|
HC CASTING 4" TCC-EZ SINGLE APP
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT Q4038
|
| Hospital Charge Code |
901698311
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CASTING 4" TCC-EZ SINGLE APP
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT Q4038
|
| Hospital Charge Code |
901698311
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$380.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$356.18
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CAST OFF LOADER KIT
|
Facility
|
OP
|
$556.57
|
|
|
Service Code
|
CPT A6452
|
| Hospital Charge Code |
901698871
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$111.31 |
| Max. Negotiated Rate |
$473.08 |
| Rate for Payer: Adventist Health Commercial |
$111.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$365.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$473.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$306.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$417.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$341.79
|
| Rate for Payer: Cash Price |
$250.46
|
| Rate for Payer: Cigna of CA HMO |
$356.20
|
| Rate for Payer: Cigna of CA PPO |
$411.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$473.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$473.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$473.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$222.63
|
| Rate for Payer: EPIC Health Plan Senior |
$222.63
|
| Rate for Payer: Galaxy Health WC |
$473.08
|
| Rate for Payer: Global Benefits Group Commercial |
$333.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$371.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$212.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$344.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$389.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$389.60
|
| Rate for Payer: Multiplan Commercial |
$445.26
|
| Rate for Payer: Networks By Design Commercial |
$361.77
|
| Rate for Payer: Prime Health Services Commercial |
$473.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$333.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$333.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$278.29
|
| Rate for Payer: United Healthcare All Other HMO |
$278.29
|
| Rate for Payer: United Healthcare HMO Rider |
$278.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$278.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$473.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$473.08
|
| Rate for Payer: Vantage Medical Group Senior |
$473.08
|
|
|
HC CAST OFF LOADER KIT
|
Facility
|
IP
|
$556.57
|
|
|
Service Code
|
CPT A6452
|
| Hospital Charge Code |
901698871
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$111.31 |
| Max. Negotiated Rate |
$473.08 |
| Rate for Payer: Adventist Health Commercial |
$111.31
|
| Rate for Payer: Cash Price |
$250.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$222.63
|
| Rate for Payer: EPIC Health Plan Senior |
$222.63
|
| Rate for Payer: Galaxy Health WC |
$473.08
|
| Rate for Payer: Global Benefits Group Commercial |
$333.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$371.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$212.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$344.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.58
|
| Rate for Payer: Multiplan Commercial |
$445.26
|
| Rate for Payer: Networks By Design Commercial |
$361.77
|
| Rate for Payer: Prime Health Services Commercial |
$473.08
|
|
|
HC CATECHOLAMINES UR FRACTIONATED
|
Facility
|
IP
|
$94.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
900910455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$79.90 |
| Rate for Payer: Adventist Health Commercial |
$18.80
|
| Rate for Payer: Cash Price |
$42.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.60
|
| Rate for Payer: EPIC Health Plan Senior |
$37.60
|
| Rate for Payer: Galaxy Health WC |
$79.90
|
| Rate for Payer: Global Benefits Group Commercial |
$56.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$62.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.56
|
| Rate for Payer: Multiplan Commercial |
$75.20
|
| Rate for Payer: Networks By Design Commercial |
$61.10
|
| Rate for Payer: Prime Health Services Commercial |
$79.90
|
|
|
HC CATECHOLAMINES UR FRACTIONATED
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
900910455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$249.43 |
| Rate for Payer: Adventist Health Commercial |
$17.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$249.43
|
| Rate for Payer: Blue Shield of California Commercial |
$56.87
|
| Rate for Payer: Blue Shield of California EPN |
$37.57
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cash Price |
$38.25
|
| Rate for Payer: Cigna of CA HMO |
$54.40
|
| Rate for Payer: Cigna of CA PPO |
$62.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.09
|
| Rate for Payer: EPIC Health Plan Senior |
$25.25
|
| Rate for Payer: Galaxy Health WC |
$72.25
|
| Rate for Payer: Global Benefits Group Commercial |
$51.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$41.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$37.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$31.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.84
|
| Rate for Payer: Multiplan Commercial |
$68.00
|
| Rate for Payer: Networks By Design Commercial |
$55.25
|
| Rate for Payer: Prime Health Services Commercial |
$72.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.46
|
| Rate for Payer: United Healthcare All Other HMO |
$20.46
|
| Rate for Payer: United Healthcare HMO Rider |
$20.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.46
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.77
