|
HC ATHRECTOMY RENAL
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
906820160
|
|
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 RENAL
|
Facility
OP
|
$33,595.00
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
909020077
|
|
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 RENAL
|
Facility
IP
|
$33,595.00
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
909020077
|
|
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 RENAL
|
Facility
OP
|
$32,366.00
|
|
|
Service Code
|
CPT 0234T
|
| Hospital Charge Code |
906820160
|
|
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 & STENT FEM/POP
|
Facility
OP
|
$44,339.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
909020068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$197.43 |
| Max. Negotiated Rate |
$41,627.02 |
| Rate for Payer: Adventist Health Commercial |
$8,867.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30,460.89
|
| 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 |
$8,054.00
|
| 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 |
$19,952.55
|
| Rate for Payer: Cash Price |
$19,952.55
|
| Rate for Payer: Cash Price |
$19,952.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$28,820.35
|
| 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 |
$27,445.84
|
| Rate for Payer: Heritage Provider Network Senior |
$26,948.02
|
| Rate for Payer: Humana Medicare |
$21,908.96
|
| Rate for Payer: IEHP Medi-Cal |
$197.43
|
| 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 |
$8,025.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,852.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,084.75
|
| 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 |
$33,254.25
|
| 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 |
$18,042.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,173.00
|
| 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 & STENT FEM/POP
|
Facility
IP
|
$44,339.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
909020068
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,025.36 |
| Max. Negotiated Rate |
$33,254.25 |
| Rate for Payer: Adventist Health Commercial |
$8,867.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$30,460.89
|
| Rate for Payer: Cash Price |
$19,952.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,017.50
|
| Rate for Payer: Heritage Provider Network Senior |
$30,017.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,025.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,084.75
|
| Rate for Payer: Multiplan Commercial |
$33,254.25
|
|
|
HC ATHRECTOMY & STENT FEM/POP
|
Facility
OP
|
$49,537.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
906820151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$197.43 |
| Max. Negotiated Rate |
$41,627.02 |
| Rate for Payer: Adventist Health Commercial |
$9,907.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34,031.92
|
| 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 |
$8,054.00
|
| 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 |
$22,291.65
|
| Rate for Payer: Cash Price |
$22,291.65
|
| Rate for Payer: Cash Price |
$22,291.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32,199.05
|
| 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 |
$30,663.40
|
| Rate for Payer: Heritage Provider Network Senior |
$26,948.02
|
| Rate for Payer: Humana Medicare |
$21,908.96
|
| Rate for Payer: IEHP Medi-Cal |
$197.43
|
| 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 |
$8,966.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,852.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,384.25
|
| 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 |
$37,152.75
|
| 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 |
$18,042.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,173.00
|
| 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 & STENT FEM/POP
|
Facility
IP
|
$49,537.00
|
|
|
Service Code
|
CPT 37227
|
| Hospital Charge Code |
906820151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,966.20 |
| Max. Negotiated Rate |
$37,152.75 |
| Rate for Payer: Adventist Health Commercial |
$9,907.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34,031.92
|
| Rate for Payer: Cash Price |
$22,291.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,536.55
|
| Rate for Payer: Heritage Provider Network Senior |
$33,536.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,966.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,384.25
|
| Rate for Payer: Multiplan Commercial |
$37,152.75
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
OP
|
$25,544.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
909020076
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$104.36 |
| Max. Negotiated Rate |
$21,712.40 |
| Rate for Payer: Adventist Health Commercial |
$5,108.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,548.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21,712.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,049.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$19,158.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| 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 |
$11,494.80
|
| Rate for Payer: Cash Price |
$11,494.80
|
| Rate for Payer: Cash Price |
$11,494.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16,603.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,712.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,712.40
|
| Rate for Payer: Dignity Health Senior |
$21,712.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,811.74
|
| Rate for Payer: Heritage Provider Network Senior |
$15,811.74
|
| Rate for Payer: IEHP Medi-Cal |
$104.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12,312.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,623.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,386.00
|
| Rate for Payer: Multiplan Commercial |
$19,158.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,712.40
|
| Rate for Payer: Vantage Medical Group Senior |
$21,712.40
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
OP
|
$16,120.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
906820159
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$104.36 |
| Max. Negotiated Rate |
$13,702.00 |
| Rate for Payer: Adventist Health Commercial |
