|
HC PASSY MUIR VALVE SPEAKING
|
Facility
|
IP
|
$288.00
|
|
|
Service Code
|
CPT L8501
|
| Hospital Charge Code |
900800700
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.13 |
| Max. Negotiated Rate |
$216.00 |
| Rate for Payer: Adventist Health Commercial |
$57.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$185.47
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$194.98
|
| Rate for Payer: Heritage Provider Network Senior |
$194.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$52.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.00
|
| Rate for Payer: Multiplan Commercial |
$216.00
|
|
|
HC PATH CONSULT SURG ADDL BLOCK P
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800220
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$79.20 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.20
|
| Rate for Payer: Blue Shield of California Commercial |
$51.36
|
| Rate for Payer: Blue Shield of California EPN |
$41.30
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$15.47
|
| Rate for Payer: Heritage Provider Network Senior |
$15.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$11.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.50
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$26.53
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$26.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.25
|
| Rate for Payer: Vantage Medical Group Senior |
$21.25
|
|
|
HC PATH CONSULT SURG ADDL BLOCK P
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 88332
|
| Hospital Charge Code |
903800220
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$18.75 |
| Rate for Payer: Adventist Health Commercial |
$5.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16.10
|
| Rate for Payer: Cash Price |
$11.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.93
|
| Rate for Payer: Heritage Provider Network Senior |
$16.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.25
|
| Rate for Payer: Multiplan Commercial |
$18.75
|
|
|
HC PATH CONSULT SURGERY FRZN PG
|
Facility
|
IP
|
$170.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
903800219
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$30.77 |
| Max. Negotiated Rate |
$127.50 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$109.48
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$115.09
|
| Rate for Payer: Heritage Provider Network Senior |
$115.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.50
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
|
|
HC PATH CONSULT SURGERY FRZN PG
|
Facility
|
OP
|
$170.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
903800219
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$30.77 |
| Max. Negotiated Rate |
$328.68 |
| Rate for Payer: Adventist Health Commercial |
$34.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$105.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$219.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$151.18
|
| Rate for Payer: Blue Shield of California Commercial |
$98.69
|
| Rate for Payer: Blue Shield of California EPN |
$79.36
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$110.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$328.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$241.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$219.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$110.50
|
| Rate for Payer: EPIC Health Plan Medicare |
$219.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$105.23
|
| Rate for Payer: Heritage Provider Network Senior |
$105.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$219.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$81.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$251.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$293.62
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$219.12
|
| Rate for Payer: TriValley Medical Group Senior |
$219.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$164.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$164.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$328.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$241.03
|
| Rate for Payer: Vantage Medical Group Senior |
$219.12
|
|
|
HC PCI BYPASS GRAFT
|
Facility
|
IP
|
$12,647.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
906811440
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,289.11 |
| Max. Negotiated Rate |
$9,485.25 |
| Rate for Payer: Adventist Health Commercial |
$2,529.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8,144.67
|
| Rate for Payer: Cash Price |
$5,691.15
|
| Rate for Payer: Cash Price |
$5,691.15
|
| 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 |
$2,289.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,161.75
|
| Rate for Payer: Multiplan Commercial |
$9,485.25
|
|
|
HC PCI BYPASS GRAFT
|
Facility
|
OP
|
$12,647.00
|
|
|
Service Code
|
CPT 92937
|
| Hospital Charge Code |
906811440
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,289.11 |
| Max. Negotiated Rate |
$28,210.74 |
| Rate for Payer: Adventist Health Commercial |
$2,529.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,815.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,309.00
|
| 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 |
$5,691.15
|
| Rate for Payer: Cash Price |
$5,691.15
|
| Rate for Payer: Cash Price |
$5,691.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,847.76
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,828.49
|
| Rate for Payer: Heritage Provider Network Senior |
$18,262.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$28,210.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,289.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17,074.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,161.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$9,485.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$16,332.54
|
| Rate for Payer: TriValley Medical Group Senior |
$14,847.76
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC PCI BYPASS GRAFT ADD
|
Facility
|
IP
|
$20,918.00
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
906811464
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$3,786.16 |
| Max. Negotiated Rate |
$15,688.50 |
| Rate for Payer: Adventist Health Commercial |
$4,183.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13,471.19
|
| Rate for Payer: Cash Price |
