|
HC TRANSCATHETER BIOPSY
|
Facility
OP
|
$5,911.00
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
909081664
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$933.61 |
| Max. Negotiated Rate |
$5,024.35 |
| Rate for Payer: Adventist Health Commercial |
$1,182.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$933.61
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,060.86
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,024.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,251.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4,433.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,749.20
|
| Rate for Payer: Blue Shield of California Commercial |
$2,356.98
|
| Rate for Payer: Blue Shield of California EPN |
$1,340.34
|
| Rate for Payer: Cash Price |
$2,659.95
|
| Rate for Payer: Cash Price |
$2,659.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,842.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,024.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,024.35
|
| Rate for Payer: Dignity Health Senior |
$5,024.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,842.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,658.91
|
| Rate for Payer: Heritage Provider Network Senior |
$3,658.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2,849.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,069.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,477.75
|
| Rate for Payer: Multiplan Commercial |
$4,433.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,024.35
|
| Rate for Payer: Vantage Medical Group Senior |
$5,024.35
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
IP
|
$5,911.00
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
909081664
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,069.89 |
| Max. Negotiated Rate |
$4,433.25 |
| Rate for Payer: Adventist Health Commercial |
$1,182.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,060.86
|
| Rate for Payer: Cash Price |
$2,659.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,001.75
|
| Rate for Payer: Heritage Provider Network Senior |
$4,001.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,069.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,477.75
|
| Rate for Payer: Multiplan Commercial |
$4,433.25
|
|
|
HC TRANSCATHETER BIOPSY
|
Facility
IP
|
$15,461.00
|
|
|
Service Code
|
CPT 37200
|
| Hospital Charge Code |
909081356
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,798.44 |
| Max. Negotiated Rate |
$11,595.75 |
| Rate for Payer: Adventist Health Commercial |
$3,092.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,621.71
|
| Rate for Payer: Cash Price |
$6,957.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,467.10
|
| Rate for Payer: Heritage Provider Network Senior |
$10,467.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,798.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,865.25
|
| Rate for Payer: Multiplan Commercial |
$11,595.75
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
OP
|
$15,461.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906811451
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$395.52 |
| Max. Negotiated Rate |
$11,595.75 |
| Rate for Payer: Adventist Health Commercial |
$3,092.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,621.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$6,957.45
|
| Rate for Payer: Cash Price |
$6,957.45
|
| Rate for Payer: Cash Price |
$6,957.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$9,570.36
|
| Rate for Payer: Heritage Provider Network Senior |
$4,898.54
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$395.52
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,798.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,865.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$11,595.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,380.80
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
IP
|
$21,245.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906820253
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,845.34 |
| Max. Negotiated Rate |
$15,933.75 |
| Rate for Payer: Adventist Health Commercial |
$4,249.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,595.32
|
| Rate for Payer: Cash Price |
$9,560.25
|
| Rate for Payer: Cash Price |
$9,560.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,845.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,311.25
|
| Rate for Payer: Multiplan Commercial |
$15,933.75
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
OP
|
$21,245.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906820253
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$395.52 |
| Max. Negotiated Rate |
$15,933.75 |
| Rate for Payer: Adventist Health Commercial |
$4,249.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3,728.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,595.32
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,982.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,505.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,706.95
|
| Rate for Payer: Blue Shield of California EPN |
$4,045.41
|
| Rate for Payer: Cash Price |
$9,560.25
|
| Rate for Payer: Cash Price |
$9,560.25
|
| Rate for Payer: Cash Price |
$9,560.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,340.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,380.80
|
| Rate for Payer: Dignity Health Senior |
$3,982.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$3,982.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,150.66
|
| Rate for Payer: Heritage Provider Network Senior |
$4,898.54
|
| Rate for Payer: Humana Medicare |
$3,982.55
|
| Rate for Payer: IEHP Medi-Cal |
$395.52
|
| Rate for Payer: IEHP Medicare Advantage |
$3,982.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$7,566.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,845.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,699.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,311.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,018.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,018.01
|
| Rate for Payer: Multiplan Commercial |
$15,933.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,380.80
|
| Rate for Payer: TriValley Medical Group Senior |
$3,982.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9,520.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,039.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,973.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,380.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,982.55
|
|
|
HC TRANSCATHETER RETRIEVAL
|
Facility
IP
|
$15,461.00
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
906811451
