|
HC CATH ASAHI CORSAIR 150CM
|
Facility
|
OP
|
$3,881.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
906812504
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$776.20 |
| Max. Negotiated Rate |
$3,298.85 |
| Rate for Payer: Adventist Health Commercial |
$776.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,298.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,134.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,910.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,247.88
|
| Rate for Payer: Blue Shield of California Commercial |
$2,864.18
|
| Rate for Payer: Blue Shield of California EPN |
$1,886.17
|
| Rate for Payer: Cash Price |
$1,746.45
|
| Rate for Payer: Cigna of CA HMO |
$2,716.70
|
| Rate for Payer: Cigna of CA PPO |
$2,716.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,298.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,298.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,298.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,552.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,552.40
|
| Rate for Payer: Galaxy Health WC |
$3,298.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,328.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,588.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,478.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,402.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$931.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,716.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,716.70
|
| Rate for Payer: Multiplan Commercial |
$3,104.80
|
| Rate for Payer: Networks By Design Commercial |
$1,940.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,298.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,328.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,328.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,456.54
|
| Rate for Payer: United Healthcare All Other HMO |
$1,417.73
|
| Rate for Payer: United Healthcare HMO Rider |
$1,387.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,271.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,298.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,298.85
|
| Rate for Payer: Vantage Medical Group Senior |
$3,298.85
|
|
|
HC CATH ASAHI CORSAIR 150CM
|
Facility
|
IP
|
$3,881.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
906812504
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$776.20 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$776.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,746.45
|
| Rate for Payer: Cash Price |
$1,746.45
|
| Rate for Payer: Cigna of CA HMO |
$2,716.70
|
| Rate for Payer: Cigna of CA PPO |
$2,716.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,552.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,552.40
|
| Rate for Payer: Galaxy Health WC |
$3,298.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2,328.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,588.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,478.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,402.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$931.44
|
| Rate for Payer: Multiplan Commercial |
$3,104.80
|
| Rate for Payer: Networks By Design Commercial |
$1,940.50
|
| Rate for Payer: Prime Health Services Commercial |
$3,298.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,456.54
|
| Rate for Payer: United Healthcare All Other HMO |
$1,417.73
|
| Rate for Payer: United Healthcare HMO Rider |
$1,387.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,271.03
|
|
|
HC CATH ASAHI TORNUS
|
Facility
|
OP
|
$3,101.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
906812389
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$620.20 |
| Max. Negotiated Rate |
$2,635.85 |
| Rate for Payer: Adventist Health Commercial |
$620.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,033.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,635.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,705.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,325.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,904.32
|
| Rate for Payer: Cash Price |
$1,395.45
|
| Rate for Payer: Cigna of CA HMO |
$1,984.64
|
| Rate for Payer: Cigna of CA PPO |
$2,294.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,635.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,635.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,635.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,240.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,240.40
|
| Rate for Payer: Galaxy Health WC |
$2,635.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,860.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,068.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,181.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,919.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$744.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,170.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,170.70
|
| Rate for Payer: Multiplan Commercial |
$2,480.80
|
| Rate for Payer: Networks By Design Commercial |
$2,015.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,635.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,860.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,860.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,550.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,550.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,550.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,550.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,635.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,635.85
|
| Rate for Payer: Vantage Medical Group Senior |
$2,635.85
|
|
|
HC CATH ASAHI TORNUS
|
Facility
|
IP
|
$3,101.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
906812389
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$620.20 |
| Max. Negotiated Rate |
$2,635.85 |
| Rate for Payer: Adventist Health Commercial |
$620.20
|
| Rate for Payer: Cash Price |
$1,395.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,240.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1,240.40
|
| Rate for Payer: Galaxy Health WC |
