|
HC ARCH AORTA
|
Facility
|
OP
|
$8,197.00
|
|
|
Service Code
|
CPT 36221
|
| Hospital Charge Code |
909020144
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$292.08 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$1,639.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| 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 |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1,924.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2,912.69
|
| Rate for Payer: Cash Price |
$3,688.65
|
| Rate for Payer: Cash Price |
$3,688.65
|
| Rate for Payer: Cash Price |
$3,688.65
|
| Rate for Payer: Cigna of CA HMO |
$5,246.08
|
| Rate for Payer: Cigna of CA PPO |
$6,065.78
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$5,737.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,700.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4,467.15
|
| Rate for Payer: Galaxy Health WC |
$6,967.45
|
| Rate for Payer: Global Benefits Group Commercial |
$4,918.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,660.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$292.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,061.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5,205.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$330.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,685.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,967.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,116.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,441.81
|
| Rate for Payer: Multiplan Commercial |
$6,557.60
|
| Rate for Payer: Multiplan WC |
$6,372.03
|
| Rate for Payer: Networks By Design Commercial |
$5,328.05
|
| Rate for Payer: Prime Health Services Commercial |
$6,967.45
|
| Rate for Payer: Prime Health Services WC |
$6,307.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,918.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,098.50
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,061.05
|
| 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 ARGON, THROMBEC CATH
|
Facility
|
OP
|
$2,827.50
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$565.50 |
| Max. Negotiated Rate |
$2,403.38 |
| Rate for Payer: Adventist Health Commercial |
$565.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,403.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,555.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,711.49
|
| Rate for Payer: Blue Shield of California Commercial |
$1,433.54
|
| Rate for Payer: Blue Shield of California Commercial |
$2,174.35
|
| Rate for Payer: Cash Price |
$1,272.38
|
| Rate for Payer: Cigna of CA HMO |
$1,979.25
|
| Rate for Payer: Cigna of CA PPO |
$1,979.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,403.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,403.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,403.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,979.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,131.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,131.00
|
| Rate for Payer: Galaxy Health WC |
$2,403.38
|
| Rate for Payer: Global Benefits Group Commercial |
$1,696.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,795.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,026.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,668.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,979.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,979.25
|
| Rate for Payer: Multiplan Commercial |
$2,262.00
|
| Rate for Payer: Networks By Design Commercial |
$1,413.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,403.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,696.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,696.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,061.16
|
| Rate for Payer: United Healthcare All Other HMO |
$1,032.89
|
| Rate for Payer: United Healthcare HMO Rider |
$1,010.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$926.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,403.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,403.38
|
| Rate for Payer: Vantage Medical Group Senior |
$2,403.38
|
|
|
HC ARGON, THROMBEC CATH
|
Facility
|
IP
|
$2,827.50
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020127
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$565.50 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$565.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$1,272.38
|
| Rate for Payer: Cash Price |
$1,272.38
|
| Rate for Payer: Cigna of CA HMO |
$1,979.25
|
| Rate for Payer: Cigna of CA PPO |
$1,979.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,979.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,131.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,131.00
|
| Rate for Payer: Galaxy Health WC |
$2,403.38
|
| Rate for Payer: Global Benefits Group Commercial |
$1,696.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,795.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,668.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$678.60
|
| Rate for Payer: Multiplan Commercial |
$2,262.00
|
| Rate for Payer: Networks By Design Commercial |
$1,413.75
|
| Rate for Payer: Prime Health Services Commercial |
$2,403.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,061.16
|
| Rate for Payer: United Healthcare All Other HMO |
$1,032.89
|
| Rate for Payer: United Healthcare HMO Rider |
$1,010.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$926.01
|
|
|
HC ARTER, EA ADDL, 2ND/3RD ORD
|
Facility
|
IP
|
$660.00
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
909081322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$132.00 |
| Max. Negotiated Rate |
$561.00 |
| Rate for Payer: Adventist Health Commercial |
$132.00
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$462.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.00
|
| Rate for Payer: EPIC Health Plan Senior |
$264.00
|
| Rate for Payer: Galaxy Health WC |
$561.00
|
| Rate for Payer: Global Benefits Group Commercial |
$396.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$419.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$389.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.40
|
| Rate for Payer: Multiplan Commercial |
$528.00
|
| Rate for Payer: Networks By Design Commercial |
