|
HC TRANSCATH MITRAL VLVE IMPL/REP
|
Facility
|
OP
|
$56,581.00
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
906800483
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,984.00 |
| Max. Negotiated Rate |
$48,093.85 |
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Adventist Health Commercial |
$11,316.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34,967.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$48,093.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31,119.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42,435.75
|
| 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: Cash Price |
$25,461.45
|
| Rate for Payer: Cash Price |
$25,461.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$36,777.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48,093.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$48,093.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48,093.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$35,023.64
|
| Rate for Payer: Heritage Provider Network Senior |
$35,023.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$26,989.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10,241.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14,145.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$39,606.70
|
| Rate for Payer: Multiplan Commercial |
$42,435.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,544.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,984.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$48,093.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48,093.85
|
| Rate for Payer: Vantage Medical Group Senior |
$48,093.85
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC ADDL ART
|
Facility
|
IP
|
$9,529.00
|
|
|
Service Code
|
CPT 37237
|
| Hospital Charge Code |
906811479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,724.75 |
| Max. Negotiated Rate |
$7,146.75 |
| Rate for Payer: Adventist Health Commercial |
$1,905.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,136.68
|
| Rate for Payer: Cash Price |
$4,288.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,451.13
|
| Rate for Payer: Heritage Provider Network Senior |
$6,451.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,724.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,382.25
|
| Rate for Payer: Multiplan Commercial |
$7,146.75
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC ADDL ART
|
Facility
|
OP
|
$9,529.00
|
|
|
Service Code
|
CPT 37237
|
| Hospital Charge Code |
906811479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,724.75 |
| Max. Negotiated Rate |
$14,160.00 |
| Rate for Payer: Adventist Health Commercial |
$1,905.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,888.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,099.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,240.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,146.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| 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 |
$4,288.05
|
| Rate for Payer: Cash Price |
$4,288.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,193.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,099.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,099.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,099.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,898.45
|
| Rate for Payer: Heritage Provider Network Senior |
$5,898.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$4,545.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,724.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,382.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,670.30
|
| Rate for Payer: Multiplan Commercial |
$7,146.75
|
| 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 |
$8,099.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,099.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8,099.65
|
|
|
HC TRANSCATH PLCMT INT STNT OPENPERC ADDL VEIN
|
Facility
|
IP
|
$9,529.00
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
906811481
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,724.75 |
| Max. Negotiated Rate |
$7,146.75 |
| Rate for Payer: Adventist Health Commercial |
$1,905.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,136.68
|
| Rate for Payer: Cash Price |
$4,288.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,451.13
|
| Rate for Payer: Heritage Provider Network Senior |
$6,451.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,724.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,382.25
|
| Rate for Payer: Multiplan Commercial |
$7,146.75
|
|
|
HC TRANSCATH PLCMT INT STNT OPENPERC ADDL VEIN
|
Facility
|
OP
|
$9,529.00
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
906811481
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,724.75 |
| Max. Negotiated Rate |
$14,160.00 |
| Rate for Payer: Adventist Health Commercial |
$1,905.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5,888.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,099.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,240.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,146.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,158.00
|
| 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 |
$4,288.05
|
| Rate for Payer: Cash Price |
$4,288.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6,193.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,099.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,099.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,099.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,898.45
|
| Rate for Payer: Heritage Provider Network Senior |
$5,898.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$4,545.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,724.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,382.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6,670.30
|
| Rate for Payer: Multiplan Commercial |
$7,146.75
|
| 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 |
$8,099.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,099.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8,099.65
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC INIT ART
|
Facility
|
OP
|
$24,620.00
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
906811478
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,456.22 |
| Max. Negotiated Rate |
$28,210.74 |
| Rate for Payer: Adventist Health Commercial |
$4,924.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,215.16
|
| 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 |
$8,435.00
|
| 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 |
$11,079.00
|
| Rate for Payer: Cash Price |
$11,079.00
|
| Rate for Payer: Cash Price |
$11,079.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16,003.00
|
| 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 |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,847.76
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,239.78
|
| 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 |
$4,456.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17,074.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,155.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$18,465.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: TriValley Medical Group Commercial |
