|
HC TAVR W PROS VALVE OPN AXLRY
|
Facility
IP
|
$63,249.00
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
906813410
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$11,448.07 |
| Max. Negotiated Rate |
$47,436.75 |
| Rate for Payer: Adventist Health Commercial |
$12,649.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$43,452.06
|
| Rate for Payer: Cash Price |
$28,462.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$42,819.57
|
| Rate for Payer: Heritage Provider Network Senior |
$42,819.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,448.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,812.25
|
| Rate for Payer: Multiplan Commercial |
$47,436.75
|
|
|
HC TAVR W PROS VALVE OPN AXLRY
|
Facility
IP
|
$27,485.00
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
906820333
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,974.78 |
| Max. Negotiated Rate |
$20,613.75 |
| Rate for Payer: Adventist Health Commercial |
$5,497.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,882.20
|
| Rate for Payer: Cash Price |
$12,368.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$18,607.34
|
| Rate for Payer: Heritage Provider Network Senior |
$18,607.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,974.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,871.25
|
| Rate for Payer: Multiplan Commercial |
$20,613.75
|
|
|
HC TAVR W PROS VALVE OPN AXLRY
|
Facility
OP
|
$27,485.00
|
|
|
Service Code
|
CPT 33363
|
| Hospital Charge Code |
906820333
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$381.34 |
| Max. Negotiated Rate |
$23,362.25 |
| Rate for Payer: Adventist Health Commercial |
$5,497.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,882.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$23,362.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15,116.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20,613.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,496.00
|
| 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 |
$12,368.25
|
| Rate for Payer: Cash Price |
$12,368.25
|
| Rate for Payer: Cash Price |
$12,368.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,865.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23,362.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$23,362.25
|
| Rate for Payer: Dignity Health Senior |
$23,362.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,013.22
|
| Rate for Payer: Heritage Provider Network Senior |
$17,013.22
|
| Rate for Payer: IEHP Medi-Cal |
$381.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13,247.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,974.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,871.25
|
| Rate for Payer: Multiplan Commercial |
$20,613.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23,362.25
|
| Rate for Payer: Vantage Medical Group Senior |
$23,362.25
|
|
|
HC TAVR W PROS VALVE OPN FMRL
|
Facility
OP
|
$26,531.00
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
906820332
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,841.10 |
| Max. Negotiated Rate |
$22,551.35 |
| Rate for Payer: Adventist Health Commercial |
$5,306.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,226.80
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22,551.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,592.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$19,898.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,496.00
|
| 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 |
$11,938.95
|
| Rate for Payer: Cash Price |
$11,938.95
|
| Rate for Payer: Cash Price |
$11,938.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$17,245.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22,551.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$22,551.35
|
| Rate for Payer: Dignity Health Senior |
$22,551.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,422.69
|
| Rate for Payer: Heritage Provider Network Senior |
$16,422.69
|
| Rate for Payer: IEHP Medi-Cal |
$1,841.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12,787.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,802.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,632.75
|
| Rate for Payer: Multiplan Commercial |
$19,898.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22,551.35
|
| Rate for Payer: Vantage Medical Group Senior |
$22,551.35
|
|
|
HC TAVR W PROS VALVE OPN FMRL
|
Facility
IP
|
$26,531.00
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
906820332
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,802.11 |
| Max. Negotiated Rate |
$19,898.25 |
| Rate for Payer: Adventist Health Commercial |
$5,306.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18,226.80
|
| Rate for Payer: Cash Price |
$11,938.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,961.49
|
| Rate for Payer: Heritage Provider Network Senior |
$17,961.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,802.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,632.75
|
| Rate for Payer: Multiplan Commercial |
$19,898.25
|
|
|
HC TAVR W PROS VALVE OPN FMRL
|
Facility
OP
|
$61,428.00
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
906813409
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,841.10 |
| Max. Negotiated Rate |
$52,213.80 |
| Rate for Payer: Adventist Health Commercial |
$12,285.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$42,201.04