$429.00
|
| Rate for Payer: Prime Health Services Commercial |
$561.00
|
|
|
HC ARTER, EA ADDL, 2ND/3RD ORD
|
Facility
|
OP
|
$660.00
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
909081322
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14.38 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$132.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$561.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$363.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$495.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Cash Price |
$297.00
|
| Rate for Payer: Cigna of CA HMO |
$422.40
|
| Rate for Payer: Cigna of CA PPO |
$488.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$561.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$561.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$561.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$462.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$264.00
|
| Rate for Payer: EPIC Health Plan Senior |
$264.00
|
| Rate for Payer: Galaxy Health WC |
$561.00
|
| Rate for Payer: Global Benefits Group Commercial |
$396.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$419.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$389.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$158.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$462.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$462.00
|
| Rate for Payer: Multiplan Commercial |
$528.00
|
| Rate for Payer: Networks By Design Commercial |
$429.00
|
| Rate for Payer: Prime Health Services Commercial |
$561.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$330.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$561.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$561.00
|
| Rate for Payer: Vantage Medical Group Senior |
$561.00
|
|
|
HC ARTERIAL, 1ST ORDER CATH PL
|
Facility
|
IP
|
$1,726.00
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
909081319
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$345.20 |
| Max. Negotiated Rate |
$1,467.10 |
| Rate for Payer: Adventist Health Commercial |
$345.20
|
| Rate for Payer: Cash Price |
$776.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,208.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$690.40
|
| Rate for Payer: EPIC Health Plan Senior |
$690.40
|
| Rate for Payer: Galaxy Health WC |
$1,467.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,035.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,096.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,018.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.24
|
| Rate for Payer: Multiplan Commercial |
$1,380.80
|
| Rate for Payer: Networks By Design Commercial |
$1,121.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,467.10
|
|
|
HC ARTERIAL, 1ST ORDER CATH PL
|
Facility
|
OP
|
$1,726.00
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
909081319
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$302.72 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$345.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,467.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$949.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,294.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$776.70
|
| Rate for Payer: Cash Price |
$776.70
|
| Rate for Payer: Cash Price |
$776.70
|
| Rate for Payer: Cigna of CA HMO |
$1,104.64
|
| Rate for Payer: Cigna of CA PPO |
$1,277.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,467.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,467.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,467.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,208.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$690.40
|
| Rate for Payer: EPIC Health Plan Senior |
$690.40
|
| Rate for Payer: Galaxy Health WC |
$1,467.10
|
| Rate for Payer: Global Benefits Group Commercial |
$1,035.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$302.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,096.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$342.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,018.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$414.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,208.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,208.20
|
| Rate for Payer: Multiplan Commercial |
$1,380.80
|
| Rate for Payer: Networks By Design Commercial |
$1,121.90
|
| Rate for Payer: Prime Health Services Commercial |
$1,467.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,035.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,467.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,467.10
|
| Rate for Payer: Vantage Medical Group Senior |
$1,467.10
|
|
|
HC ARTERIAL, 2ND ORDER CATH PL
|
Facility
|
OP
|
$875.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
909081320
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$73.80 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Galaxy Health WC |
$743.75
|
| Rate for Payer: Adventist Health Commercial |
$175.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$743.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$481.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$656.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$393.75
|
| Rate for Payer: Cash Price |
$393.75
|
| Rate for Payer: Cash Price |
$393.75
|
| Rate for Payer: Cigna of CA HMO |
$560.00
|
| Rate for Payer: Cigna of CA PPO |
$647.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$743.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$743.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$743.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$612.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$350.00
|
| Rate for Payer: EPIC Health Plan Senior |
$350.00
|
| Rate for Payer: Global Benefits Group Commercial |
$525.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$555.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$83.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$516.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$612.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$612.50
|
| Rate for Payer: Multiplan Commercial |
$700.00
|
| Rate for Payer: Networks By Design Commercial |
$568.75
|
