|
HC TRAY CATH PICC POWER 3FR SL
|
Facility
|
IP
|
$906.38
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901606420
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$181.28 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Cash Price |
$407.87
|
| Rate for Payer: Cash Price |
$407.87
|
| Rate for Payer: Cigna of CA HMO |
$634.47
|
| Rate for Payer: Cigna of CA PPO |
$634.47
|
| Rate for Payer: Adventist Health Commercial |
$181.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$634.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$362.55
|
| Rate for Payer: EPIC Health Plan Senior |
$362.55
|
| Rate for Payer: Galaxy Health WC |
$770.42
|
| Rate for Payer: Global Benefits Group Commercial |
$543.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$575.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$534.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$217.53
|
| Rate for Payer: Multiplan Commercial |
$725.10
|
| Rate for Payer: Networks By Design Commercial |
$453.19
|
| Rate for Payer: Prime Health Services Commercial |
$770.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$340.16
|
| Rate for Payer: United Healthcare All Other HMO |
$331.10
|
| Rate for Payer: United Healthcare HMO Rider |
$323.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$296.84
|
|
|
HC TRAY CATH PIGTAIL FUHRMAN 8.5FR
|
Facility
|
IP
|
$825.52
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901606896
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.10 |
| Max. Negotiated Rate |
$701.69 |
| Rate for Payer: Adventist Health Commercial |
$165.10
|
| Rate for Payer: Cash Price |
$371.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$577.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$330.21
|
| Rate for Payer: EPIC Health Plan Senior |
$330.21
|
| Rate for Payer: Galaxy Health WC |
$701.69
|
| Rate for Payer: Global Benefits Group Commercial |
$495.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$524.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$487.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.12
|
| Rate for Payer: Multiplan Commercial |
$660.42
|
| Rate for Payer: Networks By Design Commercial |
$536.59
|
| Rate for Payer: Prime Health Services Commercial |
$701.69
|
|
|
HC TRAY CATH PIGTAIL FUHRMAN 8.5FR
|
Facility
|
OP
|
$825.52
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901606896
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.10 |
| Max. Negotiated Rate |
$701.69 |
| Rate for Payer: Adventist Health Commercial |
$165.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$353.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$701.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$454.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$619.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$529.74
|
| Rate for Payer: Cash Price |
$371.48
|
| Rate for Payer: Cash Price |
$371.48
|
| Rate for Payer: Cigna of CA HMO |
$528.33
|
| Rate for Payer: Cigna of CA PPO |
$610.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$701.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$701.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$701.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$577.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$330.21
|
| Rate for Payer: EPIC Health Plan Senior |
$330.21
|
| Rate for Payer: Galaxy Health WC |
$701.69
|
| Rate for Payer: Global Benefits Group Commercial |
$495.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$524.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$299.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$487.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$577.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$577.86
|
| Rate for Payer: Multiplan Commercial |
$660.42
|
| Rate for Payer: Networks By Design Commercial |
$536.59
|
| Rate for Payer: Prime Health Services Commercial |
$701.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$495.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$495.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$412.76
|
| Rate for Payer: United Healthcare All Other HMO |
$412.76
|
| Rate for Payer: United Healthcare HMO Rider |
$412.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$412.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$701.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$701.69
|
| Rate for Payer: Vantage Medical Group Senior |
$701.69
|
|
|
HC TRAY CATH PIGTAIL WAYNE 14FR
|
Facility
|
OP
|
$1,178.66
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901607301
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.73 |
| Max. Negotiated Rate |
$1,001.86 |
| Rate for Payer: Adventist Health Commercial |
$235.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,001.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$648.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$884.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$713.44
|
| Rate for Payer: Blue Shield of California Commercial |
$597.58
|
| Rate for Payer: Blue Shield of California Commercial |
$906.39
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cigna of CA HMO |
$825.06
|
| Rate for Payer: Cigna of CA PPO |
$825.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,001.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,001.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,001.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$825.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$471.46