|
| Rate for Payer: Vantage Medical Group Senior |
$25.25
|
|
|
HC CATH 2 LUMEN 5.5FR 50CM PICC
|
Facility
|
OP
|
$940.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.05 |
| Max. Negotiated Rate |
$799.20 |
| Rate for Payer: Adventist Health Commercial |
$188.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$799.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$517.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$705.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$544.59
|
| Rate for Payer: Blue Shield of California Commercial |
$693.90
|
| Rate for Payer: Blue Shield of California EPN |
$456.96
|
| Rate for Payer: Cash Price |
$423.11
|
| Rate for Payer: Cigna of CA HMO |
$658.17
|
| Rate for Payer: Cigna of CA PPO |
$658.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$799.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$799.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$799.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.10
|
| Rate for Payer: EPIC Health Plan Senior |
$376.10
|
| Rate for Payer: Galaxy Health WC |
$799.20
|
| Rate for Payer: Global Benefits Group Commercial |
$564.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$627.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$358.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$582.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$658.17
|
| Rate for Payer: Multiplan Commercial |
$752.19
|
| Rate for Payer: Networks By Design Commercial |
$470.12
|
| Rate for Payer: Prime Health Services Commercial |
$799.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$564.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$564.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$352.87
|
| Rate for Payer: United Healthcare All Other HMO |
$343.47
|
| Rate for Payer: United Healthcare HMO Rider |
$336.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$307.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$799.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$799.20
|
| Rate for Payer: Vantage Medical Group Senior |
$799.20
|
|
|
HC CATH 2 LUMEN 5.5FR 50CM PICC
|
Facility
|
IP
|
$940.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.05 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$188.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$423.11
|
| Rate for Payer: Cash Price |
$423.11
|
| Rate for Payer: Cigna of CA HMO |
$658.17
|
| Rate for Payer: Cigna of CA PPO |
$658.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.10
|
| Rate for Payer: EPIC Health Plan Senior |
$376.10
|
| Rate for Payer: Galaxy Health WC |
$799.20
|
| Rate for Payer: Global Benefits Group Commercial |
$564.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$627.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$358.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$582.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.66
|
| Rate for Payer: Multiplan Commercial |
$752.19
|
| Rate for Payer: Networks By Design Commercial |
$470.12
|
| Rate for Payer: Prime Health Services Commercial |
$799.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$352.87
|
| Rate for Payer: United Healthcare All Other HMO |
$343.47
|
| Rate for Payer: United Healthcare HMO Rider |
$336.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$307.93
|
|
|
HC CATH 2 LUMEN 5.5FR 55CM PICC
|
Facility
|
OP
|
$940.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.05 |
| Max. Negotiated Rate |
$799.20 |
| Rate for Payer: Adventist Health Commercial |
$188.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$799.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$517.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$705.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$544.59
|
| Rate for Payer: Blue Shield of California Commercial |
$693.90
|
| Rate for Payer: Blue Shield of California EPN |
$456.96
|
| Rate for Payer: Cash Price |
$423.11
|
| Rate for Payer: Cigna of CA HMO |
$658.17
|
| Rate for Payer: Cigna of CA PPO |
$658.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$799.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$799.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$799.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.10
|
| Rate for Payer: EPIC Health Plan Senior |
$376.10
|
| Rate for Payer: Galaxy Health WC |
$799.20
|
| Rate for Payer: Global Benefits Group Commercial |
$564.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$627.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$358.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$582.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$658.17
|
| Rate for Payer: Multiplan Commercial |
$752.19
|
| Rate for Payer: Networks By Design Commercial |
$470.12
|
| Rate for Payer: Prime Health Services Commercial |
$799.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$564.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$564.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$352.87
|
| Rate for Payer: United Healthcare All Other HMO |
$343.47
|
| Rate for Payer: United Healthcare HMO Rider |
$336.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$307.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$799.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$799.20
|
| Rate for Payer: Vantage Medical Group Senior |
$799.20
|
|
|
HC CATH 2 LUMEN 5.5FR 55CM PICC
|
Facility
|
IP
|
$940.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.05 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$188.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$423.11
|
| Rate for Payer: Cash Price |
$423.11
|
| Rate for Payer: Cigna of CA HMO |
$658.17
|
| Rate for Payer: Cigna of CA PPO |