| Rate for Payer: Prime Health Services Commercial |
$743.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$525.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$437.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$743.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$743.75
|
| Rate for Payer: Vantage Medical Group Senior |
$743.75
|
|
|
HC ARTERIAL, 2ND ORDER CATH PL
|
Facility
|
IP
|
$875.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
909081320
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$743.75 |
| Rate for Payer: Adventist Health Commercial |
$175.00
|
| Rate for Payer: Cash Price |
$393.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$612.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$350.00
|
| Rate for Payer: EPIC Health Plan Senior |
$350.00
|
| Rate for Payer: Galaxy Health WC |
$743.75
|
| Rate for Payer: Global Benefits Group Commercial |
$525.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$555.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$516.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$210.00
|
| Rate for Payer: Multiplan Commercial |
$700.00
|
| Rate for Payer: Networks By Design Commercial |
$568.75
|
| Rate for Payer: Prime Health Services Commercial |
$743.75
|
|
|
HC ARTERIAL, 3RD ORDER CATH PL
|
Facility
|
OP
|
$940.00
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
909081321
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$188.00 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$188.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$799.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$517.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$705.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,240.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$423.00
|
| Rate for Payer: Cash Price |
$423.00
|
| Rate for Payer: Cash Price |
$423.00
|
| Rate for Payer: Cigna of CA HMO |
$601.60
|
| Rate for Payer: Cigna of CA PPO |
$695.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$799.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$799.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$799.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$658.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.00
|
| Rate for Payer: EPIC Health Plan Senior |
$376.00
|
| Rate for Payer: Galaxy Health WC |
$799.00
|
| Rate for Payer: Global Benefits Group Commercial |
$564.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$441.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$596.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$499.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$554.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$658.00
|
| Rate for Payer: Multiplan Commercial |
$752.00
|
| Rate for Payer: Networks By Design Commercial |
$611.00
|
| Rate for Payer: Prime Health Services Commercial |
$799.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$564.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$470.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$799.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$799.00
|
| Rate for Payer: Vantage Medical Group Senior |
$799.00
|
|
|
HC ARTERIAL, 3RD ORDER CATH PL
|
Facility
|
IP
|
$940.00
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
909081321
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$188.00 |
| Max. Negotiated Rate |
$799.00 |
| Rate for Payer: Adventist Health Commercial |
$188.00
|
| Rate for Payer: Cash Price |
$423.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$658.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.00
|
| Rate for Payer: EPIC Health Plan Senior |
$376.00
|
| Rate for Payer: Galaxy Health WC |
$799.00
|
| Rate for Payer: Global Benefits Group Commercial |
$564.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$596.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$554.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.60
|
| Rate for Payer: Multiplan Commercial |
$752.00
|
| Rate for Payer: Networks By Design Commercial |
$611.00
|
| Rate for Payer: Prime Health Services Commercial |
$799.00
|
|
|
HC ARTERIAL CATHETERIZATION KIT
|
Facility
|
OP
|
$423.23
|
|
| Hospital Charge Code |
901698288
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.65 |
| Max. Negotiated Rate |
$359.75 |
| Rate for Payer: Adventist Health Commercial |
$84.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$277.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$359.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$232.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$317.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$271.59
|
| Rate for Payer: Cash Price |
$190.45
|
| Rate for Payer: Cigna of CA HMO |
$270.87
|
| Rate for Payer: Cigna of CA PPO |
$313.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$359.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$359.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$359.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$296.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.29
|
| Rate for Payer: EPIC Health Plan Senior |
$169.29
|
| Rate for Payer: Galaxy Health WC |
$359.75
|
| Rate for Payer: Global Benefits Group Commercial |
$253.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$268.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$153.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$249.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$296.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$296.26
|
| Rate for Payer: Multiplan Commercial |
$338.58
|
| Rate for Payer: Networks By Design Commercial |
$275.10
|
| Rate for Payer: Prime Health Services Commercial |
$359.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$253.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$253.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$211.62
|
| Rate for Payer: United Healthcare All Other HMO |
$211.62
|
| Rate for Payer: United Healthcare HMO Rider |
$211.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$211.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$359.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$359.75
|
| Rate for Payer: Vantage Medical Group Senior |
$359.75
|
|
|
HC ARTERIAL CATHETERIZATION KIT
|