|
| Rate for Payer: EPIC Health Plan Senior |
$471.46
|
| Rate for Payer: Galaxy Health WC |
$1,001.86
|
| Rate for Payer: Global Benefits Group Commercial |
$707.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$748.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$427.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$695.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$825.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$825.06
|
| Rate for Payer: Multiplan Commercial |
$942.93
|
| Rate for Payer: Networks By Design Commercial |
$589.33
|
| Rate for Payer: Prime Health Services Commercial |
$1,001.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$707.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$707.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$442.35
|
| Rate for Payer: United Healthcare All Other HMO |
$430.56
|
| Rate for Payer: United Healthcare HMO Rider |
$421.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$386.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,001.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,001.86
|
|
|
HC TRAY CATH PIGTAIL WAYNE 14FR
|
Facility
|
IP
|
$1,178.66
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901607301
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$235.73 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$235.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cash Price |
$530.40
|
| Rate for Payer: Cigna of CA HMO |
$825.06
|
| Rate for Payer: Cigna of CA PPO |
$825.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$825.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$471.46
|
| Rate for Payer: EPIC Health Plan Senior |
$471.46
|
| Rate for Payer: Galaxy Health WC |
$1,001.86
|
| Rate for Payer: Global Benefits Group Commercial |
$707.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$748.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$695.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$282.88
|
| Rate for Payer: Multiplan Commercial |
$942.93
|
| Rate for Payer: Networks By Design Commercial |
$589.33
|
| Rate for Payer: Prime Health Services Commercial |
$1,001.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$442.35
|
| Rate for Payer: United Healthcare All Other HMO |
$430.56
|
| Rate for Payer: United Healthcare HMO Rider |
$421.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$386.01
|
|
|
HC TRAY CATH SLCN 16FR URN MTR
|
Facility
|
IP
|
$195.86
|
|
|
Service Code
|
CPT A4353
|
| Hospital Charge Code |
901698794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.17 |
| Max. Negotiated Rate |
$166.48 |
| Rate for Payer: Adventist Health Commercial |
$39.17
|
| Rate for Payer: Cash Price |
$88.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.34
|
| Rate for Payer: EPIC Health Plan Senior |
$78.34
|
| Rate for Payer: Galaxy Health WC |
$166.48
|
| Rate for Payer: Global Benefits Group Commercial |
$117.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.01
|
| Rate for Payer: Multiplan Commercial |
$156.69
|
| Rate for Payer: Networks By Design Commercial |
$127.31
|
| Rate for Payer: Prime Health Services Commercial |
$166.48
|
|
|
HC TRAY CATH SLCN 16FR URN MTR
|
Facility
|
OP
|
$195.86
|
|
|
Service Code
|
CPT A4353
|
| Hospital Charge Code |
901698794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.95 |
| Max. Negotiated Rate |
$166.48 |
| Rate for Payer: Adventist Health Commercial |
$39.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$166.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$107.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$146.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$125.68
|
| Rate for Payer: Cash Price |
$88.14
|
| Rate for Payer: Cash Price |
$88.14
|
| Rate for Payer: Cigna of CA HMO |
$125.35
|
| Rate for Payer: Cigna of CA PPO |
$144.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$166.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$166.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.34
|
| Rate for Payer: EPIC Health Plan Senior |
$78.34
|
| Rate for Payer: Galaxy Health WC |
$166.48
|
| Rate for Payer: Global Benefits Group Commercial |
$117.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$71.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$137.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$137.10
|
| Rate for Payer: Multiplan Commercial |
$156.69
|
| Rate for Payer: Networks By Design Commercial |
$127.31
|
| Rate for Payer: Prime Health Services Commercial |
$166.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$97.93
|
| Rate for Payer: United Healthcare All Other HMO |
$97.93
|
| Rate for Payer: United Healthcare HMO Rider |
$97.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$97.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$166.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.48
|
| Rate for Payer: Vantage Medical Group Senior |
$166.48
|
|
|
HC TRAY CATH SLCN 18FR URN MTR
|
Facility
|
IP
|
$125.86
|
|
|
Service Code
|
CPT A4353
|
| Hospital Charge Code |
901698790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.17 |
| Max. Negotiated Rate |
$106.98 |
| Rate for Payer: Adventist Health Commercial |
$25.17
|
| Rate for Payer: Cash Price |
