|
HC URINALYSIS NON AUTOMATED WO MICROSCOPY
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
900510277
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$113.90 |
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.53
|
| Rate for Payer: Blue Shield of California Commercial |
$61.77
|
| Rate for Payer: Blue Shield of California Commercial |
$93.40
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.74
|
| Rate for Payer: EPIC Health Plan Senior |
$3.83
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.66
|
| Rate for Payer: Multiplan Commercial |
$107.20
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.82
|
| Rate for Payer: United Healthcare All Other HMO |
$2.82
|
| Rate for Payer: United Healthcare HMO Rider |
$2.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.82
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Vantage Medical Group Senior |
$3.48
|
|
|
HC URINALYSIS NON AUTOMATED WO MICROSCOPY
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
900510277
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.80 |
| Max. Negotiated Rate |
$113.90 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.60
|
| Rate for Payer: EPIC Health Plan Senior |
$53.60
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$79.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.16
|
| Rate for Payer: Multiplan Commercial |
$107.20
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
|
|
HC URINALYSIS NON AUTOMATED WO MICROSCOPY
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 81002
|
| Hospital Charge Code |
900510277
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$113.90 |
| Rate for Payer: Adventist Health Commercial |
$26.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.53
|
| Rate for Payer: Blue Shield of California Commercial |
$61.77
|
| Rate for Payer: Blue Shield of California Commercial |
$93.40
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cash Price |
$60.30
|
| Rate for Payer: Cigna of CA HMO |
$85.76
|
| Rate for Payer: Cigna of CA PPO |
$99.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$93.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.74
|
| Rate for Payer: EPIC Health Plan Senior |
$3.83
|
| Rate for Payer: Galaxy Health WC |
$113.90
|
| Rate for Payer: Global Benefits Group Commercial |
$80.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$85.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.66
|
| Rate for Payer: Multiplan Commercial |
$107.20
|
| Rate for Payer: Networks By Design Commercial |
$87.10
|
| Rate for Payer: Prime Health Services Commercial |
$113.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.82
|
| Rate for Payer: United Healthcare All Other HMO |
$2.82
|
| Rate for Payer: United Healthcare HMO Rider |
$2.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.82
|
| Rate for Payer: Upland Medical Group Pediatric |
$3.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Vantage Medical Group Senior |
$3.48
|
|
|
HC URINARY CATH 3.5FR SILICONE
|
Facility
|
OP
|
$138.02
|
|
| Hospital Charge Code |
901698493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$117.32 |
| Rate for Payer: Adventist Health Commercial |
$27.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$90.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$117.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$103.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88.57
|
| Rate for Payer: Cash Price |
$62.11
|
| Rate for Payer: Cigna of CA HMO |
$88.33
|
| Rate for Payer: Cigna of CA PPO |
$102.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$117.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$117.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$117.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$96.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.21
|
| Rate for Payer: EPIC Health Plan Senior |
$55.21
|
| Rate for Payer: Galaxy Health WC |
$117.32
|
| Rate for Payer: Global Benefits Group Commercial |
$82.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$87.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96.61
|
| Rate for Payer: Multiplan Commercial |
$110.42
|
| Rate for Payer: Networks By Design Commercial |
$89.71
|
| Rate for Payer: Prime Health Services Commercial |
$117.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$69.01
|
| Rate for Payer: United Healthcare All Other HMO |
$69.01
|
| Rate for Payer: United Healthcare HMO Rider |
$69.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$117.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$117.32
|
| Rate for Payer: Vantage Medical Group Senior |
$117.32
|
|
|
HC URINARY CATH 3.5FR SILICONE
|
Facility
|
IP
|
$138.02
|
|
| Hospital Charge Code |
901698493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$117.32 |
| Rate for Payer: Adventist Health Commercial |
$27.60
|
| Rate for Payer: Cash Price |
$62.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$96.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.21
|
| Rate for Payer: EPIC Health Plan Senior |
$55.21
|
| Rate for Payer: Galaxy Health WC |
$117.32
|
| Rate for Payer: Global Benefits Group Commercial |
$82.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$87.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$81.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.12
|
| Rate for Payer: Multiplan Commercial |
$110.42
|
| Rate for Payer: Networks By Design Commercial |
$89.71
|
| Rate for Payer: Prime Health Services Commercial |
$117.32
|
|
|
HC URINARY CATH 5.0 SILICONE
|
Facility
|
IP
|
$83.60
|
|
| Hospital Charge Code |
901698568
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.72 |
| Max. Negotiated Rate |
$71.06 |
| Rate for Payer: Adventist Health Commercial |
$16.72
|
| Rate for Payer: Cash Price |
$37.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.44
|
| Rate for Payer: EPIC Health Plan Senior |
$33.44
|
| Rate for Payer: Galaxy Health WC |
$71.06
|
| Rate for Payer: Global Benefits Group Commercial |