Facility
|
IP
|
$423.23
|
|
| Hospital Charge Code |
901698288
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.65 |
| Max. Negotiated Rate |
$359.75 |
| Rate for Payer: Adventist Health Commercial |
$84.65
|
| Rate for Payer: Cash Price |
$190.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$296.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$169.29
|
| Rate for Payer: EPIC Health Plan Senior |
$169.29
|
| Rate for Payer: Galaxy Health WC |
$359.75
|
| Rate for Payer: Global Benefits Group Commercial |
$253.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$268.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$249.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.58
|
| Rate for Payer: Multiplan Commercial |
$338.58
|
| Rate for Payer: Networks By Design Commercial |
$275.10
|
| Rate for Payer: Prime Health Services Commercial |
$359.75
|
|
|
HC ARTERIAL LINE INSERTION KIT
|
Facility
|
IP
|
$111.68
|
|
| Hospital Charge Code |
901698279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$94.93 |
| Rate for Payer: Adventist Health Commercial |
$22.34
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.67
|
| Rate for Payer: EPIC Health Plan Senior |
$44.67
|
| Rate for Payer: Galaxy Health WC |
$94.93
|
| Rate for Payer: Global Benefits Group Commercial |
$67.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$70.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$65.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Multiplan Commercial |
$89.34
|
| Rate for Payer: Networks By Design Commercial |
$72.59
|
| Rate for Payer: Prime Health Services Commercial |
$94.93
|
|
|
HC ARTERIAL LINE INSERTION KIT
|
Facility
|
OP
|
$111.68
|
|
| Hospital Charge Code |
901698279
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$94.93 |
| Rate for Payer: Adventist Health Commercial |
$22.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$73.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$94.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$61.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.67
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cigna of CA HMO |
$71.48
|
| Rate for Payer: Cigna of CA PPO |
$82.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$94.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$94.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$94.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.67
|
| Rate for Payer: EPIC Health Plan Senior |
$44.67
|
| Rate for Payer: Galaxy Health WC |
$94.93
|
| Rate for Payer: Global Benefits Group Commercial |
$67.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$70.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$65.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78.18
|
| Rate for Payer: Multiplan Commercial |
$89.34
|
| Rate for Payer: Networks By Design Commercial |
$72.59
|
| Rate for Payer: Prime Health Services Commercial |
$94.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.84
|
| Rate for Payer: United Healthcare All Other HMO |
$55.84
|
| Rate for Payer: United Healthcare HMO Rider |
$55.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$94.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$94.93
|
| Rate for Payer: Vantage Medical Group Senior |
$94.93
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
OP
|
$1,057.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$79.93 |
| Max. Negotiated Rate |
$5,641.00 |
| Rate for Payer: Adventist Health Commercial |
$211.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$898.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$581.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$792.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Cash Price |
$475.65
|
| Rate for Payer: Cash Price |
$475.65
|
| Rate for Payer: Cash Price |
$475.65
|
| Rate for Payer: Cigna of CA HMO |
$676.48
|
| Rate for Payer: Cigna of CA PPO |
$782.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$898.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$898.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$898.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$739.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$422.80
|
| Rate for Payer: EPIC Health Plan Senior |
$422.80
|
| Rate for Payer: Galaxy Health WC |
$898.45
|
| Rate for Payer: Global Benefits Group Commercial |
$634.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$671.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$623.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$739.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$739.90
|
| Rate for Payer: Multiplan Commercial |
$845.60
|
| Rate for Payer: Networks By Design Commercial |
$687.05
|
| Rate for Payer: Prime Health Services Commercial |
$898.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$634.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$528.50
|
| Rate for Payer: United Healthcare All Other HMO |
$528.50
|
| Rate for Payer: United Healthcare HMO Rider |
$528.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$528.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$898.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$898.45
|
| Rate for Payer: Vantage Medical Group Senior |
$898.45
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
IP
|
$1,057.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$211.40 |
| Max. Negotiated Rate |
$898.45 |
| Rate for Payer: Adventist Health Commercial |
$211.40
|
| Rate for Payer: Cash Price |
$475.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$739.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$422.80
|
| Rate for Payer: EPIC Health Plan Senior |
$422.80
|
| Rate for Payer: Galaxy Health WC |
$898.45
|
| Rate for Payer: Global Benefits Group Commercial |
$634.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$671.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$623.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.68
|
| Rate for Payer: Multiplan Commercial |
$845.60
|
| Rate for Payer: Networks By Design Commercial |
$687.05
|
| Rate for Payer: Prime Health Services Commercial |
$898.45
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
OP
|