$56.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.34
|
| Rate for Payer: EPIC Health Plan Senior |
$50.34
|
| Rate for Payer: Galaxy Health WC |
$106.98
|
| Rate for Payer: Global Benefits Group Commercial |
$75.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$79.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$74.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.21
|
| Rate for Payer: Multiplan Commercial |
$100.69
|
| Rate for Payer: Networks By Design Commercial |
$81.81
|
| Rate for Payer: Prime Health Services Commercial |
$106.98
|
|
|
HC TRAY CATH SLCN 18FR URN MTR
|
Facility
|
OP
|
$125.86
|
|
|
Service Code
|
CPT A4353
|
| Hospital Charge Code |
901698790
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.95 |
| Max. Negotiated Rate |
$106.98 |
| Rate for Payer: Adventist Health Commercial |
$25.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$106.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$69.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$94.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80.76
|
| Rate for Payer: Cash Price |
$56.64
|
| Rate for Payer: Cash Price |
$56.64
|
| Rate for Payer: Cigna of CA HMO |
$80.55
|
| Rate for Payer: Cigna of CA PPO |
$93.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$106.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$106.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$106.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$88.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.34
|
| Rate for Payer: EPIC Health Plan Senior |
$50.34
|
| Rate for Payer: Galaxy Health WC |
$106.98
|
| Rate for Payer: Global Benefits Group Commercial |
$75.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$79.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$74.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$88.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$88.10
|
| Rate for Payer: Multiplan Commercial |
$100.69
|
| Rate for Payer: Networks By Design Commercial |
$81.81
|
| Rate for Payer: Prime Health Services Commercial |
$106.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.93
|
| Rate for Payer: United Healthcare All Other HMO |
$62.93
|
| Rate for Payer: United Healthcare HMO Rider |
$62.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$62.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$106.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$106.98
|
| Rate for Payer: Vantage Medical Group Senior |
$106.98
|
|
|
HC TRAY CATH SLCN DRAIN BAG 16FR
|
Facility
|
IP
|
$99.86
|
|
| Hospital Charge Code |
901608084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.97 |
| Max. Negotiated Rate |
$84.88 |
| Rate for Payer: Adventist Health Commercial |
$19.97
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$69.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.94
|
| Rate for Payer: EPIC Health Plan Senior |
$39.94
|
| Rate for Payer: Galaxy Health WC |
$84.88
|
| Rate for Payer: Global Benefits Group Commercial |
$59.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$63.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$58.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.97
|
| Rate for Payer: Multiplan Commercial |
$79.89
|
| Rate for Payer: Networks By Design Commercial |
$64.91
|
| Rate for Payer: Prime Health Services Commercial |
$84.88
|
|
|
HC TRAY CATH SLCN DRAIN BAG 16FR
|
Facility
|
OP
|
$99.86
|
|
| Hospital Charge Code |
901608084
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.97 |
| Max. Negotiated Rate |
$84.88 |
| Rate for Payer: Adventist Health Commercial |
$19.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$84.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$54.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$74.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.08
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Cigna of CA HMO |
$63.91
|
| Rate for Payer: Cigna of CA PPO |
$73.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$84.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$84.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$69.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.94
|
| Rate for Payer: EPIC Health Plan Senior |
$39.94
|
| Rate for Payer: Galaxy Health WC |
$84.88
|
| Rate for Payer: Global Benefits Group Commercial |
$59.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$63.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$58.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$69.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69.90
|
| Rate for Payer: Multiplan Commercial |
$79.89
|
| Rate for Payer: Networks By Design Commercial |
$64.91
|
| Rate for Payer: Prime Health Services Commercial |
$84.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.93
|
| Rate for Payer: United Healthcare All Other HMO |
$49.93
|
| Rate for Payer: United Healthcare HMO Rider |
$49.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$84.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.88
|
| Rate for Payer: Vantage Medical Group Senior |
$84.88
|
|
|
HC TRAY CATH SLCN DRAIN BAG 18FR
|
Facility
|
OP
|
$123.35
|
|
| Hospital Charge Code |
901608087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.67 |
| Max. Negotiated Rate |
$104.85 |
| Rate for Payer: Adventist Health Commercial |