$658.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.10
|
| Rate for Payer: EPIC Health Plan Senior |
$376.10
|
| Rate for Payer: Galaxy Health WC |
$799.20
|
| Rate for Payer: Global Benefits Group Commercial |
$564.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$627.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$358.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$582.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.66
|
| Rate for Payer: Multiplan Commercial |
$752.19
|
| Rate for Payer: Networks By Design Commercial |
$470.12
|
| Rate for Payer: Prime Health Services Commercial |
$799.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$352.87
|
| Rate for Payer: United Healthcare All Other HMO |
$343.47
|
| Rate for Payer: United Healthcare HMO Rider |
$336.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$307.93
|
|
|
HC CATH 3.5FR UMBILICAL 1 LUMEN
|
Facility
|
IP
|
$110.20
|
|
| Hospital Charge Code |
901698606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.04 |
| Max. Negotiated Rate |
$93.67 |
| Rate for Payer: Adventist Health Commercial |
$22.04
|
| Rate for Payer: Cash Price |
$49.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.08
|
| Rate for Payer: EPIC Health Plan Senior |
$44.08
|
| Rate for Payer: Galaxy Health WC |
$93.67
|
| Rate for Payer: Global Benefits Group Commercial |
$66.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$73.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$68.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.45
|
| Rate for Payer: Multiplan Commercial |
$88.16
|
| Rate for Payer: Networks By Design Commercial |
$71.63
|
| Rate for Payer: Prime Health Services Commercial |
$93.67
|
|
|
HC CATH 3.5FR UMBILICAL 1 LUMEN
|
Facility
|
OP
|
$110.20
|
|
| Hospital Charge Code |
901698606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.04 |
| Max. Negotiated Rate |
$93.67 |
| Rate for Payer: Adventist Health Commercial |
$22.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$72.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$60.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$82.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.67
|
| Rate for Payer: Cash Price |
$49.59
|
| Rate for Payer: Cigna of CA HMO |
$70.53
|
| Rate for Payer: Cigna of CA PPO |
$81.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$93.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$93.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.08
|
| Rate for Payer: EPIC Health Plan Senior |
$44.08
|
| Rate for Payer: Galaxy Health WC |
$93.67
|
| Rate for Payer: Global Benefits Group Commercial |
$66.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$73.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$68.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77.14
|
| Rate for Payer: Multiplan Commercial |
$88.16
|
| Rate for Payer: Networks By Design Commercial |
$71.63
|
| Rate for Payer: Prime Health Services Commercial |
$93.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.10
|
| Rate for Payer: United Healthcare All Other HMO |
$55.10
|
| Rate for Payer: United Healthcare HMO Rider |
$55.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$93.67
|
| Rate for Payer: Vantage Medical Group Senior |
$93.67
|
|
|
HC CATH 4 LUMEN 8.5FR X 6" PRS INJ
|
Facility
|
IP
|
$580.52
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698317
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.10 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$116.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$261.23
|
| Rate for Payer: Cash Price |
$261.23
|
| Rate for Payer: Cigna of CA HMO |
$406.36
|
| Rate for Payer: Cigna of CA PPO |
$406.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.21
|
| Rate for Payer: EPIC Health Plan Senior |
$232.21
|
| Rate for Payer: Galaxy Health WC |
$493.44
|
| Rate for Payer: Global Benefits Group Commercial |
$348.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$387.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$221.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.32
|
| Rate for Payer: Multiplan Commercial |
$464.42
|
| Rate for Payer: Networks By Design Commercial |
$290.26
|
| Rate for Payer: Prime Health Services Commercial |
$493.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.87
|
| Rate for Payer: United Healthcare All Other HMO |
$212.06
|
| Rate for Payer: United Healthcare HMO Rider |
$207.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$190.12
|
|
|
HC CATH 4 LUMEN 8.5FR X 6" PRS INJ
|
Facility
|
OP
|
$580.52
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698317
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.10 |
| Max. Negotiated Rate |
$493.44 |
| Rate for Payer: Adventist Health Commercial |
$116.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$336.24
|
| Rate for Payer: Blue Shield of California Commercial |
$428.42
|
| Rate for Payer: Blue Shield of California EPN |
$282.13
|
| Rate for Payer: Cash Price |
$261.23
|
| Rate for Payer: Cigna of CA HMO |
$406.36
|
| Rate for Payer: Cigna of CA PPO |
$406.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.21
|
| Rate for Payer: EPIC Health Plan Senior |
$232.21
|
| Rate for Payer: Galaxy Health WC |
$493.44
|
| Rate for Payer: Global Benefits Group Commercial |
$348.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$387.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$221.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.36
|
| Rate for Payer: Multiplan Commercial |
$464.42
|
| Rate for Payer: Networks By Design Commercial |
$290.26
|
| Rate for Payer: Prime Health Services Commercial |
$493.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.87
|