$1,057.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$70.68 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$211.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$898.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$581.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$792.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,641.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,196.06
|
| Rate for Payer: Blue Shield of California Commercial |
$4,753.44
|
| Rate for Payer: Cash Price |
$475.65
|
| Rate for Payer: Cash Price |
$475.65
|
| Rate for Payer: Cash Price |
$475.65
|
| Rate for Payer: Cigna of CA HMO |
$676.48
|
| Rate for Payer: Cigna of CA PPO |
$782.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$898.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$898.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$898.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$739.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$422.80
|
| Rate for Payer: EPIC Health Plan Senior |
$422.80
|
| Rate for Payer: Galaxy Health WC |
$898.45
|
| Rate for Payer: Global Benefits Group Commercial |
$634.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$70.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$671.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$623.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$739.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$739.90
|
| Rate for Payer: Multiplan Commercial |
$845.60
|
| Rate for Payer: Networks By Design Commercial |
$687.05
|
| Rate for Payer: Prime Health Services Commercial |
$898.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$634.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$528.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$898.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$898.45
|
| Rate for Payer: Vantage Medical Group Senior |
$898.45
|
|
|
HC ARTERIAL LINE PERFORM/ASSIST
|
Facility
|
IP
|
$1,057.00
|
|
|
Service Code
|
CPT 36620
|
| Hospital Charge Code |
901200092
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$211.40 |
| Max. Negotiated Rate |
$898.45 |
| Rate for Payer: Adventist Health Commercial |
$211.40
|
| Rate for Payer: Cash Price |
$475.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$739.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$422.80
|
| Rate for Payer: EPIC Health Plan Senior |
$422.80
|
| Rate for Payer: Galaxy Health WC |
$898.45
|
| Rate for Payer: Global Benefits Group Commercial |
$634.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$671.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$623.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$253.68
|
| Rate for Payer: Multiplan Commercial |
$845.60
|
| Rate for Payer: Networks By Design Commercial |
$687.05
|
| Rate for Payer: Prime Health Services Commercial |
$898.45
|
|
|
HC ARTERIOGRAM PELVIS
|
Facility
|
IP
|
$10,068.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
909081625
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$2,013.60 |
| Max. Negotiated Rate |
$8,557.80 |
| Rate for Payer: Adventist Health Commercial |
$2,013.60
|
| Rate for Payer: Cash Price |
$4,530.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,047.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,027.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,027.20
|
| Rate for Payer: Galaxy Health WC |
$8,557.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,040.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,393.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,940.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,416.32
|
| Rate for Payer: Multiplan Commercial |
$8,054.40
|
| Rate for Payer: Networks By Design Commercial |
$6,544.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,557.80
|
|
|
HC ARTERIOGRAM PELVIS
|
Facility
|
OP
|
$10,068.00
|
|
|
Service Code
|
CPT 75736
|
| Hospital Charge Code |
909081625
|
|
Hospital Revenue Code
|
323
|
| Min. Negotiated Rate |
$217.31 |
| Max. Negotiated Rate |
$11,808.82 |
| Rate for Payer: United Healthcare HMO Rider |
$5,341.78
|
| Rate for Payer: Adventist Health Commercial |
$2,013.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,258.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,156.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,721.07
|
| Rate for Payer: Blue Shield of California Commercial |
$4,238.63
|
| Rate for Payer: Blue Shield of California Commercial |
$6,423.38
|
| Rate for Payer: Cash Price |
$4,530.60
|
| Rate for Payer: Cash Price |
$4,530.60
|
| Rate for Payer: Cigna of CA HMO |
$6,443.52
|
| Rate for Payer: Cigna of CA PPO |
$7,450.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,872.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,156.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,047.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,808.82
|
| Rate for Payer: EPIC Health Plan Senior |
$7,872.55
|
| Rate for Payer: Galaxy Health WC |
$8,557.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,040.80
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,737.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$217.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,156.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,393.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$245.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,019.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,416.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,017.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,590.19
|
| Rate for Payer: Multiplan Commercial |
$8,054.40
|
| Rate for Payer: Networks By Design Commercial |
$6,544.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,557.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,040.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,040.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,341.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5,341.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,341.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,156.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,735.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,872.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,156.86
|
|
|
HC ARTERY CATHETRZATION KIT 20GA
|
Facility
|
OP
|
$379.32
|
|