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52,213.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$33,785.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$46,071.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,496.00
|
| 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 |
$27,642.60
|
| Rate for Payer: Cash Price |
$27,642.60
|
| Rate for Payer: Cash Price |
$27,642.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$39,928.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52,213.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$52,213.80
|
| Rate for Payer: Dignity Health Senior |
$52,213.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$38,023.93
|
| Rate for Payer: Heritage Provider Network Senior |
$38,023.93
|
| Rate for Payer: IEHP Medi-Cal |
$1,841.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$29,608.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,118.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,357.00
|
| Rate for Payer: Multiplan Commercial |
$46,071.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52,213.80
|
| Rate for Payer: Vantage Medical Group Senior |
$52,213.80
|
|
|
HC TAVR W PROS VALVE OPN FMRL
|
Facility
IP
|
$61,428.00
|
|
|
Service Code
|
CPT 33362
|
| Hospital Charge Code |
906813409
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$11,118.47 |
| Max. Negotiated Rate |
$46,071.00 |
| Rate for Payer: Adventist Health Commercial |
$12,285.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$42,201.04
|
| Rate for Payer: Cash Price |
$27,642.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$41,586.76
|
| Rate for Payer: Heritage Provider Network Senior |
$41,586.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,118.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,357.00
|
| Rate for Payer: Multiplan Commercial |
$46,071.00
|
|
|
HC TAVR W PROS VALVE OPN ILIAC
|
Facility
IP
|
$63,684.00
|
|
|
Service Code
|
CPT 33364
|
| Hospital Charge Code |
906813412
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$11,526.80 |
| Max. Negotiated Rate |
$47,763.00 |
| Rate for Payer: Adventist Health Commercial |
$12,736.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$43,750.91
|
| Rate for Payer: Cash Price |
$28,657.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$43,114.07
|
| Rate for Payer: Heritage Provider Network Senior |
$43,114.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,526.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,921.00
|
| Rate for Payer: Multiplan Commercial |
$47,763.00
|
|
|
HC TAVR W PROS VALVE OPN ILIAC
|
Facility
OP
|
$63,684.00
|
|
|
Service Code
|
CPT 33364
|
| Hospital Charge Code |
906813412
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,031.60 |
| Max. Negotiated Rate |
$54,131.40 |
| Rate for Payer: Adventist Health Commercial |
$12,736.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$43,750.91
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$54,131.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$35,026.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$47,763.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,496.00
|
| 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 |
$28,657.80
|
| Rate for Payer: Cash Price |
$28,657.80
|
| Rate for Payer: Cash Price |
$28,657.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$41,394.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54,131.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$54,131.40
|
| Rate for Payer: Dignity Health Senior |
$54,131.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$39,420.40
|
| Rate for Payer: Heritage Provider Network Senior |
$39,420.40
|
| Rate for Payer: IEHP Medi-Cal |
$2,031.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$30,695.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,526.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,921.00
|
| Rate for Payer: Multiplan Commercial |
$47,763.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54,131.40
|
| Rate for Payer: Vantage Medical Group Senior |
$54,131.40
|
|
|
HC TAVR W PROS VALVE OPN ILIAC
|
Facility
IP
|
$63,684.00
|
|
|
Service Code
|
CPT 33364
|
| Hospital Charge Code |
906820339
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$11,526.80 |
| Max. Negotiated Rate |
$47,763.00 |
| Rate for Payer: Adventist Health Commercial |
$12,736.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$43,750.91
|
| Rate for Payer: Cash Price |
$28,657.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$43,114.07
|
| Rate for Payer: Heritage Provider Network Senior |
$43,114.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,526.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,921.00
|
| Rate for Payer: Multiplan Commercial |
$47,763.00
|
|
|
HC TAVR W PROS VALVE OPN ILIAC
|
Facility
OP
|
$63,684.00
|
|
|
Service Code
|
CPT 33364
|
| Hospital Charge Code |
906820339
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,031.60 |
| Max. Negotiated Rate |
$54,131.40 |
| Rate for Payer: Adventist Health Commercial |
$12,736.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$43,750.91
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$54,131.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$35,026.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$47,763.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,496.00
|
| 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 |
$28,657.80
|
| Rate for Payer: Cash Price |
$28,657.80
|