$9,413.10
|
| Rate for Payer: Cash Price |
$9,413.10
|
| 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 |
$3,786.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,229.50
|
| Rate for Payer: Multiplan Commercial |
$15,688.50
|
|
|
HC PCI BYPASS GRAFT ADD
|
Facility
|
OP
|
$20,918.00
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
906811464
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$17,780.30 |
| Rate for Payer: Adventist Health Commercial |
$4,183.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12,927.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17,780.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11,504.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15,688.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,185.00
|
| 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 |
$9,413.10
|
| Rate for Payer: Cash Price |
$9,413.10
|
| Rate for Payer: Cash Price |
$9,413.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13,596.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17,780.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$17,780.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17,780.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,341.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$12,948.24
|
| Rate for Payer: Heritage Provider Network Senior |
$12,948.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$9,977.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,786.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,229.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,642.60
|
| Rate for Payer: Multiplan Commercial |
$15,688.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17,780.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17,780.30
|
| Rate for Payer: Vantage Medical Group Senior |
$17,780.30
|
|
|
HC PCI BYPASS GRAFT, ADDN'L
|
Facility
|
IP
|
$6,323.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
906811441
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,144.46 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$1,264.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,072.01
|
| Rate for Payer: Cash Price |
$2,845.35
|
| Rate for Payer: Cash Price |
$2,845.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,144.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,580.75
|
| Rate for Payer: Multiplan Commercial |
$4,742.25
|
|
|
HC PCI BYPASS GRAFT, ADDN'L
|
Facility
|
OP
|
$6,323.00
|
|
|
Service Code
|
CPT 92938
|
| Hospital Charge Code |
906811441
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,144.46 |
| Max. Negotiated Rate |
$14,160.00 |
| Rate for Payer: Adventist Health Commercial |
$1,264.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,907.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,374.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,477.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,742.25
|
| 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 |
$2,845.35
|
| Rate for Payer: Cash Price |
$2,845.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,374.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,374.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,374.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,913.94
|
| Rate for Payer: Heritage Provider Network Senior |
$3,913.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,016.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,144.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,580.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4,426.10
|
| Rate for Payer: Multiplan Commercial |
$4,742.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,374.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,374.55
|
| Rate for Payer: Vantage Medical Group Senior |
$5,374.55
|
|
|
HC PCI CORO/BYPASS CHRNC CMBND AG AND RG
|
Facility
|
OP
|
$37,323.00
|
|
|
Service Code
|
CPT 92945
|
| Hospital Charge Code |
906811867
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,755.46 |
| Max. Negotiated Rate |
$28,210.74 |
| Rate for Payer: Adventist Health Commercial |
$7,464.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$23,065.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,668.96
|
| 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 |
$16,795.35
|
| Rate for Payer: Cash Price |
$16,795.35
|
| Rate for Payer: Cash Price |
$16,795.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,020.57
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,847.76
|
| Rate for Payer: Heritage Provider Network Commercial |
$23,102.94
|
| Rate for Payer: Heritage Provider Network Senior |
$18,262.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$28,210.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,755.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17,074.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,330.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$27,992.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$16,332.54
|
| Rate for Payer: TriValley Medical Group Senior |
$14,847.76
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18,661.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18,661.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC PCI CORO/BYPASS CHRNC CMBND AG AND RG
|
Facility
|
IP
|
$37,323.00
|
|
|
Service Code
|
CPT 92945
|
| Hospital Charge Code |
906811867
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$27,992.25 |
| Rate for Payer: Adventist Health Commercial |
$7,464.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$24,036.01
|
| Rate for Payer: Cash Price |
$16,795.35
|
| Rate for Payer: Cash Price |
$16,795.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,755.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9,330.75
|
| Rate for Payer: Multiplan Commercial |
$27,992.25
|
|
|
HC PCI CORO/BYPASS CHRONIC 1 VESL
|
Facility
|
OP
|
$15,177.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
906811443
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,747.04 |
| Max. Negotiated Rate |
$28,210.74 |
| Rate for Payer: Adventist Health Commercial |
$3,035.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,379.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14,847.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,309.00
|
| 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 |
$6,829.65
|
| Rate for Payer: Cash Price |
$6,829.65
|