| Hospital Charge Code |
901698947
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.86 |
| Max. Negotiated Rate |
$322.42 |
| Rate for Payer: Adventist Health Commercial |
$75.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$248.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$322.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$208.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$284.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$243.41
|
| Rate for Payer: Cash Price |
$170.69
|
| Rate for Payer: Cigna of CA HMO |
$242.76
|
| Rate for Payer: Cigna of CA PPO |
$280.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$322.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$322.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$322.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$265.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.73
|
| Rate for Payer: EPIC Health Plan Senior |
$151.73
|
| Rate for Payer: Galaxy Health WC |
$322.42
|
| Rate for Payer: Global Benefits Group Commercial |
$227.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$240.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$137.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$223.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$265.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$265.52
|
| Rate for Payer: Multiplan Commercial |
$303.46
|
| Rate for Payer: Networks By Design Commercial |
$246.56
|
| Rate for Payer: Prime Health Services Commercial |
$322.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$227.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$227.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$189.66
|
| Rate for Payer: United Healthcare All Other HMO |
$189.66
|
| Rate for Payer: United Healthcare HMO Rider |
$189.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$322.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$322.42
|
| Rate for Payer: Vantage Medical Group Senior |
$322.42
|
|
|
HC ARTERY CATHETRZATION KIT 20GA
|
Facility
|
IP
|
$379.32
|
|
| Hospital Charge Code |
901698947
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.86 |
| Max. Negotiated Rate |
$322.42 |
| Rate for Payer: Adventist Health Commercial |
$75.86
|
| Rate for Payer: Cash Price |
$170.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$265.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$151.73
|
| Rate for Payer: EPIC Health Plan Senior |
$151.73
|
| Rate for Payer: Galaxy Health WC |
$322.42
|
| Rate for Payer: Global Benefits Group Commercial |
$227.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$240.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$223.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$91.04
|
| Rate for Payer: Multiplan Commercial |
$303.46
|
| Rate for Payer: Networks By Design Commercial |
$246.56
|
| Rate for Payer: Prime Health Services Commercial |
$322.42
|
|
|
HC ARTHO ASP &/OR INJ INTER JOINT
|
Facility
|
OP
|
$1,370.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
900501054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$72.14 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$274.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,171.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Cigna of CA HMO |
$876.80
|
| Rate for Payer: Cigna of CA PPO |
$1,013.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$959.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,164.50
|
| Rate for Payer: Global Benefits Group Commercial |
$822.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$869.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$424.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$328.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$497.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$1,096.00
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$890.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,164.50
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$822.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$685.00
|
| Rate for Payer: United Healthcare All Other HMO |
$685.00
|
| Rate for Payer: United Healthcare HMO Rider |
$685.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$685.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
|
HC ARTHO ASP &/OR INJ INTER JOINT
|
Facility
|
OP
|
$1,370.00
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
900501054
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$72.14 |
| Max. Negotiated Rate |
$6,716.00 |
| Rate for Payer: Adventist Health Commercial |
$561.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$261.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$394.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,716.00
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Cash Price |
$616.50
|
| Rate for Payer: Cigna of CA HMO |
$876.80
|
| Rate for Payer: Cigna of CA PPO |
$1,013.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$394.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$959.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$651.40
|
| Rate for Payer: EPIC Health Plan Senior |
$434.27
|
| Rate for Payer: Galaxy Health WC |
$1,164.50
|
| Rate for Payer: Global Benefits Group Commercial |
$822.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$647.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$394.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$869.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$72.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$424.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$328.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$497.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$529.02
|
| Rate for Payer: Multiplan Commercial |
$1,096.00
|
| Rate for Payer: Multiplan WC |
$597.61
|
| Rate for Payer: Networks By Design Commercial |
$890.50
|
| Rate for Payer: Prime Health Services Commercial |
$1,164.50
|
| Rate for Payer: Prime Health Services WC |
$591.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$822.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$822.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$394.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.27
|
| Rate for Payer: Vantage Medical Group Senior |
$394.79
|
|