$50.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$49.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.06
|
| Rate for Payer: Multiplan Commercial |
$66.88
|
| Rate for Payer: Networks By Design Commercial |
$54.34
|
| Rate for Payer: Prime Health Services Commercial |
$71.06
|
|
|
HC URINARY CATH 5.0 SILICONE
|
Facility
|
OP
|
$83.60
|
|
| Hospital Charge Code |
901698568
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.72 |
| Max. Negotiated Rate |
$71.06 |
| Rate for Payer: Adventist Health Commercial |
$16.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$71.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$53.65
|
| Rate for Payer: Cash Price |
$37.62
|
| Rate for Payer: Cigna of CA HMO |
$53.50
|
| Rate for Payer: Cigna of CA PPO |
$61.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$71.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$71.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$71.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$58.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.44
|
| Rate for Payer: EPIC Health Plan Senior |
$33.44
|
| Rate for Payer: Galaxy Health WC |
$71.06
|
| Rate for Payer: Global Benefits Group Commercial |
$50.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$53.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$49.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$58.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58.52
|
| Rate for Payer: Multiplan Commercial |
$66.88
|
| Rate for Payer: Networks By Design Commercial |
$54.34
|
| Rate for Payer: Prime Health Services Commercial |
$71.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$50.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$50.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.80
|
| Rate for Payer: United Healthcare All Other HMO |
$41.80
|
| Rate for Payer: United Healthcare HMO Rider |
$41.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$71.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71.06
|
| Rate for Payer: Vantage Medical Group Senior |
$71.06
|
|
|
HC URINARY DRAIN CATH KIT 8FR
|
Facility
|
OP
|
$196.00
|
|
| Hospital Charge Code |
901698629
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$166.60 |
| Rate for Payer: United Healthcare HMO Rider |
$98.00
|
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$128.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$107.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$125.77
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$166.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$166.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$71.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$137.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$137.20
|
| Rate for Payer: Multiplan Commercial |
$156.80
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$98.00
|
| Rate for Payer: United Healthcare All Other HMO |
$98.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$98.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.60
|
| Rate for Payer: Vantage Medical Group Senior |
$166.60
|
|
|
HC URINARY DRAIN CATH KIT 8FR
|
Facility
|
IP
|
$196.00
|
|
| Hospital Charge Code |
901698629
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$166.60 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.04
|
| Rate for Payer: Multiplan Commercial |
$156.80
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC URINARY DRAIN KIT W/5FR CATH
|
Facility
|
IP
|
$248.92
|
|
| Hospital Charge Code |
901698447
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$211.58 |
| Rate for Payer: Adventist Health Commercial |
$49.78
|
| Rate for Payer: Cash Price |
$112.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$174.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.57
|
| Rate for Payer: EPIC Health Plan Senior |
$99.57
|
| Rate for Payer: Galaxy Health WC |
$211.58
|
| Rate for Payer: Global Benefits Group Commercial |
$149.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$146.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.74
|
| Rate for Payer: Multiplan Commercial |
$199.14
|
| Rate for Payer: Networks By Design Commercial |
$161.80
|
| Rate for Payer: Prime Health Services Commercial |
$211.58
|
|
|
HC URINARY DRAIN KIT W/5FR CATH
|
Facility
|
OP
|
$248.92
|
|
| Hospital Charge Code |
901698447
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$211.58 |
| Rate for Payer: Adventist Health Commercial |
$49.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$163.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$211.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$186.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.73
|
| Rate for Payer: Cash Price |
$112.01
|
| Rate for Payer: Cigna of CA HMO |
$159.31
|
| Rate for Payer: Cigna of CA PPO |
$184.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$211.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$211.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$174.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.57
|
| Rate for Payer: EPIC Health Plan Senior |
$99.57
|
| Rate for Payer: Galaxy Health WC |
$211.58
|
| Rate for Payer: Global Benefits Group Commercial |
$149.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$90.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$146.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$174.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$174.24
|
| Rate for Payer: Multiplan Commercial |
$199.14
|
| Rate for Payer: Networks By Design Commercial |
$161.80
|
| Rate for Payer: Prime Health Services Commercial |
$211.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$149.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$149.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$124.46
|
| Rate for Payer: United Healthcare All Other HMO |
$124.46
|
| Rate for Payer: United Healthcare HMO Rider |
$124.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$124.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$211.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$211.58