| Rate for Payer: Cash Price |
$6,829.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16,332.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14,847.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,847.76
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,394.56
|
| Rate for Payer: Heritage Provider Network Senior |
$18,262.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,847.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$28,210.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,747.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17,074.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,794.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$11,382.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$16,332.54
|
| Rate for Payer: TriValley Medical Group Senior |
$14,847.76
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,271.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16,332.54
|
| Rate for Payer: Vantage Medical Group Senior |
$14,847.76
|
|
|
HC PCI CORO/BYPASS CHRONIC 1 VESL
|
Facility
|
IP
|
$15,177.00
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
906811443
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,747.04 |
| Max. Negotiated Rate |
$11,382.75 |
| Rate for Payer: Adventist Health Commercial |
$3,035.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,773.99
|
| Rate for Payer: Cash Price |
$6,829.65
|
| Rate for Payer: Cash Price |
$6,829.65
|
| 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 |
$2,747.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,794.25
|
| Rate for Payer: Multiplan Commercial |
$11,382.75
|
|
|
HC PCI CORO BYPASS CHRONIC 1 VSL
|
Facility
|
OP
|
$20,918.00
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
906811466
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$44,797.35 |
| Rate for Payer: Adventist Health Commercial |
$4,183.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12,927.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,577.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,185.00
|
| 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 |
$9,413.10
|
| Rate for Payer: Cash Price |
$9,413.10
|
| Rate for Payer: Cash Price |
$9,413.10
|
| Rate for Payer: Cash Price |
$9,413.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13,596.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$25,935.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23,577.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,341.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$23,577.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$12,948.24
|
| Rate for Payer: Heritage Provider Network Senior |
$29,000.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23,577.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$44,797.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,786.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27,114.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,229.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$31,593.92
|
| Rate for Payer: Multiplan Commercial |
$15,688.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$25,935.31
|
| Rate for Payer: TriValley Medical Group Senior |
$23,577.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35,366.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25,935.31
|
| Rate for Payer: Vantage Medical Group Senior |
$23,577.55
|
|
|
HC PCI CORO BYPASS CHRONIC 1 VSL
|
Facility
|
IP
|
$20,918.00
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
906811466
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$3,786.16 |
| Max. Negotiated Rate |
$15,688.50 |
| Rate for Payer: Adventist Health Commercial |
$4,183.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13,471.19
|
| Rate for Payer: Cash Price |
$9,413.10
|
| Rate for Payer: Cash Price |
$9,413.10
|
| 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 |
$3,786.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,229.50
|
| Rate for Payer: Multiplan Commercial |
$15,688.50
|
|
|
HC PCI CORO BYPASS CHRONIC ADD
|
Facility
|
IP
|
$26,769.00
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
906811467
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,845.19 |
| Max. Negotiated Rate |
$20,076.75 |
| Rate for Payer: Adventist Health Commercial |
$5,353.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,239.24
|
| Rate for Payer: Cash Price |
$12,046.05
|
| Rate for Payer: Cash Price |
$12,046.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,845.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,692.25
|
| Rate for Payer: Multiplan Commercial |
$20,076.75
|
|
|
HC PCI CORO BYPASS CHRONIC ADD
|
Facility
|
OP
|
$26,769.00
|
|
|
Service Code
|
CPT C9608
|
| Hospital Charge Code |
906811467
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$22,753.65 |
| Rate for Payer: Adventist Health Commercial |
$5,353.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,543.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22,753.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14,722.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20,076.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,185.00
|
| 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 |
$12,046.05
|
| Rate for Payer: Cash Price |
$12,046.05
|
| Rate for Payer: Cash Price |
$12,046.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,399.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,753.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,753.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22,753.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,793.71
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,570.01
|
| Rate for Payer: Heritage Provider Network Senior |
$16,570.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$12,768.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,845.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,692.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,738.30
|
| Rate for Payer: Multiplan Commercial |
$20,076.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22,753.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22,753.65
|
| Rate for Payer: Vantage Medical Group Senior |
$22,753.65
|
|
|
HC PCI CORO/BYPASS CHRONIC, ADD'L
|
Facility
|
IP
|
$7,588.00
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
906811444