| Rate for Payer: Cash Price |
$28,657.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$41,394.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54,131.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$54,131.40
|
| Rate for Payer: Dignity Health Senior |
$54,131.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$39,420.40
|
| Rate for Payer: Heritage Provider Network Senior |
$39,420.40
|
| Rate for Payer: IEHP Medi-Cal |
$2,031.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$30,695.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,526.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,921.00
|
| Rate for Payer: Multiplan Commercial |
$47,763.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54,131.40
|
| Rate for Payer: Vantage Medical Group Senior |
$54,131.40
|
|
|
HC TAVR W PROS VALVE PERC FMRL
|
Facility
OP
|
$24,229.00
|
|
|
Service Code
|
CPT 33361
|
| Hospital Charge Code |
906820331
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$336.27 |
| Max. Negotiated Rate |
$20,594.65 |
| Rate for Payer: Adventist Health Commercial |
$4,845.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,645.32
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20,594.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13,325.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18,171.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,792.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$10,903.05
|
| Rate for Payer: Cash Price |
$10,903.05
|
| Rate for Payer: Cash Price |
$10,903.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$15,748.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20,594.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$20,594.65
|
| Rate for Payer: Dignity Health Senior |
$20,594.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,997.75
|
| Rate for Payer: Heritage Provider Network Senior |
$14,997.75
|
| Rate for Payer: IEHP Medi-Cal |
$336.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11,678.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,385.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,057.25
|
| Rate for Payer: Multiplan Commercial |
$18,171.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20,594.65
|
| Rate for Payer: Vantage Medical Group Senior |
$20,594.65
|
|
|
HC TAVR W PROS VALVE PERC FMRL
|
Facility
IP
|
$24,229.00
|
|
|
Service Code
|
CPT 33361
|
| Hospital Charge Code |
906820331
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,385.45 |
| Max. Negotiated Rate |
$18,171.75 |
| Rate for Payer: Adventist Health Commercial |
$4,845.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16,645.32
|
| Rate for Payer: Cash Price |
$10,903.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,403.03
|
| Rate for Payer: Heritage Provider Network Senior |
$16,403.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,385.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,057.25
|
| Rate for Payer: Multiplan Commercial |
$18,171.75
|
|
|
HC TAVR W PROS VALVE PERC FMRL
|
Facility
OP
|
$56,794.00
|
|
|
Service Code
|
CPT 33361
|
| Hospital Charge Code |
906813408
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$336.27 |
| Max. Negotiated Rate |
$48,274.90 |
| Rate for Payer: Adventist Health Commercial |
$11,358.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$39,017.48
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$48,274.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$31,236.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$42,595.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,792.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,689.75
|
| Rate for Payer: Blue Shield of California EPN |
$7,468.44
|
| Rate for Payer: Cash Price |
$25,557.30
|
| Rate for Payer: Cash Price |
$25,557.30
|
| Rate for Payer: Cash Price |
$25,557.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$36,916.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48,274.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$48,274.90
|
| Rate for Payer: Dignity Health Senior |
$48,274.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$35,155.49
|
| Rate for Payer: Heritage Provider Network Senior |
$35,155.49
|
| Rate for Payer: IEHP Medi-Cal |
$336.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27,374.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,279.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,198.50
|
| Rate for Payer: Multiplan Commercial |
$42,595.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48,274.90
|
| Rate for Payer: Vantage Medical Group Senior |
$48,274.90
|
|
|
HC TAVR W PROS VALVE PERC FMRL
|
Facility
IP
|
$56,794.00
|
|
|
Service Code
|
CPT 33361
|
| Hospital Charge Code |
906813408
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$10,279.71 |
| Max. Negotiated Rate |
$42,595.50 |
| Rate for Payer: Adventist Health Commercial |
$11,358.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$39,017.48
|
| Rate for Payer: Cash Price |
$25,557.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$38,449.54
|
| Rate for Payer: Heritage Provider Network Senior |
$38,449.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,279.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,198.50
|
| Rate for Payer: Multiplan Commercial |
$42,595.50
|
|
|
HC TAVR W PROS VALVE TRNSAORTIC
|
Facility
OP
|
$67,098.00
|
|
|
Service Code
|
CPT 33365
|
| Hospital Charge Code |
906820340
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$442.56 |