$2,635.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,860.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,068.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,181.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,919.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$744.24
|
| Rate for Payer: Multiplan Commercial |
$2,480.80
|
| Rate for Payer: Networks By Design Commercial |
$2,015.65
|
| Rate for Payer: Prime Health Services Commercial |
$2,635.85
|
|
|
HC CATH ATHERECTOMY CROSSER
|
Facility
|
OP
|
$4,737.50
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909020040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$947.50 |
| Max. Negotiated Rate |
$4,026.88 |
| Rate for Payer: Adventist Health Commercial |
$947.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,107.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,026.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,605.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,553.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,909.30
|
| Rate for Payer: Cash Price |
$2,131.88
|
| Rate for Payer: Cigna of CA HMO |
$3,032.00
|
| Rate for Payer: Cigna of CA PPO |
$3,505.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,026.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,026.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,026.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,895.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,895.00
|
| Rate for Payer: Galaxy Health WC |
$4,026.88
|
| Rate for Payer: Global Benefits Group Commercial |
$2,842.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,159.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,804.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,932.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,137.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,316.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,316.25
|
| Rate for Payer: Multiplan Commercial |
$3,790.00
|
| Rate for Payer: Networks By Design Commercial |
$3,079.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,026.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,842.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,842.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,368.75
|
| Rate for Payer: United Healthcare All Other HMO |
$2,368.75
|
| Rate for Payer: United Healthcare HMO Rider |
$2,368.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,368.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,026.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,026.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,026.88
|
|
|
HC CATH ATHERECTOMY CROSSER
|
Facility
|
IP
|
$4,737.50
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909020040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$947.50 |
| Max. Negotiated Rate |
$4,026.88 |
| Rate for Payer: Adventist Health Commercial |
$947.50
|
| Rate for Payer: Cash Price |
$2,131.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,895.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,895.00
|
| Rate for Payer: Galaxy Health WC |
$4,026.88
|
| Rate for Payer: Global Benefits Group Commercial |
$2,842.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,159.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,804.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,932.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,137.00
|
| Rate for Payer: Multiplan Commercial |
$3,790.00
|
| Rate for Payer: Networks By Design Commercial |
$3,079.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,026.88
|
|
|
HC CATH ATRIUM EXPRESSWAY
|
Facility
|
IP
|
$1,840.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
906812426
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$368.00 |
| Max. Negotiated Rate |
$1,564.00 |
| Rate for Payer: Adventist Health Commercial |
$368.00
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$736.00
|
| Rate for Payer: EPIC Health Plan Senior |
$736.00
|
| Rate for Payer: Galaxy Health WC |
$1,564.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,104.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,227.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$701.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,138.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$441.60
|
| Rate for Payer: Multiplan Commercial |
$1,472.00
|
| Rate for Payer: Networks By Design Commercial |
$1,196.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,564.00
|
|
|
HC CATH ATRIUM EXPRESSWAY
|
Facility
|
OP
|
$1,840.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
906812426
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$368.00 |
| Max. Negotiated Rate |
$1,564.00 |
| Rate for Payer: Adventist Health Commercial |
$368.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,206.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,564.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,012.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,380.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,129.94
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Cigna of CA HMO |
$1,177.60
|
| Rate for Payer: Cigna of CA PPO |
$1,361.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,564.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,564.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,564.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$736.00
|
| Rate for Payer: EPIC Health Plan Senior |
$736.00
|
| Rate for Payer: Galaxy Health WC |
$1,564.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,104.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,227.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$701.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,138.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$441.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,288.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,288.00
|
| Rate for Payer: Multiplan Commercial |
$1,472.00
|
| Rate for Payer: Networks By Design Commercial |
$1,196.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,564.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,104.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,104.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$920.00
|