$16,332.54
|
| Rate for Payer: TriValley Medical Group Senior |
$16,332.54
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| 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 TRANSCATH PLCMT INT STNT OPEN PERC INIT ART
|
Facility
|
IP
|
$24,620.00
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
906811478
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,456.22 |
| Max. Negotiated Rate |
$18,465.00 |
| Rate for Payer: Adventist Health Commercial |
$4,924.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$15,855.28
|
| Rate for Payer: Cash Price |
$11,079.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$16,667.74
|
| Rate for Payer: Heritage Provider Network Senior |
$16,667.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,456.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,155.00
|
| Rate for Payer: Multiplan Commercial |
$18,465.00
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC INIT VEIN
|
Facility
|
IP
|
$22,276.00
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
906811480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,031.96 |
| Max. Negotiated Rate |
$16,707.00 |
| Rate for Payer: Adventist Health Commercial |
$4,455.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14,345.74
|
| Rate for Payer: Cash Price |
$10,024.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$15,080.85
|
| Rate for Payer: Heritage Provider Network Senior |
$15,080.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4,031.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,569.00
|
| Rate for Payer: Multiplan Commercial |
$16,707.00
|
|
|
HC TRANSCATH PLCMT INT STNT OPEN PERC INIT VEIN
|
Facility
|
OP
|
$22,276.00
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
906811480
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,031.96 |
| Max. Negotiated Rate |
$28,210.74 |
| Rate for Payer: Adventist Health Commercial |
$4,455.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13,766.57
|
| 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 |
$8,435.00
|
| 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 |
$10,024.20
|
| Rate for Payer: Cash Price |
$10,024.20
|
| Rate for Payer: Cash Price |
$10,024.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$14,479.40
|
| 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 |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$14,847.76
|
| Rate for Payer: Heritage Provider Network Commercial |
$13,788.84
|
| 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 |
$4,031.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17,074.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5,569.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,896.00
|
| Rate for Payer: Multiplan Commercial |
$16,707.00
|
| Rate for Payer: Multiplan WC |
$22,958.69
|
| Rate for Payer: TriValley Medical Group Commercial |
$16,332.54
|
| Rate for Payer: TriValley Medical Group Senior |
$16,332.54
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$17,861.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15,025.00
|
| 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 TRANSCATH RENAL DENERVATION
|
Facility
|
IP
|
$11,261.00
|
|
|
Service Code
|
CPT 0338T
|
| Hospital Charge Code |
906811473
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,038.24 |
| Max. Negotiated Rate |
$8,445.75 |
| Rate for Payer: Adventist Health Commercial |
$2,252.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7,252.08
|
| Rate for Payer: Cash Price |
$5,067.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$7,623.70
|
| Rate for Payer: Heritage Provider Network Senior |
$7,623.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,038.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,815.25
|
| Rate for Payer: Multiplan Commercial |
$8,445.75
|
|
|
HC TRANSCATH RENAL DENERVATION
|
Facility
|
OP
|
$11,261.00
|
|
|
Service Code
|
CPT 0338T
|
| Hospital Charge Code |
906811473
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,038.24 |
| Max. Negotiated Rate |
$10,980.45 |
| Rate for Payer: Adventist Health Commercial |
$2,252.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,959.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,320.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6,869.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,495.37
|
| Rate for Payer: Cash Price |
$5,067.45
|
| Rate for Payer: Cash Price |
$5,067.45
|
| Rate for Payer: Cash Price |
$5,067.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7,319.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,052.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,320.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,320.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$6,970.56
|
| Rate for Payer: Heritage Provider Network Senior |
$6,970.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$5,371.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,038.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,418.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,815.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,809.20
|
| Rate for Payer: Multiplan Commercial |
$8,445.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,320.30
|
| Rate for Payer: TriValley Medical Group Senior |
$7,320.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5,630.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5,630.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Vantage Medical Group Senior |
$7,320.30
|
|
|
HC TRANSCATH RENAL DENERVATION BILATERAL
|
Facility
|
IP
|
$16,891.00
|
|
|
Service Code
|
CPT 0339T
|
| Hospital Charge Code |
906811474
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,057.27 |
| Max. Negotiated Rate |
$12,668.25 |
| Rate for Payer: Adventist Health Commercial |
$3,378.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,877.80
|
| Rate for Payer: Cash Price |
$7,600.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$11,435.21
|
| Rate for Payer: Heritage Provider Network Senior |
$11,435.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,057.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,222.75
|
| Rate for Payer: Multiplan Commercial |
$12,668.25
|
|
|
HC TRANSCATH RENAL DENERVATION BILATERAL
|
Facility
|
OP
|
$16,891.00
|
|
|
Service Code
|
CPT 0339T
|
| Hospital Charge Code |
906811474
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,057.27 |
| Max. Negotiated Rate |
$12,668.25 |
| Rate for Payer: Adventist Health Commercial |
$3,378.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10,438.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,320.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,245.00
|
| Rate for Payer: Blue Shield of California Commercial |
$10,303.51
|
| Rate for Payer: Blue Shield of California EPN |
$8,242.81
|
| Rate for Payer: Cash Price |
$7,600.95
|
| Rate for Payer: Cash Price |
$7,600.95
|
| Rate for Payer: Cash Price |
$7,600.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10,979.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,052.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,320.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$7,320.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$10,455.53
|
| Rate for Payer: Heritage Provider Network Senior |