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,798.44 |
| Max. Negotiated Rate |
$11,595.75 |
| Rate for Payer: Adventist Health Commercial |
$3,092.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,621.71
|
| Rate for Payer: Cash Price |
$6,957.45
|
| Rate for Payer: Cash Price |
$6,957.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,798.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,865.25
|
| Rate for Payer: Multiplan Commercial |
$11,595.75
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA PM COMPNT
|
Facility
IP
|
$53,470.00
|
|
|
Service Code
|
CPT 0796T
|
| Hospital Charge Code |
906819778
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,678.07 |
| Max. Negotiated Rate |
$40,102.50 |
| Rate for Payer: Adventist Health Commercial |
$10,694.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36,733.89
|
| Rate for Payer: Cash Price |
$24,061.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$36,199.19
|
| Rate for Payer: Heritage Provider Network Senior |
$36,199.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,678.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,367.50
|
| Rate for Payer: Multiplan Commercial |
$40,102.50
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA PM COMPNT
|
Facility
OP
|
$53,470.00
|
|
|
Service Code
|
CPT 0796T
|
| Hospital Charge Code |
906819778
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,857.00 |
| Max. Negotiated Rate |
$46,256.43 |
| Rate for Payer: Adventist Health Commercial |
$10,694.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36,733.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| 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 |
$24,061.50
|
| Rate for Payer: Cash Price |
$24,061.50
|
| Rate for Payer: Cash Price |
$24,061.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$34,755.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,780.04
|
| Rate for Payer: Dignity Health Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$24,345.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,097.93
|
| Rate for Payer: Heritage Provider Network Senior |
$29,944.95
|
| Rate for Payer: Humana Medicare |
$24,345.49
|
| Rate for Payer: IEHP Medicare Advantage |
$24,345.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$46,256.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,678.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,727.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,367.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,675.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,675.32
|
| Rate for Payer: Multiplan Commercial |
$40,102.50
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$26,780.04
|
| Rate for Payer: TriValley Medical Group Senior |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA RV COMP SYS
|
Facility
OP
|
$53,470.00
|
|
|
Service Code
|
CPT 0795T
|
| Hospital Charge Code |
906819777
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,245.00 |
| Max. Negotiated Rate |
$46,256.43 |
| Rate for Payer: Adventist Health Commercial |
$10,694.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5,245.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36,733.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| 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 |
$24,061.50
|
| Rate for Payer: Cash Price |
$24,061.50
|
| Rate for Payer: Cash Price |
$24,061.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$34,755.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,780.04
|
| Rate for Payer: Dignity Health Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$24,345.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,097.93
|
| Rate for Payer: Heritage Provider Network Senior |
$29,944.95
|
| Rate for Payer: Humana Medicare |
$24,345.49
|
| Rate for Payer: IEHP Medicare Advantage |
$24,345.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$46,256.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,678.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,727.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,367.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,675.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,675.32
|
| Rate for Payer: Multiplan Commercial |
$40,102.50
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$26,780.04
|
| Rate for Payer: TriValley Medical Group Senior |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RA RV COMP SYS
|
Facility
IP
|
$53,470.00
|
|
|
Service Code
|
CPT 0795T
|
| Hospital Charge Code |
906819777
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,678.07 |
| Max. Negotiated Rate |
$40,102.50 |
| Rate for Payer: Adventist Health Commercial |
$10,694.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36,733.89
|
| Rate for Payer: Cash Price |
$24,061.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$36,199.19
|
| Rate for Payer: Heritage Provider Network Senior |
$36,199.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,678.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,367.50
|
| Rate for Payer: Multiplan Commercial |
$40,102.50
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RV PM COMPNT
|
Facility
IP
|
$53,470.00
|
|
|
Service Code
|
CPT 0797T
|
| Hospital Charge Code |
906819779
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,678.07 |
| Max. Negotiated Rate |
$40,102.50 |
| Rate for Payer: Adventist Health Commercial |
$10,694.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36,733.89
|
| Rate for Payer: Cash Price |
$24,061.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$36,199.19
|
| Rate for Payer: Heritage Provider Network Senior |
$36,199.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,678.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,367.50
|
| Rate for Payer: Multiplan Commercial |
$40,102.50
|
|
|
HC TRANSCATH INSRTN DC LEADLESS PMKR RV PM COMPNT
|
Facility
OP
|
$53,470.00
|
|
|
Service Code
|
CPT 0797T
|
| Hospital Charge Code |
906819779
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,857.00 |
| Max. Negotiated Rate |
$46,256.43 |
| Rate for Payer: Adventist Health Commercial |
$10,694.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4,857.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36,733.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| 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 |
$24,061.50
|
| Rate for Payer: Cash Price |
$24,061.50
|
| Rate for Payer: Cash Price |
$24,061.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$34,755.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,780.04
|
| Rate for Payer: Dignity Health Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$24,345.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,097.93
|