| Rate for Payer: United Healthcare All Other HMO |
$920.00
|
| Rate for Payer: United Healthcare HMO Rider |
$920.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$920.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,564.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,564.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,564.00
|
|
|
HC CATH BALLOON PURSUIT
|
Facility
|
OP
|
$630.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$535.50 |
| Rate for Payer: Adventist Health Commercial |
$126.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$535.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$346.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$472.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$364.90
|
| Rate for Payer: Blue Shield of California Commercial |
$464.94
|
| Rate for Payer: Blue Shield of California EPN |
$306.18
|
| Rate for Payer: Cash Price |
$283.50
|
| Rate for Payer: Cigna of CA HMO |
$441.00
|
| Rate for Payer: Cigna of CA PPO |
$441.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$535.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$535.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$535.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.00
|
| Rate for Payer: EPIC Health Plan Senior |
$252.00
|
| Rate for Payer: Galaxy Health WC |
$535.50
|
| Rate for Payer: Global Benefits Group Commercial |
$378.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$389.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$441.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$441.00
|
| Rate for Payer: Multiplan Commercial |
$504.00
|
| Rate for Payer: Networks By Design Commercial |
$315.00
|
| Rate for Payer: Prime Health Services Commercial |
$535.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$378.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$378.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$236.44
|
| Rate for Payer: United Healthcare All Other HMO |
$230.14
|
| Rate for Payer: United Healthcare HMO Rider |
$225.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$535.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$535.50
|
| Rate for Payer: Vantage Medical Group Senior |
$535.50
|
|
|
HC CATH BALLOON PURSUIT
|
Facility
|
IP
|
$630.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$126.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$283.50
|
| Rate for Payer: Cash Price |
$283.50
|
| Rate for Payer: Cigna of CA HMO |
$441.00
|
| Rate for Payer: Cigna of CA PPO |
$441.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.00
|
| Rate for Payer: EPIC Health Plan Senior |
$252.00
|
| Rate for Payer: Galaxy Health WC |
$535.50
|
| Rate for Payer: Global Benefits Group Commercial |
$378.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$420.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$240.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$389.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.20
|
| Rate for Payer: Multiplan Commercial |
$504.00
|
| Rate for Payer: Networks By Design Commercial |
$315.00
|
| Rate for Payer: Prime Health Services Commercial |
$535.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$236.44
|
| Rate for Payer: United Healthcare All Other HMO |
$230.14
|
| Rate for Payer: United Healthcare HMO Rider |
$225.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.32
|
|
|
HC CATH BAYLIS BMC
|
Facility
|
OP
|
$851.00
|
|
| Hospital Charge Code |
906812324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$170.20 |
| Max. Negotiated Rate |
$723.35 |
| Rate for Payer: Adventist Health Commercial |
$170.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$558.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$723.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$468.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$638.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$522.60
|
| Rate for Payer: Cash Price |
$382.95
|
| Rate for Payer: Cigna of CA HMO |
$544.64
|
| Rate for Payer: Cigna of CA PPO |
$629.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$723.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$723.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$723.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.40
|
| Rate for Payer: EPIC Health Plan Senior |
$340.40
|
| Rate for Payer: Galaxy Health WC |
$723.35
|
| Rate for Payer: Global Benefits Group Commercial |
$510.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$567.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$324.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$526.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$595.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$595.70
|
| Rate for Payer: Multiplan Commercial |
$680.80
|
| Rate for Payer: Networks By Design Commercial |
$553.15
|
| Rate for Payer: Prime Health Services Commercial |
$723.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$510.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$510.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$425.50
|
| Rate for Payer: United Healthcare All Other HMO |
$425.50
|
| Rate for Payer: United Healthcare HMO Rider |
$425.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$425.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$723.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$723.35
|
| Rate for Payer: Vantage Medical Group Senior |
$723.35
|
|
|
HC CATH BAYLIS BMC
|
Facility
|
IP
|
$851.00
|
|
| Hospital Charge Code |
906812324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$170.20 |
| Max. Negotiated Rate |
$723.35 |
| Rate for Payer: Adventist Health Commercial |
$170.20
|
| Rate for Payer: Cash Price |
$382.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.40
|
| Rate for Payer: EPIC Health Plan Senior |
$340.40
|
| Rate for Payer: Galaxy Health WC |
$723.35
|
| Rate for Payer: Global Benefits Group Commercial |
$510.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$567.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$324.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$526.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.24
|
| Rate for Payer: Multiplan Commercial |
$680.80
|
| Rate for Payer: Networks By Design Commercial |