$3,224.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,074.44
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13,702.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8,866.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12,090.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| 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 |
$7,254.00
|
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,478.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,702.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,702.00
|
| Rate for Payer: Dignity Health Senior |
$13,702.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,978.28
|
| Rate for Payer: Heritage Provider Network Senior |
$9,978.28
|
| Rate for Payer: IEHP Medi-Cal |
$104.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,769.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,917.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,030.00
|
| Rate for Payer: Multiplan Commercial |
$12,090.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13,479.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,381.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,702.00
|
| Rate for Payer: Vantage Medical Group Senior |
$13,702.00
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
IP
|
$16,120.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
906820159
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,917.72 |
| Max. Negotiated Rate |
$12,090.00 |
| Rate for Payer: Adventist Health Commercial |
$3,224.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11,074.44
|
| Rate for Payer: Cash Price |
$7,254.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,913.24
|
| Rate for Payer: Heritage Provider Network Senior |
$10,913.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,917.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,030.00
|
| Rate for Payer: Multiplan Commercial |
$12,090.00
|
|
|
HC ATHRECTOMY & STENT TIBIOPER EA
|
Facility
IP
|
$25,544.00
|
|
|
Service Code
|
CPT 37235
|
| Hospital Charge Code |
909020076
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,623.46 |
| Max. Negotiated Rate |
$19,158.00 |
| Rate for Payer: Adventist Health Commercial |
$5,108.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,548.73
|
| Rate for Payer: Cash Price |
$11,494.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,293.29
|
| Rate for Payer: Heritage Provider Network Senior |
$17,293.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,623.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,386.00
|
| Rate for Payer: Multiplan Commercial |
$19,158.00
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
OP
|
$49,537.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
906820155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$201.61 |
| Max. Negotiated Rate |
$41,627.02 |
| Rate for Payer: Adventist Health Commercial |
$9,907.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34,031.92
|
| 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 |
$8,054.00
|
| 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 |
$22,291.65
|
| Rate for Payer: Cash Price |
$22,291.65
|
| Rate for Payer: Cash Price |
$22,291.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32,199.05
|
| 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 |
$30,663.40
|
| Rate for Payer: Heritage Provider Network Senior |
$26,948.02
|
| Rate for Payer: Humana Medicare |
$21,908.96
|
| Rate for Payer: IEHP Medi-Cal |
$201.61
|
| 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 |
$8,966.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,852.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,384.25
|
| 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 |
$37,152.75
|
| 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 |
$18,042.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,173.00
|
| 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 & STENT TIBIOPERONE
|
Facility
IP
|
$49,537.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
906820155
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,966.20 |
| Max. Negotiated Rate |
$37,152.75 |
| Rate for Payer: Adventist Health Commercial |
$9,907.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34,031.92
|
| Rate for Payer: Cash Price |
$22,291.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,536.55
|
| Rate for Payer: Heritage Provider Network Senior |
$33,536.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,966.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12,384.25
|
| Rate for Payer: Multiplan Commercial |
$37,152.75
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
IP
|
$26,298.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
909020072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,759.94 |
| Max. Negotiated Rate |
$19,723.50 |
| Rate for Payer: Adventist Health Commercial |
$5,259.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,066.73
|
| Rate for Payer: Cash Price |
$11,834.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,803.75
|
| Rate for Payer: Heritage Provider Network Senior |
$17,803.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,759.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,574.50
|
| Rate for Payer: Multiplan Commercial |
$19,723.50
|
|
|
HC ATHRECTOMY & STENT TIBIOPERONE
|
Facility
OP
|
$26,298.00
|
|
|
Service Code
|
CPT 37231
|
| Hospital Charge Code |
909020072
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$201.61 |
| Max. Negotiated Rate |
$41,627.02 |
| Rate for Payer: Adventist Health Commercial |
$5,259.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,066.73
|
| 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 |
$8,054.00
|
| 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 |
$11,834.10
|
| Rate for Payer: Cash Price |
$11,834.10
|
| Rate for Payer: Cash Price |
$11,834.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,093.70
|
| 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 |
$16,278.46
|
| Rate for Payer: Heritage Provider Network Senior |
$26,948.02
|
| Rate for Payer: Humana Medicare |
$21,908.96
|
| Rate for Payer: IEHP Medi-Cal |
$201.61
|
| 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 |
$4,759.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,852.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,574.50
|
| 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 |