| Rate for Payer: United Healthcare All Other HMO |
$212.06
|
| Rate for Payer: United Healthcare HMO Rider |
$207.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$190.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.44
|
| Rate for Payer: Vantage Medical Group Senior |
$493.44
|
|
|
HC CATH ACUTE PERITONEAL DIALYSS
|
Facility
|
IP
|
$990.15
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
901602939
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.03 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$198.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$445.57
|
| Rate for Payer: Cash Price |
$445.57
|
| Rate for Payer: Cigna of CA HMO |
$693.11
|
| Rate for Payer: Cigna of CA PPO |
$693.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$396.06
|
| Rate for Payer: EPIC Health Plan Senior |
$396.06
|
| Rate for Payer: Galaxy Health WC |
$841.63
|
| Rate for Payer: Global Benefits Group Commercial |
$594.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$660.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$377.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$612.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.64
|
| Rate for Payer: Multiplan Commercial |
$792.12
|
| Rate for Payer: Networks By Design Commercial |
$495.07
|
| Rate for Payer: Prime Health Services Commercial |
$841.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$371.60
|
| Rate for Payer: United Healthcare All Other HMO |
$361.70
|
| Rate for Payer: United Healthcare HMO Rider |
$353.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$324.27
|
|
|
HC CATH ACUTE PERITONEAL DIALYSS
|
Facility
|
OP
|
$990.15
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
901602939
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.03 |
| Max. Negotiated Rate |
$841.63 |
| Rate for Payer: Adventist Health Commercial |
$198.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$841.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$544.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$742.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$573.49
|
| Rate for Payer: Blue Shield of California Commercial |
$730.73
|
| Rate for Payer: Blue Shield of California EPN |
$481.21
|
| Rate for Payer: Cash Price |
$445.57
|
| Rate for Payer: Cigna of CA HMO |
$693.11
|
| Rate for Payer: Cigna of CA PPO |
$693.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$841.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$841.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$841.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$396.06
|
| Rate for Payer: EPIC Health Plan Senior |
$396.06
|
| Rate for Payer: Galaxy Health WC |
$841.63
|
| Rate for Payer: Global Benefits Group Commercial |
$594.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$660.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$377.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$612.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$693.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$693.11
|
| Rate for Payer: Multiplan Commercial |
$792.12
|
| Rate for Payer: Networks By Design Commercial |
$495.07
|
| Rate for Payer: Prime Health Services Commercial |
$841.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$594.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$594.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$371.60
|
| Rate for Payer: United Healthcare All Other HMO |
$361.70
|
| Rate for Payer: United Healthcare HMO Rider |
$353.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$324.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$841.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$841.63
|
| Rate for Payer: Vantage Medical Group Senior |
$841.63
|
|
|
HC CATH AGA EXCHANGE SYS
|
Facility
|
OP
|
$2,355.60
|
|
| Hospital Charge Code |
906812241
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$471.12 |
| Max. Negotiated Rate |
$2,002.26 |
| Rate for Payer: Adventist Health Commercial |
$471.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,545.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,002.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,295.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,766.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,446.57
|
| Rate for Payer: Cash Price |
$1,060.02
|
| Rate for Payer: Cigna of CA HMO |
$1,507.58
|
| Rate for Payer: Cigna of CA PPO |
$1,743.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,002.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,002.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,002.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$942.24
|
| Rate for Payer: EPIC Health Plan Senior |
$942.24
|
| Rate for Payer: Galaxy Health WC |
$2,002.26
|
| Rate for Payer: Global Benefits Group Commercial |
$1,413.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,571.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$897.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,458.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$565.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,648.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,648.92
|
| Rate for Payer: Multiplan Commercial |
$1,884.48
|
| Rate for Payer: Networks By Design Commercial |
$1,531.14
|
| Rate for Payer: Prime Health Services Commercial |
$2,002.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,413.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,413.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,177.80
|
| Rate for Payer: United Healthcare All Other HMO |
$1,177.80
|
| Rate for Payer: United Healthcare HMO Rider |