$553.15
|
| Rate for Payer: Prime Health Services Commercial |
$723.35
|
|
|
HC CATH BLLN BAKRI PSTPRM 236539
|
Facility
|
IP
|
$998.20
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
901693140
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$199.64 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$199.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$449.19
|
| Rate for Payer: Cash Price |
$449.19
|
| Rate for Payer: Cigna of CA HMO |
$698.74
|
| Rate for Payer: Cigna of CA PPO |
$698.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$399.28
|
| Rate for Payer: EPIC Health Plan Senior |
$399.28
|
| Rate for Payer: Galaxy Health WC |
$848.47
|
| Rate for Payer: Global Benefits Group Commercial |
$598.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$665.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$380.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$617.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$239.57
|
| Rate for Payer: Multiplan Commercial |
$798.56
|
| Rate for Payer: Networks By Design Commercial |
$499.10
|
| Rate for Payer: Prime Health Services Commercial |
$848.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$374.62
|
| Rate for Payer: United Healthcare All Other HMO |
$364.64
|
| Rate for Payer: United Healthcare HMO Rider |
$356.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$326.91
|
|
|
HC CATH BLLN BAKRI PSTPRM 236539
|
Facility
|
OP
|
$998.20
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
901693140
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$199.64 |
| Max. Negotiated Rate |
$848.47 |
| Rate for Payer: Adventist Health Commercial |
$199.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$848.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$549.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$748.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$578.16
|
| Rate for Payer: Blue Shield of California Commercial |
$736.67
|
| Rate for Payer: Blue Shield of California EPN |
$485.13
|
| Rate for Payer: Cash Price |
$449.19
|
| Rate for Payer: Cigna of CA HMO |
$698.74
|
| Rate for Payer: Cigna of CA PPO |
$698.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$848.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$848.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$848.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$399.28
|
| Rate for Payer: EPIC Health Plan Senior |
$399.28
|
| Rate for Payer: Galaxy Health WC |
$848.47
|
| Rate for Payer: Global Benefits Group Commercial |
$598.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$665.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$380.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$617.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$239.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$698.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$698.74
|
| Rate for Payer: Multiplan Commercial |
$798.56
|
| Rate for Payer: Networks By Design Commercial |
$499.10
|
| Rate for Payer: Prime Health Services Commercial |
$848.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$598.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$598.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$374.62
|
| Rate for Payer: United Healthcare All Other HMO |
$364.64
|
| Rate for Payer: United Healthcare HMO Rider |
$356.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$326.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$848.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$848.47
|
| Rate for Payer: Vantage Medical Group Senior |
$848.47
|
|
|
HC CATH BLLN CORDIS MAXI LD
|
Facility
|
OP
|
$1,170.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$234.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Adventist Health Commercial |
$234.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$994.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$643.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$877.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$677.66
|
| Rate for Payer: Blue Shield of California Commercial |
$863.46
|
| Rate for Payer: Blue Shield of California EPN |
$568.62
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Cigna of CA HMO |
$819.00
|
| Rate for Payer: Cigna of CA PPO |
$819.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$994.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$994.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$994.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$468.00
|
| Rate for Payer: EPIC Health Plan Senior |
$468.00
|
| Rate for Payer: Galaxy Health WC |
$994.50
|
| Rate for Payer: Global Benefits Group Commercial |
$702.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$780.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$445.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$724.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$819.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$819.00
|
| Rate for Payer: Multiplan Commercial |
$936.00
|
| Rate for Payer: Networks By Design Commercial |
$585.00
|
| Rate for Payer: Prime Health Services Commercial |
$994.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$702.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$702.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$439.10
|
| Rate for Payer: United Healthcare All Other HMO |
$427.40
|
| Rate for Payer: United Healthcare HMO Rider |
$418.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$383.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$994.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$994.50
|
| Rate for Payer: Vantage Medical Group Senior |
$994.50
|
|
|
HC CATH BLLN CORDIS MAXI LD
|
Facility
|
IP
|
$1,170.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$234.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$234.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Cigna of CA HMO |
$819.00
|
| Rate for Payer: Cigna of CA PPO |
$819.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$468.00
|
| Rate for Payer: EPIC Health Plan Senior |
$468.00
|
| Rate for Payer: Galaxy Health WC |
$994.50
|
| Rate for Payer: Global Benefits Group Commercial |