$10,455.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$8,057.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,057.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8,418.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,222.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,809.20
|
| Rate for Payer: Multiplan Commercial |
$12,668.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$7,320.30
|
| Rate for Payer: TriValley Medical Group Senior |
$7,320.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8,445.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8,445.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Vantage Medical Group Senior |
$7,320.30
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
IP
|
$7,466.00
|
|
|
Service Code
|
CPT 0799T
|
| Hospital Charge Code |
906819781
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,351.35 |
| Max. Negotiated Rate |
$5,599.50 |
| Rate for Payer: Adventist Health Commercial |
$1,493.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,808.10
|
| Rate for Payer: Cash Price |
$3,359.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,054.48
|
| Rate for Payer: Heritage Provider Network Senior |
$5,054.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,351.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,866.50
|
| Rate for Payer: Multiplan Commercial |
$5,599.50
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
OP
|
$7,466.00
|
|
|
Service Code
|
CPT 0799T
|
| Hospital Charge Code |
906819781
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,351.35 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,493.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,613.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,734.49
|
| 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 |
$3,359.70
|
| Rate for Payer: Cash Price |
$3,359.70
|
| Rate for Payer: Cash Price |
$3,359.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,852.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,061.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,621.45
|
| Rate for Payer: Heritage Provider Network Senior |
$4,995.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7,715.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,351.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,670.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,866.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$5,599.50
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,467.15
|
| Rate for Payer: TriValley Medical Group Senior |
$4,467.15
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,733.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,733.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV COMP SYS
|
Facility
|
OP
|
$7,466.00
|
|
|
Service Code
|
CPT 0798T
|
| Hospital Charge Code |
906819780
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,351.35 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,493.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,613.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,734.49
|
| 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 |
$3,359.70
|
| Rate for Payer: Cash Price |
$3,359.70
|
| Rate for Payer: Cash Price |
$3,359.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,852.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,061.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,621.45
|
| Rate for Payer: Heritage Provider Network Senior |
$4,995.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7,715.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,351.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,670.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,866.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$5,599.50
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,467.15
|
| Rate for Payer: TriValley Medical Group Senior |
$4,467.15
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,733.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,733.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV COMP SYS
|
Facility
|
IP
|
$7,466.00
|
|
|
Service Code
|
CPT 0798T
|
| Hospital Charge Code |
906819780
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,351.35 |
| Max. Negotiated Rate |
$5,599.50 |
| Rate for Payer: Adventist Health Commercial |
$1,493.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,808.10
|
| Rate for Payer: Cash Price |
$3,359.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,054.48
|
| Rate for Payer: Heritage Provider Network Senior |
$5,054.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,351.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,866.50
|
| Rate for Payer: Multiplan Commercial |
$5,599.50
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV PM COMPNT
|
Facility
|
IP
|
$7,466.00
|
|
|
Service Code
|
CPT 0800T
|
| Hospital Charge Code |
906819782
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,351.35 |
| Max. Negotiated Rate |
$5,599.50 |
| Rate for Payer: Adventist Health Commercial |
$1,493.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,808.10
|
| Rate for Payer: Cash Price |
$3,359.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,054.48
|
| Rate for Payer: Heritage Provider Network Senior |
$5,054.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,351.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,866.50
|
| Rate for Payer: Multiplan Commercial |
$5,599.50
|
|
|
HC TRANSCATH RMVL DC LEADLESS PMKR RA RV PM COMPNT
|
Facility
|
OP
|
$7,466.00
|
|
|
Service Code
|
CPT 0800T
|
| Hospital Charge Code |
906819782
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,351.35 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$1,493.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$4,613.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,061.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,734.49
|
| 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 |
$3,359.70
|
| Rate for Payer: Cash Price |
$3,359.70
|
| Rate for Payer: Cash Price |
$3,359.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,852.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,467.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,061.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$4,061.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,621.45
|
| Rate for Payer: Heritage Provider Network Senior |
$4,995.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$7,715.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,351.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4,670.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,866.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$5,599.50
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,467.15
|
| Rate for Payer: TriValley Medical Group Senior |
$4,467.15
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,733.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,733.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,091.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,467.15
|
| Rate for Payer: Vantage Medical Group Senior |
$4,061.05
|
|
|
HC TRANSCATH RMVL REPL DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
OP
|
$45,636.00
|
|
|
Service Code
|
CPT 0802T
|
| Hospital Charge Code |
906819784
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,178.49 |
| Max. Negotiated Rate |