|
| Rate for Payer: Vantage Medical Group Senior |
$211.58
|
|
|
HC URINARY DRAIN KIT W/CATH 5.0
|
Facility
|
OP
|
$196.00
|
|
| Hospital Charge Code |
901698567
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$166.60 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$128.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$107.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$125.77
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$166.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$166.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$71.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$137.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$137.20
|
| Rate for Payer: Multiplan Commercial |
$156.80
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$98.00
|
| Rate for Payer: United Healthcare All Other HMO |
$98.00
|
| Rate for Payer: United Healthcare HMO Rider |
$98.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$98.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.60
|
| Rate for Payer: Vantage Medical Group Senior |
$166.60
|
|
|
HC URINARY DRAIN KIT W/CATH 5.0
|
Facility
|
IP
|
$196.00
|
|
| Hospital Charge Code |
901698567
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$166.60 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.04
|
| Rate for Payer: Multiplan Commercial |
$156.80
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC URINARY DRAIN SET CATH 3.5FR
|
Facility
|
IP
|
$248.92
|
|
| Hospital Charge Code |
901698491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$211.58 |
| Rate for Payer: Adventist Health Commercial |
$49.78
|
| Rate for Payer: Cash Price |
$112.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$174.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.57
|
| Rate for Payer: EPIC Health Plan Senior |
$99.57
|
| Rate for Payer: Galaxy Health WC |
$211.58
|
| Rate for Payer: Global Benefits Group Commercial |
$149.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$146.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.74
|
| Rate for Payer: Multiplan Commercial |
$199.14
|
| Rate for Payer: Networks By Design Commercial |
$161.80
|
| Rate for Payer: Prime Health Services Commercial |
$211.58
|
|
|
HC URINARY DRAIN SET CATH 3.5FR
|
Facility
|
OP
|
$248.92
|
|
| Hospital Charge Code |
901698491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$211.58 |
| Rate for Payer: Adventist Health Commercial |
$49.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$163.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$211.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$186.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.73
|
| Rate for Payer: Cash Price |
$112.01
|
| Rate for Payer: Cigna of CA HMO |
$159.31
|
| Rate for Payer: Cigna of CA PPO |
$184.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$211.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$211.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$174.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.57
|
| Rate for Payer: EPIC Health Plan Senior |
$99.57
|
| Rate for Payer: Galaxy Health WC |
$211.58
|
| Rate for Payer: Global Benefits Group Commercial |
$149.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$90.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$146.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$174.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$174.24
|
| Rate for Payer: Multiplan Commercial |
$199.14
|
| Rate for Payer: Networks By Design Commercial |
$161.80
|
| Rate for Payer: Prime Health Services Commercial |
$211.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$149.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$149.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$124.46
|
| Rate for Payer: United Healthcare All Other HMO |
$124.46
|
| Rate for Payer: United Healthcare HMO Rider |
$124.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$124.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$211.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$211.58
|
| Rate for Payer: Vantage Medical Group Senior |
$211.58
|
|
|
HC URINARY DRAIN SET CATH 8FR
|
Facility
|
IP
|
$248.92
|
|
| Hospital Charge Code |
901698512
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$211.58 |
| Rate for Payer: Adventist Health Commercial |
$49.78
|
| Rate for Payer: Cash Price |
$112.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$174.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.57
|
| Rate for Payer: EPIC Health Plan Senior |
$99.57
|
| Rate for Payer: Galaxy Health WC |
$211.58
|
| Rate for Payer: Global Benefits Group Commercial |
$149.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$146.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.74
|
| Rate for Payer: Multiplan Commercial |
$199.14
|
| Rate for Payer: Networks By Design Commercial |
$161.80
|
| Rate for Payer: Prime Health Services Commercial |
$211.58
|
|
|
HC URINARY DRAIN SET CATH 8FR
|
Facility
|
OP
|
$248.92
|
|
| Hospital Charge Code |
901698512
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.78 |
| Max. Negotiated Rate |
$211.58 |
| Rate for Payer: Adventist Health Commercial |
$49.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$163.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$211.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$186.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.73
|
| Rate for Payer: Cash Price |
$112.01
|
| Rate for Payer: Cigna of CA HMO |
$159.31
|
| Rate for Payer: Cigna of CA PPO |
$184.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$211.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$211.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$174.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.57
|
| Rate for Payer: EPIC Health Plan Senior |
$99.57
|
| Rate for Payer: Galaxy Health WC |
$211.58
|
| Rate for Payer: Global Benefits Group Commercial |