$24.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$80.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$104.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$67.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$92.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.15
|
| Rate for Payer: Cash Price |
$55.51
|
| Rate for Payer: Cigna of CA HMO |
$78.94
|
| Rate for Payer: Cigna of CA PPO |
$91.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$104.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$104.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$104.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$86.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.34
|
| Rate for Payer: EPIC Health Plan Senior |
$49.34
|
| Rate for Payer: Galaxy Health WC |
$104.85
|
| Rate for Payer: Global Benefits Group Commercial |
$74.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$78.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$44.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$86.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$86.34
|
| Rate for Payer: Multiplan Commercial |
$98.68
|
| Rate for Payer: Networks By Design Commercial |
$80.18
|
| Rate for Payer: Prime Health Services Commercial |
$104.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$74.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$74.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$61.67
|
| Rate for Payer: United Healthcare All Other HMO |
$61.67
|
| Rate for Payer: United Healthcare HMO Rider |
$61.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$61.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$104.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$104.85
|
| Rate for Payer: Vantage Medical Group Senior |
$104.85
|
|
|
HC TRAY CATH SLCN DRAIN BAG 18FR
|
Facility
|
IP
|
$123.35
|
|
| Hospital Charge Code |
901608087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.67 |
| Max. Negotiated Rate |
$104.85 |
| Rate for Payer: Adventist Health Commercial |
$24.67
|
| Rate for Payer: Cash Price |
$55.51
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$86.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.34
|
| Rate for Payer: EPIC Health Plan Senior |
$49.34
|
| Rate for Payer: Galaxy Health WC |
$104.85
|
| Rate for Payer: Global Benefits Group Commercial |
$74.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$78.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$72.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.60
|
| Rate for Payer: Multiplan Commercial |
$98.68
|
| Rate for Payer: Networks By Design Commercial |
$80.18
|
| Rate for Payer: Prime Health Services Commercial |
$104.85
|
|
|
HC TRAY CATH SLCN URN METER 16FR
|
Facility
|
OP
|
$112.25
|
|
| Hospital Charge Code |
901608088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$95.41 |
| Rate for Payer: Adventist Health Commercial |
$22.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$73.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$95.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$61.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$84.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.03
|
| Rate for Payer: Cash Price |
$50.51
|
| Rate for Payer: Cigna of CA HMO |
$71.84
|
| Rate for Payer: Cigna of CA PPO |
$83.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$95.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$95.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$95.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.90
|
| Rate for Payer: EPIC Health Plan Senior |
$44.90
|
| Rate for Payer: Galaxy Health WC |
$95.41
|
| Rate for Payer: Global Benefits Group Commercial |
$67.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$71.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78.58
|
| Rate for Payer: Multiplan Commercial |
$89.80
|
| Rate for Payer: Networks By Design Commercial |
$72.96
|
| Rate for Payer: Prime Health Services Commercial |
$95.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$56.12
|
| Rate for Payer: United Healthcare All Other HMO |
$56.12
|
| Rate for Payer: United Healthcare HMO Rider |
$56.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$56.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$95.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$95.41
|
| Rate for Payer: Vantage Medical Group Senior |
$95.41
|
|
|
HC TRAY CATH SLCN URN METER 16FR
|
Facility
|
IP
|
$112.25
|
|
| Hospital Charge Code |
901608088
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$95.41 |
| Rate for Payer: Adventist Health Commercial |
$22.45
|
| Rate for Payer: Cash Price |
$50.51
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.90
|
| Rate for Payer: EPIC Health Plan Senior |
$44.90
|
| Rate for Payer: Galaxy Health WC |
$95.41
|
| Rate for Payer: Global Benefits Group Commercial |
$67.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$71.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$66.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.94
|
| Rate for Payer: Multiplan Commercial |
$89.80
|
| Rate for Payer: Networks By Design Commercial |
$72.96
|
| Rate for Payer: Prime Health Services Commercial |
$95.41
|
|
|
HC TRAY CATH SLCN URN METER 18FR
|
Facility
|
IP
|
$119.09
|
|
| Hospital Charge Code |
901608085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.82 |
| Max. Negotiated Rate |
$101.23 |