$47,070.12 |
| Rate for Payer: Adventist Health Commercial |
$9,127.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28,203.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,773.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,827.13
|
| 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 |
$20,536.20
|
| Rate for Payer: Cash Price |
$20,536.20
|
| Rate for Payer: Cash Price |
$20,536.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29,663.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,251.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,773.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$24,773.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$28,248.68
|
| Rate for Payer: Heritage Provider Network Senior |
$30,471.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$47,070.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8,260.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28,489.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,409.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$33,196.82
|
| Rate for Payer: Multiplan Commercial |
$34,227.00
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: TriValley Medical Group Commercial |
$27,251.12
|
| Rate for Payer: TriValley Medical Group Senior |
$27,251.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$22,818.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$22,818.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Vantage Medical Group Senior |
$24,773.75
|
|
|
HC TRANSCATH RMVL REPL DC LEADLESS PMKR RA PM COMPNT
|
Facility
|
IP
|
$45,636.00
|
|
|
Service Code
|
CPT 0802T
|
| Hospital Charge Code |
906819784
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,260.12 |
| Max. Negotiated Rate |
$34,227.00 |
| Rate for Payer: Adventist Health Commercial |
$9,127.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$29,389.58
|
| Rate for Payer: Cash Price |
$20,536.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,895.57
|
| Rate for Payer: Heritage Provider Network Senior |
$30,895.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8,260.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,409.00
|
| Rate for Payer: Multiplan Commercial |
$34,227.00
|
|
|
HC TRANSCATH RMVL REPL DC LEADLESS PMKR RA RV
|
Facility
|
OP
|
$45,636.00
|
|
|
Service Code
|
CPT 0801T
|
| Hospital Charge Code |
906819783
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,178.49 |
| Max. Negotiated Rate |
$47,070.12 |
| Rate for Payer: Adventist Health Commercial |
$9,127.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28,203.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,773.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,827.13
|
| 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 |
$20,536.20
|
| Rate for Payer: Cash Price |
$20,536.20
|
| Rate for Payer: Cash Price |
$20,536.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29,663.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,251.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,773.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$24,773.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$28,248.68
|
| Rate for Payer: Heritage Provider Network Senior |
$30,471.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$47,070.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8,260.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28,489.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,409.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$33,196.82
|
| Rate for Payer: Multiplan Commercial |
$34,227.00
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: TriValley Medical Group Commercial |
$27,251.12
|
| Rate for Payer: TriValley Medical Group Senior |
$27,251.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$22,818.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$22,818.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Vantage Medical Group Senior |
$24,773.75
|
|
|
HC TRANSCATH RMVL REPL DC LEADLESS PMKR RA RV
|
Facility
|
IP
|
$45,636.00
|
|
|
Service Code
|
CPT 0801T
|
| Hospital Charge Code |
906819783
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,260.12 |
| Max. Negotiated Rate |
$34,227.00 |
| Rate for Payer: Adventist Health Commercial |
$9,127.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$29,389.58
|
| Rate for Payer: Cash Price |
$20,536.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,895.57
|
| Rate for Payer: Heritage Provider Network Senior |
$30,895.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8,260.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,409.00
|
| Rate for Payer: Multiplan Commercial |
$34,227.00
|
|
|
HC TRANSCATH RMVL REPL DC LEADLESS PMKR RV PM COMPNT
|
Facility
|
OP
|
$45,636.00
|
|
|
Service Code
|
CPT 0803T
|
| Hospital Charge Code |
906819785
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,178.49 |
| Max. Negotiated Rate |
$47,070.12 |
| Rate for Payer: Adventist Health Commercial |
$9,127.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28,203.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24,773.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,827.13
|
| 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 |
$20,536.20
|
| Rate for Payer: Cash Price |
$20,536.20
|
| Rate for Payer: Cash Price |
$20,536.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$29,663.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$27,251.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24,773.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$24,773.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$28,248.68
|
| Rate for Payer: Heritage Provider Network Senior |
$30,471.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,773.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$47,070.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8,260.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28,489.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,409.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$33,196.82
|
| Rate for Payer: Multiplan Commercial |
$34,227.00
|
| Rate for Payer: Multiplan WC |
$38,609.08
|
| Rate for Payer: TriValley Medical Group Commercial |
$27,251.12
|
| Rate for Payer: TriValley Medical Group Senior |
$27,251.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$22,818.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$22,818.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37,160.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27,251.12
|
| Rate for Payer: Vantage Medical Group Senior |
$24,773.75
|
|
|
HC TRANSCATH RMVL REPL DC LEADLESS PMKR RV PM COMPNT
|
Facility
|
IP
|
$45,636.00
|
|
|
Service Code
|
CPT 0803T
|
| Hospital Charge Code |
906819785
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,260.12 |
| Max. Negotiated Rate |
$34,227.00 |
| Rate for Payer: Adventist Health Commercial |
$9,127.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$29,389.58
|
| Rate for Payer: Cash Price |
$20,536.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$30,895.57
|
| Rate for Payer: Heritage Provider Network Senior |
$30,895.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8,260.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11,409.00
|
| Rate for Payer: Multiplan Commercial |
$34,227.00
|
|