$149.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$158.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$90.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$146.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$174.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$174.24
|
| Rate for Payer: Multiplan Commercial |
$199.14
|
| Rate for Payer: Networks By Design Commercial |
$161.80
|
| Rate for Payer: Prime Health Services Commercial |
$211.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$149.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$149.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$124.46
|
| Rate for Payer: United Healthcare All Other HMO |
$124.46
|
| Rate for Payer: United Healthcare HMO Rider |
$124.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$124.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$211.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$211.58
|
| Rate for Payer: Vantage Medical Group Senior |
$211.58
|
|
|
HC URINE CHEMISTRY SCREEN
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
900910180
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$17.40 |
| Max. Negotiated Rate |
$73.95 |
| Rate for Payer: Adventist Health Commercial |
$17.40
|
| Rate for Payer: Cash Price |
$39.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$60.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.80
|
| Rate for Payer: EPIC Health Plan Senior |
$34.80
|
| Rate for Payer: Galaxy Health WC |
$73.95
|
| Rate for Payer: Global Benefits Group Commercial |
$52.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$51.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.88
|
| Rate for Payer: Multiplan Commercial |
$69.60
|
| Rate for Payer: Networks By Design Commercial |
$56.55
|
| Rate for Payer: Prime Health Services Commercial |
$73.95
|
|
|
HC URINE CHEMISTRY SCREEN
|
Facility
|
OP
|
$87.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
900910180
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$73.95 |
| Rate for Payer: Adventist Health Commercial |
$17.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.21
|
| Rate for Payer: Blue Shield of California Commercial |
$40.11
|
| Rate for Payer: Blue Shield of California Commercial |
$60.64
|
| Rate for Payer: Cash Price |
$39.15
|
| Rate for Payer: Cash Price |
$39.15
|
| Rate for Payer: Cigna of CA HMO |
$55.68
|
| Rate for Payer: Cigna of CA PPO |
$64.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$60.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.71
|
| Rate for Payer: EPIC Health Plan Senior |
$2.48
|
| Rate for Payer: Galaxy Health WC |
$73.95
|
| Rate for Payer: Global Benefits Group Commercial |
$52.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.02
|
| Rate for Payer: Multiplan Commercial |
$69.60
|
| Rate for Payer: Networks By Design Commercial |
$56.55
|
| Rate for Payer: Prime Health Services Commercial |
$73.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$52.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.83
|
| Rate for Payer: United Healthcare All Other HMO |
$1.83
|
| Rate for Payer: United Healthcare HMO Rider |
$1.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.83
|
| Rate for Payer: Upland Medical Group Pediatric |
$2.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.48
|
| Rate for Payer: Vantage Medical Group Senior |
$2.25
|
|
|
HC URINE CHEM SCREEN POC
|
Facility
|
OP
|
$87.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
900912015
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$73.95 |
| Rate for Payer: Adventist Health Commercial |
$17.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.21
|
| Rate for Payer: Blue Shield of California Commercial |
$40.11
|
| Rate for Payer: Blue Shield of California Commercial |
$60.64
|
| Rate for Payer: Cash Price |
$39.15
|
| Rate for Payer: Cash Price |
$39.15
|
| Rate for Payer: Cigna of CA HMO |
$55.68
|
| Rate for Payer: Cigna of CA PPO |
$64.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$60.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.71
|
| Rate for Payer: EPIC Health Plan Senior |
$2.48
|
| Rate for Payer: Galaxy Health WC |
$73.95
|
| Rate for Payer: Global Benefits Group Commercial |
$52.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.02
|
| Rate for Payer: Multiplan Commercial |
$69.60
|
| Rate for Payer: Networks By Design Commercial |
$56.55
|
| Rate for Payer: Prime Health Services Commercial |
$73.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$52.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.83
|
| Rate for Payer: United Healthcare All Other HMO |
$1.83
|
| Rate for Payer: United Healthcare HMO Rider |
$1.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.83
|
| Rate for Payer: Upland Medical Group Pediatric |
$2.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.48
|
| Rate for Payer: Vantage Medical Group Senior |
$2.25
|
|
|
HC URINE CHEM SCREEN POC
|
Facility
|
IP
|
$87.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
900912015
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.40 |
| Max. Negotiated Rate |
$73.95 |
| Rate for Payer: Adventist Health Commercial |
$17.40
|
| Rate for Payer: Cash Price |
$39.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$60.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.80
|
| Rate for Payer: EPIC Health Plan Senior |
$34.80
|
| Rate for Payer: Galaxy Health WC |
$73.95
|
| Rate for Payer: Global Benefits Group Commercial |
$52.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$51.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.88
|
| Rate for Payer: Multiplan Commercial |
$69.60
|
| Rate for Payer: Networks By Design Commercial |
$56.55
|
| Rate for Payer: Prime Health Services Commercial |
$73.95
|
|
|
HC URINE COLL KIT W/5FR CATH
|
Facility
|
OP
|
$219.73
|
|
| Hospital Charge Code |
901698695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.95 |
| Max. Negotiated Rate |
$186.77 |
| Rate for Payer: Adventist Health Commercial |