| Rate for Payer: Heritage Provider Network Senior |
$29,944.95
|
| Rate for Payer: Humana Medicare |
$24,345.49
|
| Rate for Payer: IEHP Medicare Advantage |
$24,345.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$46,256.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,678.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,727.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,367.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,675.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,675.32
|
| Rate for Payer: Multiplan Commercial |
$40,102.50
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$26,780.04
|
| Rate for Payer: TriValley Medical Group Senior |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC TRANSCATH INSRTN SC LEADLESS PMKR RA
|
Facility
IP
|
$53,470.00
|
|
|
Service Code
|
CPT 0823T
|
| Hospital Charge Code |
906819773
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,678.07 |
| Max. Negotiated Rate |
$40,102.50 |
| Rate for Payer: Adventist Health Commercial |
$10,694.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36,733.89
|
| Rate for Payer: Cash Price |
$24,061.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$36,199.19
|
| Rate for Payer: Heritage Provider Network Senior |
$36,199.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,678.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,367.50
|
| Rate for Payer: Multiplan Commercial |
$40,102.50
|
|
|
HC TRANSCATH INSRTN SC LEADLESS PMKR RA
|
Facility
OP
|
$53,470.00
|
|
|
Service Code
|
CPT 0823T
|
| Hospital Charge Code |
906819773
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,245.00 |
| Max. Negotiated Rate |
$46,256.43 |
| Rate for Payer: Adventist Health Commercial |
$10,694.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$5,245.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36,733.89
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24,345.49
|
| 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 |
$24,061.50
|
| Rate for Payer: Cash Price |
$24,061.50
|
| Rate for Payer: Cash Price |
$24,061.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$34,755.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$26,780.04
|
| Rate for Payer: Dignity Health Senior |
$24,345.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$24,345.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$33,097.93
|
| Rate for Payer: Heritage Provider Network Senior |
$29,944.95
|
| Rate for Payer: Humana Medicare |
$24,345.49
|
| Rate for Payer: IEHP Medicare Advantage |
$24,345.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$46,256.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,678.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28,727.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13,367.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30,675.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30,675.32
|
| Rate for Payer: Multiplan Commercial |
$40,102.50
|
| Rate for Payer: Multiplan WC |
$33,283.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$26,780.04
|
| Rate for Payer: TriValley Medical Group Senior |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36,518.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26,780.04
|
| Rate for Payer: Vantage Medical Group Senior |
$24,345.49
|
|
|
HC TRANSCATH MITRAL VAL REPAIR AD
|
Facility
OP
|
$25,472.00
|
|
|
Service Code
|
CPT 33419
|
| Hospital Charge Code |
906820001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$116.16 |
| Max. Negotiated Rate |
$21,651.20 |
| Rate for Payer: Adventist Health Commercial |
$5,094.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,499.26
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21,651.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14,009.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$19,104.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,496.00
|
| 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 |
$11,462.40
|
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16,556.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21,651.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$21,651.20
|
| Rate for Payer: Dignity Health Senior |
$21,651.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,767.17
|
| Rate for Payer: Heritage Provider Network Senior |
$15,767.17
|
| Rate for Payer: IEHP Medi-Cal |
$116.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12,277.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,610.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,368.00
|
| Rate for Payer: Multiplan Commercial |
$19,104.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21,651.20
|
| Rate for Payer: Vantage Medical Group Senior |
$21,651.20
|
|
|
HC TRANSCATH MITRAL VAL REPAIR AD
|
Facility
OP
|
$21,606.00
|
|
|
Service Code
|
CPT 33419
|
| Hospital Charge Code |
906811489
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$116.16 |
| Max. Negotiated Rate |
$18,365.10 |
| Rate for Payer: Adventist Health Commercial |
$4,321.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,843.32
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18,365.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11,883.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16,204.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,496.00
|
| 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 |
$9,722.70
|
| Rate for Payer: Cash Price |
$9,722.70
|
| Rate for Payer: Cash Price |
$9,722.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14,043.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18,365.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$18,365.10
|
| Rate for Payer: Dignity Health Senior |
$18,365.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,374.11
|
| Rate for Payer: Heritage Provider Network Senior |
$13,374.11
|
| Rate for Payer: IEHP Medi-Cal |
$116.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$10,414.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,910.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,401.50
|
| Rate for Payer: Multiplan Commercial |
$16,204.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,040.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$874.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18,365.10
|
| Rate for Payer: Vantage Medical Group Senior |
$18,365.10
|
|
|
HC TRANSCATH MITRAL VAL REPAIR AD
|
Facility
IP
|
$21,606.00
|
|
|
Service Code
|
CPT 33419
|
| Hospital Charge Code |
906811489
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,910.69 |
| Max. Negotiated Rate |
$16,204.50 |
| Rate for Payer: Adventist Health Commercial |
$4,321.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,843.32
|