$19,723.50
|
| 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 |
$18,042.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,173.00
|
| 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 TIBIOPERONEAL
|
Facility
IP
|
$28,001.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
906820153
|
|
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 TIBIOPERONEAL
|
Facility
OP
|
$28,001.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
906820153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$191.33 |
| 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 |
$8,054.00
|
| 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 |
$191.33
|
| 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 TIBIOPERONEAL
|
Facility
IP
|
$26,298.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
909020070
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,759.94 |
| Max. Negotiated Rate |
$19,723.50 |
| Rate for Payer: Adventist Health Commercial |
$5,259.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,066.73
|
| Rate for Payer: Cash Price |
$11,834.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,803.75
|
| Rate for Payer: Heritage Provider Network Senior |
$17,803.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,759.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,574.50
|
| Rate for Payer: Multiplan Commercial |
$19,723.50
|
|
|
HC ATHRECTOMY TIBIOPERONEAL
|
Facility
OP
|
$26,298.00
|
|
|
Service Code
|
CPT 37229
|
| Hospital Charge Code |
909020070
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$191.33 |
| Max. Negotiated Rate |
$41,627.02 |
| Rate for Payer: Adventist Health Commercial |
$5,259.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,066.73
|
| 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 |
$8,054.00
|
| 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 |
$11,834.10
|
| Rate for Payer: Cash Price |
$11,834.10
|
| Rate for Payer: Cash Price |
$11,834.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,093.70
|
| 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 |
$16,278.46
|
| Rate for Payer: Heritage Provider Network Senior |
$26,948.02
|
| Rate for Payer: Humana Medicare |
$21,908.96
|
| Rate for Payer: IEHP Medi-Cal |
$191.33
|
| 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 |
$4,759.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,852.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,574.50
|
| 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 |
$19,723.50
|
| 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 TIBIOPERONEAL EA AD
|
Facility
IP
|
$28,001.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
906820157
|
|
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 TIBIOPERONEAL EA AD
|
Facility
IP
|
$26,298.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
909020074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,759.94 |
| Max. Negotiated Rate |
$19,723.50 |
| Rate for Payer: Adventist Health Commercial |
$5,259.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,066.73
|
| Rate for Payer: Cash Price |
$11,834.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,803.75
|
| Rate for Payer: Heritage Provider Network Senior |
$17,803.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,759.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,574.50
|
| Rate for Payer: Multiplan Commercial |
$19,723.50
|
|
|
HC ATHRECTOMY TIBIOPERONEAL EA AD
|
Facility
OP
|
$26,298.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
909020074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$88.33 |
| Max. Negotiated Rate |
$22,353.30 |
| Rate for Payer: Adventist Health Commercial |
$5,259.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,066.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22,353.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,463.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$19,723.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| 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 |
$11,834.10
|
| Rate for Payer: Cash Price |
$11,834.10
|
| Rate for Payer: Cash Price |
$11,834.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,093.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,353.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,353.30
|
| Rate for Payer: Dignity Health Senior |
$22,353.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,278.46
|
| Rate for Payer: Heritage Provider Network Senior |
$16,278.46
|
| Rate for Payer: IEHP Medi-Cal |
$88.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12,675.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,759.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,574.50
|
| Rate for Payer: Multiplan Commercial |
$19,723.50
|
| 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 |
$22,353.30
|
| Rate for Payer: Vantage Medical Group Senior |
$22,353.30
|
|
|
HC ATHRECTOMY TIBIOPERONEAL EA AD
|
Facility
OP
|
$28,001.00
|
|
|
Service Code
|
CPT 37233
|
| Hospital Charge Code |
906820157
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$88.33 |
| Max. Negotiated Rate |
$23,800.85 |
| Rate for Payer: Adventist Health Commercial |
$5,600.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1,335.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,236.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$23,800.85
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,400.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21,000.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,547.00
|
| 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 |
$23,800.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,800.85
|
| Rate for Payer: Dignity Health Senior |
$23,800.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,332.62
|
| Rate for Payer: Heritage Provider Network Senior |
$17,332.62
|
| Rate for Payer: IEHP Medi-Cal |
$88.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,496.48
|
| 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
|
| 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 |
$23,800.85
|
| Rate for Payer: Vantage Medical Group Senior |
$23,800.85
|
|
|
HC ATHRECTOMY VISCERAL
|
Facility
IP
|
$32,366.00
|
|
|
Service Code
|
CPT 0235T
|
| Hospital Charge Code |
906820161
|
|
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
|
|