| Rate for Payer: Adventist Health Commercial |
$23.82
|
| Rate for Payer: Cash Price |
$53.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$83.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.64
|
| Rate for Payer: EPIC Health Plan Senior |
$47.64
|
| Rate for Payer: Galaxy Health WC |
$101.23
|
| Rate for Payer: Global Benefits Group Commercial |
$71.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$75.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$70.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.58
|
| Rate for Payer: Multiplan Commercial |
$95.27
|
| Rate for Payer: Networks By Design Commercial |
$77.41
|
| Rate for Payer: Prime Health Services Commercial |
$101.23
|
|
|
HC TRAY CATH SLCN URN METER 18FR
|
Facility
|
OP
|
$119.09
|
|
| Hospital Charge Code |
901608085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.82 |
| Max. Negotiated Rate |
$101.23 |
| Rate for Payer: Adventist Health Commercial |
$23.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$78.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$101.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$65.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$89.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.42
|
| Rate for Payer: Cash Price |
$53.59
|
| Rate for Payer: Cigna of CA HMO |
$76.22
|
| Rate for Payer: Cigna of CA PPO |
$88.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$101.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$101.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$101.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$83.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.64
|
| Rate for Payer: EPIC Health Plan Senior |
$47.64
|
| Rate for Payer: Galaxy Health WC |
$101.23
|
| Rate for Payer: Global Benefits Group Commercial |
$71.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$75.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$70.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$83.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$83.36
|
| Rate for Payer: Multiplan Commercial |
$95.27
|
| Rate for Payer: Networks By Design Commercial |
$77.41
|
| Rate for Payer: Prime Health Services Commercial |
$101.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$71.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$71.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$59.55
|
| Rate for Payer: United Healthcare All Other HMO |
$59.55
|
| Rate for Payer: United Healthcare HMO Rider |
$59.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$59.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$101.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$101.23
|
| Rate for Payer: Vantage Medical Group Senior |
$101.23
|
|
|
HC TRAY CATH URETHRAL 14FR
|
Facility
|
OP
|
$24.52
|
|
| Hospital Charge Code |
901607380
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$20.84 |
| Rate for Payer: United Healthcare HMO Rider |
$12.26
|
| Rate for Payer: Adventist Health Commercial |
$4.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.73
|
| Rate for Payer: Cash Price |
$11.03
|
| Rate for Payer: Cigna of CA HMO |
$15.69
|
| Rate for Payer: Cigna of CA PPO |
$18.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.81
|
| Rate for Payer: EPIC Health Plan Senior |
$9.81
|
| Rate for Payer: Galaxy Health WC |
$20.84
|
| Rate for Payer: Global Benefits Group Commercial |
$14.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.16
|
| Rate for Payer: Multiplan Commercial |
$19.62
|
| Rate for Payer: Networks By Design Commercial |
$15.94
|
| Rate for Payer: Prime Health Services Commercial |
$20.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.26
|
| Rate for Payer: United Healthcare All Other HMO |
$12.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.84
|
| Rate for Payer: Vantage Medical Group Senior |
$20.84
|
|
|
HC TRAY CATH URETHRAL 14FR
|
Facility
|
IP
|
$24.52
|
|
| Hospital Charge Code |
901607380
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$20.84 |
| Rate for Payer: Adventist Health Commercial |
$4.90
|
| Rate for Payer: Cash Price |
$11.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.81
|
| Rate for Payer: EPIC Health Plan Senior |
$9.81
|
| Rate for Payer: Galaxy Health WC |
$20.84
|
| Rate for Payer: Global Benefits Group Commercial |
$14.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.88
|
| Rate for Payer: Multiplan Commercial |
$19.62
|
| Rate for Payer: Networks By Design Commercial |
$15.94
|
| Rate for Payer: Prime Health Services Commercial |
$20.84
|
|
|
HC TRAY CATH URN METER 14FR SLCN
|
Facility
|
OP
|
$120.38
|
|
| Hospital Charge Code |
901607613
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.08 |
| Max. Negotiated Rate |
$102.32 |
| Rate for Payer: Adventist Health Commercial |
$24.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$78.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$102.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$66.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$77.25
|
| Rate for Payer: Cash Price |
$54.17
|
| Rate for Payer: Cigna of CA HMO |
$77.04
|
| Rate for Payer: Cigna of CA PPO |
$89.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$102.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$102.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$102.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.15