| Rate for Payer: Cash Price |
$9,722.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$14,627.26
|
| Rate for Payer: Heritage Provider Network Senior |
$14,627.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,910.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,401.50
|
| Rate for Payer: Multiplan Commercial |
$16,204.50
|
|
|
HC TRANSCATH MITRAL VAL REPAIR AD
|
Facility
IP
|
$25,472.00
|
|
|
Service Code
|
CPT 33419
|
| Hospital Charge Code |
906820001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$4,610.43 |
| Max. Negotiated Rate |
$19,104.00 |
| Rate for Payer: Adventist Health Commercial |
$5,094.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17,499.26
|
| Rate for Payer: Cash Price |
$11,462.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$17,244.54
|
| Rate for Payer: Heritage Provider Network Senior |
$17,244.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,610.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,368.00
|
| Rate for Payer: Multiplan Commercial |
$19,104.00
|
|
|
HC TRANSCATH MITRAL VALVE ANNUL
|
Facility
IP
|
$69,783.00
|
|
|
Service Code
|
CPT 0544T
|
| Hospital Charge Code |
906810544
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$12,630.72 |
| Max. Negotiated Rate |
$52,337.25 |
| Rate for Payer: Adventist Health Commercial |
$13,956.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$47,940.92
|
| Rate for Payer: Cash Price |
$31,402.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$47,243.09
|
| Rate for Payer: Heritage Provider Network Senior |
$47,243.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,630.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17,445.75
|
| Rate for Payer: Multiplan Commercial |
$52,337.25
|
|
|
HC TRANSCATH MITRAL VALVE ANNUL
|
Facility
OP
|
$69,783.00
|
|
|
Service Code
|
CPT 0544T
|
| Hospital Charge Code |
906810544
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$933.56 |
| Max. Negotiated Rate |
$59,315.55 |
| Rate for Payer: Adventist Health Commercial |
$13,956.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$47,940.92
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$59,315.55
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$38,380.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$52,337.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,742.00
|
| 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 |
$31,402.35
|
| Rate for Payer: Cash Price |
$31,402.35
|
| Rate for Payer: Cash Price |
$31,402.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$45,358.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$59,315.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$59,315.55
|
| Rate for Payer: Dignity Health Senior |
$59,315.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$43,195.68
|
| Rate for Payer: Heritage Provider Network Senior |
$43,195.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$33,635.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12,630.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17,445.75
|
| Rate for Payer: Multiplan Commercial |
$52,337.25
|
| 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 |
$59,315.55
|
| Rate for Payer: Vantage Medical Group Senior |
$59,315.55
|
|
|
HC TRANSCATH MITRAL VALVE ANNUL
|
Facility
IP
|
$82,271.00
|
|
|
Service Code
|
CPT 0544T
|
| Hospital Charge Code |
906820270
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$14,891.05 |
| Max. Negotiated Rate |
$61,703.25 |
| Rate for Payer: Adventist Health Commercial |
$16,454.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$56,520.18
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$55,697.47
|
| Rate for Payer: Heritage Provider Network Senior |
$55,697.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,891.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20,567.75
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
|
|
HC TRANSCATH MITRAL VALVE ANNUL
|
Facility
OP
|
$82,271.00
|
|
|
Service Code
|
CPT 0544T
|
| Hospital Charge Code |
906820270
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$933.56 |
| Max. Negotiated Rate |
$69,930.35 |
| Rate for Payer: Adventist Health Commercial |
$16,454.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12,620.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$56,520.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$69,930.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$45,249.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$61,703.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10,742.00
|
| 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 |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$53,476.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69,930.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$69,930.35
|
| Rate for Payer: Dignity Health Senior |
$69,930.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$50,925.75
|
| Rate for Payer: Heritage Provider Network Senior |
$50,925.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$39,654.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,891.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20,567.75
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
| 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 |
$69,930.35
|
| Rate for Payer: Vantage Medical Group Senior |
$69,930.35
|
|
|
HC TRANSCATH MITRAL VALVE REPAIR
|
Facility
IP
|
$82,271.00
|
|
|
Service Code
|
CPT 33418
|
| Hospital Charge Code |
906820021
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$14,891.05 |
| Max. Negotiated Rate |
$61,703.25 |
| Rate for Payer: Adventist Health Commercial |
$16,454.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$56,520.18
|
| Rate for Payer: Cash Price |
$37,021.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$55,697.47
|
| Rate for Payer: Heritage Provider Network Senior |
$55,697.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14,891.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20,567.75
|
| Rate for Payer: Multiplan Commercial |
$61,703.25
|
|
|
HC TRANSCATH MITRAL VALVE REPAIR
|
Facility
IP
|
$6,608.00
|
|
|
Service Code
|
CPT 33418
|
| Hospital Charge Code |
906811487
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,196.05 |
| Max. Negotiated Rate |
$4,956.00 |
| Rate for Payer: Adventist Health Commercial |
$1,321.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,539.70
|
| Rate for Payer: Cash Price |
$2,973.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,473.62
|
| Rate for Payer: Heritage Provider Network Senior |
$4,473.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,196.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,652.00
|
| Rate for Payer: Multiplan Commercial |
$4,956.00
|
|