$702.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$780.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$445.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$724.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.80
|
| Rate for Payer: Multiplan Commercial |
$936.00
|
| Rate for Payer: Networks By Design Commercial |
$585.00
|
| Rate for Payer: Prime Health Services Commercial |
$994.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$439.10
|
| Rate for Payer: United Healthcare All Other HMO |
$427.40
|
| Rate for Payer: United Healthcare HMO Rider |
$418.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$383.18
|
|
|
HC CATH BLLN CORDIS PWRFLEX EXTRM
|
Facility
|
OP
|
$900.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$765.00 |
| Rate for Payer: Adventist Health Commercial |
$180.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$765.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$495.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$675.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$521.28
|
| Rate for Payer: Blue Shield of California Commercial |
$664.20
|
| Rate for Payer: Blue Shield of California EPN |
$437.40
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cigna of CA HMO |
$630.00
|
| Rate for Payer: Cigna of CA PPO |
$630.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$765.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$765.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$765.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$360.00
|
| Rate for Payer: EPIC Health Plan Senior |
$360.00
|
| Rate for Payer: Galaxy Health WC |
$765.00
|
| Rate for Payer: Global Benefits Group Commercial |
$540.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$600.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$342.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$557.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$630.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$630.00
|
| Rate for Payer: Multiplan Commercial |
$720.00
|
| Rate for Payer: Networks By Design Commercial |
$450.00
|
| Rate for Payer: Prime Health Services Commercial |
$765.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$540.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$540.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$337.77
|
| Rate for Payer: United Healthcare All Other HMO |
$328.77
|
| Rate for Payer: United Healthcare HMO Rider |
$321.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$294.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$765.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$765.00
|
| Rate for Payer: Vantage Medical Group Senior |
$765.00
|
|
|
HC CATH BLLN CORDIS PWRFLEX EXTRM
|
Facility
|
IP
|
$900.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$180.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cigna of CA HMO |
$630.00
|
| Rate for Payer: Cigna of CA PPO |
$630.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$360.00
|
| Rate for Payer: EPIC Health Plan Senior |
$360.00
|
| Rate for Payer: Galaxy Health WC |
$765.00
|
| Rate for Payer: Global Benefits Group Commercial |
$540.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$600.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$342.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$557.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.00
|
| Rate for Payer: Multiplan Commercial |
$720.00
|
| Rate for Payer: Networks By Design Commercial |
$450.00
|
| Rate for Payer: Prime Health Services Commercial |
$765.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$337.77
|
| Rate for Payer: United Healthcare All Other HMO |
$328.77
|
| Rate for Payer: United Healthcare HMO Rider |
$321.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$294.75
|
|
|
HC CATH BLLN JUPITER PTA
|
Facility
|
OP
|
$2,340.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081412
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.00 |
| Max. Negotiated Rate |
$1,989.00 |
| Rate for Payer: Adventist Health Commercial |
$468.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,989.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,287.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,755.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,355.33
|
| Rate for Payer: Blue Shield of California Commercial |
$1,726.92
|
| Rate for Payer: Blue Shield of California EPN |
$1,137.24
|
| Rate for Payer: Cash Price |
$1,053.00
|
| Rate for Payer: Cigna of CA HMO |
$1,638.00
|
| Rate for Payer: Cigna of CA PPO |
$1,638.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,989.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,989.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,989.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.00
|
| Rate for Payer: EPIC Health Plan Senior |
$936.00
|
| Rate for Payer: Galaxy Health WC |
$1,989.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,404.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,560.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$891.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,448.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$561.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,638.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,638.00
|
| Rate for Payer: Multiplan Commercial |
$1,872.00
|
| Rate for Payer: Networks By Design Commercial |
$1,170.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,989.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,404.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,404.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$878.20
|
| Rate for Payer: United Healthcare All Other HMO |
$854.80
|
| Rate for Payer: United Healthcare HMO Rider |
$836.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$766.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,989.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,989.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,989.00
|
|
|
HC CATH BLLN JUPITER PTA
|
Facility
|
IP
|
$2,340.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081412
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$468.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,053.00
|