|
| Rate for Payer: EPIC Health Plan Senior |
$48.15
|
| Rate for Payer: Galaxy Health WC |
$102.32
|
| Rate for Payer: Global Benefits Group Commercial |
$72.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$43.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$84.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$84.27
|
| Rate for Payer: Multiplan Commercial |
$96.30
|
| Rate for Payer: Networks By Design Commercial |
$78.25
|
| Rate for Payer: Prime Health Services Commercial |
$102.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$60.19
|
| Rate for Payer: United Healthcare All Other HMO |
$60.19
|
| Rate for Payer: United Healthcare HMO Rider |
$60.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$60.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$102.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$102.32
|
| Rate for Payer: Vantage Medical Group Senior |
$102.32
|
|
|
HC TRAY CATH URN METER 14FR SLCN
|
Facility
|
IP
|
$120.38
|
|
| Hospital Charge Code |
901607613
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.08 |
| Max. Negotiated Rate |
$102.32 |
| Rate for Payer: Adventist Health Commercial |
$24.08
|
| Rate for Payer: Cash Price |
$54.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$84.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.15
|
| Rate for Payer: EPIC Health Plan Senior |
$48.15
|
| Rate for Payer: Galaxy Health WC |
$102.32
|
| Rate for Payer: Global Benefits Group Commercial |
$72.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$76.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$71.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.89
|
| Rate for Payer: Multiplan Commercial |
$96.30
|
| Rate for Payer: Networks By Design Commercial |
$78.25
|
| Rate for Payer: Prime Health Services Commercial |
$102.32
|
|
|
HC TRAY FOLEY INS PVP 10CC SYR
|
Facility
|
IP
|
$12.87
|
|
|
Service Code
|
CPT A4310
|
| Hospital Charge Code |
901698655
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$10.94 |
| Rate for Payer: Adventist Health Commercial |
$2.57
|
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.15
|
| Rate for Payer: EPIC Health Plan Senior |
$5.15
|
| Rate for Payer: Galaxy Health WC |
$10.94
|
| Rate for Payer: Global Benefits Group Commercial |
$7.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.09
|
| Rate for Payer: Multiplan Commercial |
$10.30
|
| Rate for Payer: Networks By Design Commercial |
$8.37
|
| Rate for Payer: Prime Health Services Commercial |
$10.94
|
|
|
HC TRAY FOLEY INS PVP 10CC SYR
|
Facility
|
OP
|
$12.87
|
|
|
Service Code
|
CPT A4310
|
| Hospital Charge Code |
901698655
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$22.04 |
| Rate for Payer: Adventist Health Commercial |
$2.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.26
|
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: Cigna of CA HMO |
$8.24
|
| Rate for Payer: Cigna of CA PPO |
$9.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.15
|
| Rate for Payer: EPIC Health Plan Senior |
$5.15
|
| Rate for Payer: Galaxy Health WC |
$10.94
|
| Rate for Payer: Global Benefits Group Commercial |
$7.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.01
|
| Rate for Payer: Multiplan Commercial |
$10.30
|
| Rate for Payer: Networks By Design Commercial |
$8.37
|
| Rate for Payer: Prime Health Services Commercial |
$10.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.43
|
| Rate for Payer: United Healthcare All Other HMO |
$6.43
|
| Rate for Payer: United Healthcare HMO Rider |
$6.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.94
|
| Rate for Payer: Vantage Medical Group Senior |
$10.94
|
|
|
HC TRAY FOLEY INS PVP 10ML SYR
|
Facility
|
OP
|
$21.24
|
|
|
Service Code
|
CPT A4310
|
| Hospital Charge Code |
901698656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$22.04 |
| Rate for Payer: Adventist Health Commercial |
$4.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.63
|
| Rate for Payer: Cash Price |
$9.56
|
| Rate for Payer: Cash Price |
$9.56
|
| Rate for Payer: Cigna of CA HMO |
$13.59
|
| Rate for Payer: Cigna of CA PPO |
$15.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8.50
|
| Rate for Payer: Galaxy Health WC |
$18.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.87
|
| Rate for Payer: Multiplan Commercial |
$16.99
|
| Rate for Payer: Networks By Design Commercial |
$13.81
|
| Rate for Payer: Prime Health Services Commercial |
$18.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.62
|
| Rate for Payer: United Healthcare All Other HMO |
$10.62
|
| Rate for Payer: United Healthcare HMO Rider |
$10.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.05
|
| Rate for Payer: Vantage Medical Group Senior |
$18.05
|
|
|
HC TRAY FOLEY INS PVP 10ML SYR
|
Facility
|
IP
|
$21.24
|
|
|
Service Code
|
CPT A4310
|
| Hospital Charge Code |
901698656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$18.05 |
| Rate for Payer: Networks By Design Commercial |
$13.81
|
| Rate for Payer: Multiplan Commercial |
$16.99
|
| Rate for Payer: Adventist Health Commercial |
$4.25
|
| Rate for Payer: Cash Price |
$9.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8.50
|
| Rate for Payer: Galaxy Health WC |
$18.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.10
|
| Rate for Payer: Prime Health Services Commercial |
$18.05
|
|
