,196.25 |
| Rate for Payer: Adventist Health Commercial |
$6,719.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$23,079.76
|
| Rate for Payer: Cash Price |
$15,117.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$22,743.82
|
| Rate for Payer: Heritage Provider Network Senior |
$22,743.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,080.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,398.75
|
| Rate for Payer: Multiplan Commercial |
$25,196.25
|
|
|
HC ATHRECTOMY FEM/POP
|
Facility
OP
|
$26,307.00
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
909020066
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$163.49 |
| Max. Negotiated Rate |
$41,627.02 |
| Rate for Payer: Adventist Health Commercial |
$5,261.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,072.91
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,651.80
|
| Rate for Payer: Blue Shield of California EPN |
$5,716.91
|
| Rate for Payer: Cash Price |
$11,838.15
|
| Rate for Payer: Cash Price |
$11,838.15
|
| Rate for Payer: Cash Price |
$11,838.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,099.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,099.86
|
| Rate for Payer: Dignity Health Senior |
$21,908.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$21,908.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,284.03
|
| Rate for Payer: Heritage Provider Network Senior |
$26,948.02
|
| Rate for Payer: Humana Medicare |
$21,908.96
|
| Rate for Payer: IEHP Medi-Cal |
$163.49
|
| Rate for Payer: IEHP Medicare Advantage |
$21,908.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$41,627.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,761.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,852.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,576.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,605.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,605.29
|
| Rate for Payer: Multiplan Commercial |
$19,730.25
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: TriValley Medical Group Commercial |
$24,099.86
|
| Rate for Payer: TriValley Medical Group Senior |
$24,099.86
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Vantage Medical Group Senior |
$21,908.96
|
|
|
HC ATHRECTOMY FEM/POP
|
Facility
OP
|
$28,001.00
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
906820149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$163.49 |
| Max. Negotiated Rate |
$41,627.02 |
| Rate for Payer: Adventist Health Commercial |
$5,600.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,236.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,651.80
|
| Rate for Payer: Blue Shield of California EPN |
$5,716.91
|
| Rate for Payer: Cash Price |
$12,600.45
|
| Rate for Payer: Cash Price |
$12,600.45
|
| Rate for Payer: Cash Price |
$12,600.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18,200.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,099.86
|
| Rate for Payer: Dignity Health Senior |
$21,908.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$21,908.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,332.62
|
| Rate for Payer: Heritage Provider Network Senior |
$26,948.02
|
| Rate for Payer: Humana Medicare |
$21,908.96
|
| Rate for Payer: IEHP Medi-Cal |
$163.49
|
| Rate for Payer: IEHP Medicare Advantage |
$21,908.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$41,627.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,068.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,852.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,000.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,605.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,605.29
|
| Rate for Payer: Multiplan Commercial |
$21,000.75
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: TriValley Medical Group Commercial |
$24,099.86
|
| Rate for Payer: TriValley Medical Group Senior |
$24,099.86
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Vantage Medical Group Senior |
$21,908.96
|
|
|
HC ATHRECTOMY FEM/POP
|
Facility
IP
|
$28,001.00
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
906820149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,068.18 |
| Max. Negotiated Rate |
$21,000.75 |
| Rate for Payer: Adventist Health Commercial |
$5,600.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,236.69
|
| Rate for Payer: Cash Price |
$12,600.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,956.68
|
| Rate for Payer: Heritage Provider Network Senior |
$18,956.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,068.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,000.25
|
| Rate for Payer: Multiplan Commercial |
$21,000.75
|
|
|
HC ATHRECTOMY FEM/POP
|
Facility
IP
|
$26,307.00
|
|
|
Service Code
|
CPT 37225
|
| Hospital Charge Code |
909020066
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,761.57 |
| Max. Negotiated Rate |
$19,730.25 |
| Rate for Payer: Adventist Health Commercial |
$5,261.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,072.91
|
| Rate for Payer: Cash Price |
$11,838.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,809.84
|
| Rate for Payer: Heritage Provider Network Senior |
$17,809.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,761.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,576.75
|
| Rate for Payer: Multiplan Commercial |
$19,730.25
|
|
|
HC ATHRECTOMY ILIAC
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
906820164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,858.25 |
| Max. Negotiated Rate |
$24,274.50 |
| Rate for Payer: Adventist Health Commercial |
$6,473.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$22,235.44
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$21,911.78
|
| Rate for Payer: Heritage Provider Network Senior |
$21,911.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,858.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,091.50
|
| Rate for Payer: Multiplan Commercial |
$24,274.50
|
|
|
HC ATHRECTOMY ILIAC
|
Facility
OP
|
$27,048.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
909020081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,895.69 |
| Max. Negotiated Rate |
$41,627.02 |
| Rate for Payer: Adventist Health Commercial |
$5,409.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,581.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,500.11
|
| Rate for Payer: Blue Shield of California EPN |
$9,024.37
|
| Rate for Payer: Cash Price |
$12,171.60
|
| Rate for Payer: Cash Price |
$12,171.60
|
| Rate for Payer: Cash Price |
$12,171.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,581.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,099.86
|
| Rate for Payer: Dignity Health Senior |
$21,908.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,228.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$21,908.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,742.71
|
| Rate for Payer: Heritage Provider Network Senior |
$26,948.02
|
| Rate for Payer: Humana Medicare |
$21,908.96
|
| Rate for Payer: IEHP Medicare Advantage |
$21,908.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$41,627.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,895.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,852.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,762.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,605.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,605.29
|
| Rate for Payer: Multiplan Commercial |
$20,286.00
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: TriValley Medical Group Commercial |
$24,099.86
|
| Rate for Payer: TriValley Medical Group Senior |
$24,099.86
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Vantage Medical Group Senior |
$21,908.96
|
|
|
HC ATHRECTOMY ILIAC
|
Facility
OP
|
$32,366.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
906820164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,858.25 |
| Max. Negotiated Rate |
$41,627.02 |
| Rate for Payer: Adventist Health Commercial |
$6,473.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$22,235.44
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21,908.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,436.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,500.11
|
| Rate for Payer: Blue Shield of California EPN |
$9,024.37
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cash Price |
$14,564.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$21,037.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$24,099.86
|
| Rate for Payer: Dignity Health Senior |
$21,908.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,419.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$21,908.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$20,034.55
|
| Rate for Payer: Heritage Provider Network Senior |
$26,948.02
|
| Rate for Payer: Humana Medicare |
$21,908.96
|
| Rate for Payer: IEHP Medicare Advantage |
$21,908.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$41,627.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,858.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,852.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8,091.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27,605.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27,605.29
|
| Rate for Payer: Multiplan Commercial |
$24,274.50
|
| Rate for Payer: Multiplan WC |
$29,952.68
|
| Rate for Payer: TriValley Medical Group Commercial |
$24,099.86
|
| Rate for Payer: TriValley Medical Group Senior |
$24,099.86
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,002.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14,303.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32,863.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24,099.86
|
| Rate for Payer: Vantage Medical Group Senior |
$21,908.96
|
|
|
HC ATHRECTOMY ILIAC
|
Facility
IP
|
$27,048.00
|
|
|
Service Code
|
CPT 0238T
|
| Hospital Charge Code |
909020081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,895.69 |
| Max. Negotiated Rate |
$20,286.00 |
| Rate for Payer: Adventist Health Commercial |
$5,409.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,581.98
|
| Rate for Payer: Cash Price |
$12,171.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,311.50
|
| Rate for Payer: Heritage Provider Network Senior |
$18,311.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,895.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,762.00
|
| Rate for Payer: Multiplan Commercial |
$20,286.00
|
|