| Max. Negotiated Rate |
$57,033.30 |
| Rate for Payer: Adventist Health Commercial |
$13,419.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$46,096.33
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$57,033.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$36,903.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$50,323.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,496.00
|
| 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 |
$30,194.10
|
| Rate for Payer: Cash Price |
$30,194.10
|
| Rate for Payer: Cash Price |
$30,194.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$43,613.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$57,033.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$57,033.30
|
| Rate for Payer: Dignity Health Senior |
$57,033.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$41,533.66
|
| Rate for Payer: Heritage Provider Network Senior |
$41,533.66
|
| Rate for Payer: IEHP Medi-Cal |
$442.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$32,341.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,144.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,774.50
|
| Rate for Payer: Multiplan Commercial |
$50,323.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$57,033.30
|
| Rate for Payer: Vantage Medical Group Senior |
$57,033.30
|
|
|
HC TAVR W PROS VALVE TRNSAORTIC
|
Facility
IP
|
$67,098.00
|
|
|
Service Code
|
CPT 33365
|
| Hospital Charge Code |
906820340
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,144.74 |
| Max. Negotiated Rate |
$50,323.50 |
| Rate for Payer: Adventist Health Commercial |
$13,419.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$46,096.33
|
| Rate for Payer: Cash Price |
$30,194.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$45,425.35
|
| Rate for Payer: Heritage Provider Network Senior |
$45,425.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,144.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,774.50
|
| Rate for Payer: Multiplan Commercial |
$50,323.50
|
|
|
HC TAVR W PROS VALVE TRNSAORTIC
|
Facility
OP
|
$67,098.00
|
|
|
Service Code
|
CPT 33365
|
| Hospital Charge Code |
906813413
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$442.56 |
| Max. Negotiated Rate |
$57,033.30 |
| Rate for Payer: Adventist Health Commercial |
$13,419.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$46,096.33
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$57,033.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$36,903.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$50,323.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,496.00
|
| 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 |
$30,194.10
|
| Rate for Payer: Cash Price |
$30,194.10
|
| Rate for Payer: Cash Price |
$30,194.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$43,613.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$57,033.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$57,033.30
|
| Rate for Payer: Dignity Health Senior |
$57,033.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$41,533.66
|
| Rate for Payer: Heritage Provider Network Senior |
$41,533.66
|
| Rate for Payer: IEHP Medi-Cal |
$442.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$32,341.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,144.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,774.50
|
| Rate for Payer: Multiplan Commercial |
$50,323.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$57,033.30
|
| Rate for Payer: Vantage Medical Group Senior |
$57,033.30
|
|
|
HC TAVR W PROS VALVE TRNSAORTIC
|
Facility
IP
|
$67,098.00
|
|
|
Service Code
|
CPT 33365
|
| Hospital Charge Code |
906813413
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,144.74 |
| Max. Negotiated Rate |
$50,323.50 |
| Rate for Payer: Adventist Health Commercial |
$13,419.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$46,096.33
|
| Rate for Payer: Cash Price |
$30,194.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$45,425.35
|
| Rate for Payer: Heritage Provider Network Senior |
$45,425.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,144.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16,774.50
|
| Rate for Payer: Multiplan Commercial |
$50,323.50
|
|
|
HC TAVR W PROS VALVE TRNSAPICAL
|
Facility
IP
|
$61,488.00
|
|
|
Service Code
|
CPT 33366
|
| Hospital Charge Code |
906813415
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$11,129.33 |
| Max. Negotiated Rate |
$46,116.00 |
| Rate for Payer: Adventist Health Commercial |
$12,297.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$42,242.26
|
| Rate for Payer: Cash Price |
$27,669.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$41,627.38
|
| Rate for Payer: Heritage Provider Network Senior |
$41,627.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,129.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,372.00
|
| Rate for Payer: Multiplan Commercial |
$46,116.00
|
|
|
HC TAVR W PROS VALVE TRNSAPICAL
|
Facility
IP
|
$61,488.00
|
|
|
Service Code
|
CPT 33366
|
| Hospital Charge Code |
906820341
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$11,129.33 |
| Max. Negotiated Rate |
$46,116.00 |
| Rate for Payer: Adventist Health Commercial |
$12,297.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$42,242.26
|
| Rate for Payer: Cash Price |
$27,669.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$41,627.38
|