$1,177.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,177.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,002.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,002.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,002.26
|
|
|
HC CATH AGA EXCHANGE SYS
|
Facility
|
IP
|
$2,355.60
|
|
| Hospital Charge Code |
906812241
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$471.12 |
| Max. Negotiated Rate |
$2,002.26 |
| Rate for Payer: Adventist Health Commercial |
$471.12
|
| Rate for Payer: Cash Price |
$1,060.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$942.24
|
| Rate for Payer: EPIC Health Plan Senior |
$942.24
|
| Rate for Payer: Galaxy Health WC |
$2,002.26
|
| Rate for Payer: Global Benefits Group Commercial |
$1,413.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,571.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$897.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,458.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$565.34
|
| Rate for Payer: Multiplan Commercial |
$1,884.48
|
| Rate for Payer: Networks By Design Commercial |
$1,531.14
|
| Rate for Payer: Prime Health Services Commercial |
$2,002.26
|
|
|
HC CATH AIRWAY EXCHANGE 11FR
|
Facility
|
IP
|
$393.18
|
|
| Hospital Charge Code |
901603694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$243.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
|
|
HC CATH AIRWAY EXCHANGE 11FR
|
Facility
|
OP
|
$393.18
|
|
| Hospital Charge Code |
901603694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$334.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$216.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$241.45
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: Cigna of CA HMO |
$251.64
|
| Rate for Payer: Cigna of CA PPO |
$290.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$334.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$334.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$334.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$243.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$275.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$275.23
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$235.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$235.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$196.59
|
| Rate for Payer: United Healthcare All Other HMO |
$196.59
|
| Rate for Payer: United Healthcare HMO Rider |
$196.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$334.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$334.20
|
| Rate for Payer: Vantage Medical Group Senior |
$334.20
|
|
|
HC CATH AIRWAY EXCHANGE 14FR
|
Facility
|
OP
|
$393.18
|
|
| Hospital Charge Code |
901603695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$334.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$216.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$241.45
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: Cigna of CA HMO |
$251.64
|
| Rate for Payer: Cigna of CA PPO |
$290.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$334.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$334.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$334.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$243.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$275.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$275.23
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$235.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$235.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$196.59
|
| Rate for Payer: United Healthcare All Other HMO |
$196.59
|
| Rate for Payer: United Healthcare HMO Rider |
$196.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$334.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$334.20
|
| Rate for Payer: Vantage Medical Group Senior |
$334.20
|
|
|
HC CATH AIRWAY EXCHANGE 14FR
|
Facility
|
IP
|
$393.18
|
|
| Hospital Charge Code |
901603695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$243.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
|
|
HC CATH AIRWAY EXCHANGE 19FR
|
Facility
|
OP
|
$393.18
|
|
| Hospital Charge Code |
901604178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$334.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$216.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$241.45
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: Cigna of CA HMO |
$251.64
|
| Rate for Payer: Cigna of CA PPO |
$290.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$334.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$334.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$334.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$243.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$275.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$275.23
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$235.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$235.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$196.59
|
| Rate for Payer: United Healthcare All Other HMO |
$196.59
|
| Rate for Payer: United Healthcare HMO Rider |
$196.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$334.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$334.20
|
| Rate for Payer: Vantage Medical Group Senior |
$334.20
|
|
|
HC CATH AIRWAY EXCHANGE 19FR
|
Facility
|
IP
|
$393.18
|
|
| Hospital Charge Code |
901604178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$243.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
|
|
HC CATH AIRWAY EXCHANGE 8FR
|
Facility
|
IP
|
$393.18
|
|
| Hospital Charge Code |
901603693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$262.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$149.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$243.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
|