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,373.43 |
| Max. Negotiated Rate |
$5,691.00 |
| Rate for Payer: Adventist Health Commercial |
$1,517.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,886.67
|
| Rate for Payer: Cash Price |
$3,414.60
|
| Rate for Payer: Cash Price |
$3,414.60
|
| 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 |
$1,373.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,897.00
|
| Rate for Payer: Multiplan Commercial |
$5,691.00
|
|
|
HC PCI CORO/BYPASS CHRONIC, ADD'L
|
Facility
|
OP
|
$7,588.00
|
|
|
Service Code
|
CPT 92944
|
| Hospital Charge Code |
906811444
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,373.43 |
| Max. Negotiated Rate |
$14,160.00 |
| Rate for Payer: Adventist Health Commercial |
$1,517.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,689.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,449.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,173.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,691.00
|
| 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 |
$3,414.60
|
| Rate for Payer: Cash Price |
$3,414.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,449.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,449.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,449.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,696.97
|
| Rate for Payer: Heritage Provider Network Senior |
$4,696.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$3,619.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,373.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,897.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,311.60
|
| Rate for Payer: Multiplan Commercial |
$5,691.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,449.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,449.80
|
| Rate for Payer: Vantage Medical Group Senior |
$6,449.80
|
|
|
HC PCI CORO BYPASS W MI 1 VESSEL
|
Facility
|
IP
|
$30,825.00
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
906811465
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$4,982.00 |
| Max. Negotiated Rate |
$23,118.75 |
| Rate for Payer: Adventist Health Commercial |
$6,165.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,851.30
|
| Rate for Payer: Cash Price |
$13,871.25
|
| Rate for Payer: Cash Price |
$13,871.25
|
| 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 |
$5,579.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,706.25
|
| Rate for Payer: Multiplan Commercial |
$23,118.75
|
|
|
HC PCI CORO BYPASS W MI 1 VESSEL
|
Facility
|
OP
|
$30,825.00
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
906811465
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$483.00 |
| Max. Negotiated Rate |
$26,201.25 |
| Rate for Payer: Adventist Health Commercial |
$6,165.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19,049.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26,201.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16,953.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23,118.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,185.00
|
| 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 |
$13,871.25
|
| Rate for Payer: Cash Price |
$13,871.25
|
| Rate for Payer: Cash Price |
$13,871.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20,036.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26,201.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,201.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26,201.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,186.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$19,080.67
|
| Rate for Payer: Heritage Provider Network Senior |
$19,080.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$14,703.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,579.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7,706.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21,577.50
|
| Rate for Payer: Multiplan Commercial |
$23,118.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26,201.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,201.25
|
| Rate for Payer: Vantage Medical Group Senior |
$26,201.25
|
|
|
HC PCI CORO/BYPASS W MI, 1 VESSEL
|
Facility
|
OP
|
$15,843.00
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
906811442
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,867.58 |
| Max. Negotiated Rate |
$15,309.00 |
| Rate for Payer: Adventist Health Commercial |
$3,168.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9,790.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13,466.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,713.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11,882.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,309.00
|
| 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 |
$7,129.35
|
| Rate for Payer: Cash Price |
$7,129.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13,466.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$13,466.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13,466.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,556.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,806.82
|
| Rate for Payer: Heritage Provider Network Senior |
$9,806.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7,557.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,867.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,960.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11,090.10
|
| Rate for Payer: Multiplan Commercial |
$11,882.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14,160.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11,956.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13,466.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13,466.55
|
| Rate for Payer: Vantage Medical Group Senior |
$13,466.55
|
|
|
HC PCI CORO/BYPASS W MI, 1 VESSEL
|
Facility
|
IP
|
$15,843.00
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
906811442
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,867.58 |
| Max. Negotiated Rate |
$11,882.25 |
| Rate for Payer: Adventist Health Commercial |
$3,168.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,202.89
|
| Rate for Payer: Cash Price |
$7,129.35
|
| Rate for Payer: Cash Price |
$7,129.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,867.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,960.75
|
| Rate for Payer: Multiplan Commercial |
$11,882.25
|
|