$43.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$144.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$186.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$120.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$164.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$141.00
|
| Rate for Payer: Cash Price |
$98.88
|
| Rate for Payer: Cigna of CA HMO |
$140.63
|
| Rate for Payer: Cigna of CA PPO |
$162.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$186.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$186.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$186.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$153.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.89
|
| Rate for Payer: EPIC Health Plan Senior |
$87.89
|
| Rate for Payer: Galaxy Health WC |
$186.77
|
| Rate for Payer: Global Benefits Group Commercial |
$131.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$139.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$129.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$153.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$153.81
|
| Rate for Payer: Multiplan Commercial |
$175.78
|
| Rate for Payer: Networks By Design Commercial |
$142.82
|
| Rate for Payer: Prime Health Services Commercial |
$186.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$131.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$131.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$109.86
|
| Rate for Payer: United Healthcare All Other HMO |
$109.86
|
| Rate for Payer: United Healthcare HMO Rider |
$109.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$109.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$186.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$186.77
|
| Rate for Payer: Vantage Medical Group Senior |
$186.77
|
|
|
HC URINE COLL KIT W/5FR CATH
|
Facility
|
IP
|
$219.73
|
|
| Hospital Charge Code |
901698695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.95 |
| Max. Negotiated Rate |
$186.77 |
| Rate for Payer: Adventist Health Commercial |
$43.95
|
| Rate for Payer: Cash Price |
$98.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$153.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.89
|
| Rate for Payer: EPIC Health Plan Senior |
$87.89
|
| Rate for Payer: Galaxy Health WC |
$186.77
|
| Rate for Payer: Global Benefits Group Commercial |
$131.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$139.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$129.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.74
|
| Rate for Payer: Multiplan Commercial |
$175.78
|
| Rate for Payer: Networks By Design Commercial |
$142.82
|
| Rate for Payer: Prime Health Services Commercial |
$186.77
|
|
|
HC UROGRAPHY ANTEGRADE
|
Facility
|
IP
|
$1,093.00
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
909001935
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$218.60 |
| Max. Negotiated Rate |
$929.05 |
| Rate for Payer: Adventist Health Commercial |
$218.60
|
| Rate for Payer: Cash Price |
$491.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$765.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$437.20
|
| Rate for Payer: EPIC Health Plan Senior |
$437.20
|
| Rate for Payer: Galaxy Health WC |
$929.05
|
| Rate for Payer: Global Benefits Group Commercial |
$655.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$694.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$644.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$262.32
|
| Rate for Payer: Multiplan Commercial |
$874.40
|
| Rate for Payer: Networks By Design Commercial |
$710.45
|
| Rate for Payer: Prime Health Services Commercial |
$929.05
|
|
|
HC UROGRAPHY ANTEGRADE
|
Facility
|
OP
|
$1,093.00
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
909001935
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$84.32 |
| Max. Negotiated Rate |
$1,267.87 |
| Rate for Payer: Adventist Health Commercial |
$218.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,267.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$382.68
|
| Rate for Payer: Blue Shield of California Commercial |
$460.15
|
| Rate for Payer: Blue Shield of California Commercial |
$697.33
|
| Rate for Payer: Cash Price |
$491.85
|
| Rate for Payer: Cash Price |
$491.85
|
| Rate for Payer: Cigna of CA HMO |
$699.52
|
| Rate for Payer: Cigna of CA PPO |
$808.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$673.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$448.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$765.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$740.37
|
| Rate for Payer: EPIC Health Plan Senior |
$493.58
|
| Rate for Payer: Galaxy Health WC |
$929.05
|
| Rate for Payer: Global Benefits Group Commercial |
$655.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$735.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$84.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$448.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$694.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$95.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$628.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$262.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$565.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$601.27
|
| Rate for Payer: Multiplan Commercial |
$874.40
|
| Rate for Payer: Networks By Design Commercial |
$710.45
|
| Rate for Payer: Prime Health Services Commercial |
$929.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$655.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$655.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$470.69
|
| Rate for Payer: United Healthcare All Other HMO |
$470.69
|
| Rate for Payer: United Healthcare HMO Rider |
$470.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$470.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$448.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$673.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.58
|
| Rate for Payer: Vantage Medical Group Senior |
$448.71
|
|