| Rate for Payer: Heritage Provider Network Senior |
$41,627.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,129.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,372.00
|
| Rate for Payer: Multiplan Commercial |
$46,116.00
|
|
|
HC TAVR W PROS VALVE TRNSAPICAL
|
Facility
OP
|
$61,488.00
|
|
|
Service Code
|
CPT 33366
|
| Hospital Charge Code |
906820341
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$933.56 |
| Max. Negotiated Rate |
$52,264.80 |
| Rate for Payer: Adventist Health Commercial |
$12,297.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$42,242.26
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52,264.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$33,818.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$46,116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,792.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,086.22
|
| Rate for Payer: Blue Shield of California EPN |
$933.56
|
| Rate for Payer: Cash Price |
$27,669.60
|
| Rate for Payer: Cash Price |
$27,669.60
|
| Rate for Payer: Cash Price |
$27,669.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$39,967.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52,264.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$52,264.80
|
| Rate for Payer: Dignity Health Senior |
$52,264.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$38,061.07
|
| Rate for Payer: Heritage Provider Network Senior |
$38,061.07
|
| Rate for Payer: IEHP Medi-Cal |
$2,507.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$29,637.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,129.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,372.00
|
| Rate for Payer: Multiplan Commercial |
$46,116.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52,264.80
|
| Rate for Payer: Vantage Medical Group Senior |
$52,264.80
|
|
|
HC TAVR W PROS VALVE TRNSAPICAL
|
Facility
OP
|
$61,488.00
|
|
|
Service Code
|
CPT 33366
|
| Hospital Charge Code |
906813415
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$933.56 |
| Max. Negotiated Rate |
$52,264.80 |
| Rate for Payer: Adventist Health Commercial |
$12,297.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$42,242.26
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$52,264.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$33,818.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$46,116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,792.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,086.22
|
| Rate for Payer: Blue Shield of California EPN |
$933.56
|
| Rate for Payer: Cash Price |
$27,669.60
|
| Rate for Payer: Cash Price |
$27,669.60
|
| Rate for Payer: Cash Price |
$27,669.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$39,967.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52,264.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$52,264.80
|
| Rate for Payer: Dignity Health Senior |
$52,264.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$38,061.07
|
| Rate for Payer: Heritage Provider Network Senior |
$38,061.07
|
| Rate for Payer: IEHP Medi-Cal |
$2,507.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$29,637.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,129.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15,372.00
|
| Rate for Payer: Multiplan Commercial |
$46,116.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,374.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,841.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52,264.80
|
| Rate for Payer: Vantage Medical Group Senior |
$52,264.80
|
|
|
HC TB INTRADERMAL TEST
|
Facility
OP
|
$60.00
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
900501583
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$70.68 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$16.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$41.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$37.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.56
|
| Rate for Payer: Blue Shield of California Commercial |
$37.26
|
| Rate for Payer: Blue Shield of California EPN |
$35.22
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$39.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.92
|
| Rate for Payer: Dignity Health Senior |
$37.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$37.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$37.14
|
| Rate for Payer: Heritage Provider Network Senior |
$37.14
|
| Rate for Payer: Humana Medicare |
$37.20
|
| Rate for Payer: IEHP Medi-Cal |
$5.24
|
| Rate for Payer: IEHP Medicare Advantage |
$37.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$70.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.87
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$37.20
|
| Rate for Payer: TriValley Medical Group Senior |
$37.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$27.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$27.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.92
|
| Rate for Payer: Vantage Medical Group Senior |
$37.20
|
|
|
HC TB INTRADERMAL TEST
|
Facility
IP
|
$60.00
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
900501583
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$41.22
|
| Rate for Payer: Cash Price |
$27.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.62
|
| Rate for Payer: Heritage Provider Network Senior |
$40.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.00
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
|