| Rate for Payer: Cash Price |
$1,053.00
|
| Rate for Payer: Cigna of CA HMO |
$1,638.00
|
| Rate for Payer: Cigna of CA PPO |
$1,638.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$936.00
|
| Rate for Payer: EPIC Health Plan Senior |
$936.00
|
| Rate for Payer: Galaxy Health WC |
$1,989.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,404.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,560.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$891.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,448.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$561.60
|
| Rate for Payer: Multiplan Commercial |
$1,872.00
|
| Rate for Payer: Networks By Design Commercial |
$1,170.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,989.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$878.20
|
| Rate for Payer: United Healthcare All Other HMO |
$854.80
|
| Rate for Payer: United Healthcare HMO Rider |
$836.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$766.35
|
|
|
HC CATH BLLN URETHRAL COOK
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
901692022
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| 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 |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC CATH BLLN URETHRAL COOK
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1726
|
| Hospital Charge Code |
901692022
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| 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 |
$335.94
|
| Rate for Payer: Blue Shield of California Commercial |
$428.04
|
| Rate for Payer: Blue Shield of California EPN |
$281.88
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| 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 |
$290.00
|
| 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 |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| 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 CATH BP CROSSBOSS
|
Facility
|
IP
|
$3,413.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
906812474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$682.60 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$682.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,535.85
|
| Rate for Payer: Cash Price |
$1,535.85
|
| Rate for Payer: Cigna of CA HMO |
$2,389.10
|
| Rate for Payer: Cigna of CA PPO |
$2,389.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,365.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,365.20
|
| Rate for Payer: Galaxy Health WC |
$2,901.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,047.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,276.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,300.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,112.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$819.12
|
| Rate for Payer: Multiplan Commercial |
$2,730.40
|
| Rate for Payer: Networks By Design Commercial |
$1,706.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,901.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,280.90
|
| Rate for Payer: United Healthcare All Other HMO |
$1,246.77
|
| Rate for Payer: United Healthcare HMO Rider |
$1,219.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,117.76
|
|
|
HC CATH BP CROSSBOSS
|
Facility
|
OP
|
$3,413.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
906812474
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$682.60 |
| Max. Negotiated Rate |
$2,901.05 |
| Rate for Payer: Adventist Health Commercial |
$682.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,901.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,877.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,559.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,976.81
|
| Rate for Payer: Blue Shield of California Commercial |
$2,518.79
|
| Rate for Payer: Blue Shield of California EPN |
$1,658.72
|
| Rate for Payer: Cash Price |
$1,535.85
|
| Rate for Payer: Cigna of CA HMO |
$2,389.10
|
| Rate for Payer: Cigna of CA PPO |
$2,389.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,901.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,901.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,901.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,365.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,365.20
|
| Rate for Payer: Galaxy Health WC |
$2,901.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,047.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,276.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,300.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,112.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$819.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,389.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,389.10
|
| Rate for Payer: Multiplan Commercial |
$2,730.40
|
| Rate for Payer: Networks By Design Commercial |
$1,706.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,901.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,047.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,047.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,280.90
|
| Rate for Payer: United Healthcare All Other HMO |
$1,246.77
|
| Rate for Payer: United Healthcare HMO Rider |
$1,219.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,117.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,901.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,901.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,901.05
|
|
|
HC CATH BRAUN MULTI TRACK 5FR
|
Facility
|
IP
|
$250.67
|
|
| Hospital Charge Code |
906812268
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.13 |
| Max. Negotiated Rate |
$213.07 |
| Rate for Payer: Adventist Health Commercial |
$50.13
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.27
|
| Rate for Payer: EPIC Health Plan Senior |
$100.27
|
| Rate for Payer: Galaxy Health WC |
$213.07
|
| Rate for Payer: Global Benefits Group Commercial |
$150.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$167.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$95.51
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.16
|
| Rate for Payer: Multiplan Commercial |
$200.54
|
| Rate for Payer: Networks By Design Commercial |
$162.94
|
| Rate for Payer: Prime Health Services Commercial |
$213.07
|
|
