|
HC CATH CLOSED SUCTION 14FR 24HR
|
Facility
|
IP
|
$123.50
|
|
| Hospital Charge Code |
901602438
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.70 |
| Max. Negotiated Rate |
$104.97 |
| Rate for Payer: Adventist Health Commercial |
$24.70
|
| Rate for Payer: Cash Price |
$55.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.40
|
| Rate for Payer: EPIC Health Plan Senior |
$49.40
|
| Rate for Payer: Galaxy Health WC |
$104.97
|
| Rate for Payer: Global Benefits Group Commercial |
$74.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$82.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.64
|
| Rate for Payer: Multiplan Commercial |
$98.80
|
| Rate for Payer: Networks By Design Commercial |
$80.28
|
| Rate for Payer: Prime Health Services Commercial |
$104.97
|
|
|
HC CATH CLOSED SUCTION 14FR 24HR
|
Facility
|
OP
|
$123.50
|
|
| Hospital Charge Code |
901602438
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.70 |
| Max. Negotiated Rate |
$104.97 |
| Rate for Payer: Adventist Health Commercial |
$24.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$81.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$104.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$67.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$92.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.84
|
| Rate for Payer: Cash Price |
$55.58
|
| Rate for Payer: Cigna of CA HMO |
$79.04
|
| Rate for Payer: Cigna of CA PPO |
$91.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$104.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$104.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$104.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.40
|
| Rate for Payer: EPIC Health Plan Senior |
$49.40
|
| Rate for Payer: Galaxy Health WC |
$104.97
|
| Rate for Payer: Global Benefits Group Commercial |
$74.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$82.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$76.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$86.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$86.45
|
| Rate for Payer: Multiplan Commercial |
$98.80
|
| Rate for Payer: Networks By Design Commercial |
$80.28
|
| Rate for Payer: Prime Health Services Commercial |
$104.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$74.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$74.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$61.75
|
| Rate for Payer: United Healthcare All Other HMO |
$61.75
|
| Rate for Payer: United Healthcare HMO Rider |
$61.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$61.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$104.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$104.97
|
| Rate for Payer: Vantage Medical Group Senior |
$104.97
|
|
|
HC CATH CLOSED SUCTION 14FR 72HR
|
Facility
|
IP
|
$126.01
|
|
|
Service Code
|
CPT A4605
|
| Hospital Charge Code |
901698822
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$107.11 |
| Rate for Payer: Adventist Health Commercial |
$25.20
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.40
|
| Rate for Payer: EPIC Health Plan Senior |
$50.40
|
| Rate for Payer: Galaxy Health WC |
$107.11
|
| Rate for Payer: Global Benefits Group Commercial |
$75.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$84.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$78.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.24
|
| Rate for Payer: Multiplan Commercial |
$100.81
|
| Rate for Payer: Networks By Design Commercial |
$81.91
|
| Rate for Payer: Prime Health Services Commercial |
$107.11
|
|
|
HC CATH CLOSED SUCTION 14FR 72HR
|
Facility
|
OP
|
$126.01
|
|
|
Service Code
|
CPT A4605
|
| Hospital Charge Code |
901698822
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$107.11 |
| Rate for Payer: Adventist Health Commercial |
$25.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$82.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$107.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$69.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$94.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$77.38
|
| Rate for Payer: Cash Price |
$56.70
|
| Rate for Payer: Cigna of CA HMO |
$80.65
|
| Rate for Payer: Cigna of CA PPO |
$93.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$107.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$107.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$107.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.40
|
| Rate for Payer: EPIC Health Plan Senior |
$50.40
|
| Rate for Payer: Galaxy Health WC |
$107.11
|
| Rate for Payer: Global Benefits Group Commercial |
$75.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$84.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$78.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$88.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$88.21
|
| Rate for Payer: Multiplan Commercial |
$100.81
|
| Rate for Payer: Networks By Design Commercial |
$81.91
|
| Rate for Payer: Prime Health Services Commercial |
$107.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$63.01
|
| Rate for Payer: United Healthcare All Other HMO |
$63.01
|
| Rate for Payer: United Healthcare HMO Rider |
$63.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$63.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$107.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$107.11
|
| Rate for Payer: Vantage Medical Group Senior |
$107.11
|
|
|
HC CATH CLOSED SUCTION 5FR
|
Facility
|
OP
|
$101.84
|
|
| Hospital Charge Code |
901604306
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.37 |
| Max. Negotiated Rate |
$86.56 |
| Rate for Payer: Adventist Health Commercial |
$20.37
|
| Rate for Payer: Aetna of CA HMO/PPO |
$66.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.54
|
| Rate for Payer: Cash Price |
$45.83
|
| Rate for Payer: Cigna of CA HMO |
$65.18
|
| Rate for Payer: Cigna of CA PPO |
$75.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.74
|
| Rate for Payer: EPIC Health Plan Senior |
$40.74
|
| Rate for Payer: Galaxy Health WC |
$86.56
|
| Rate for Payer: Global Benefits Group Commercial |
$61.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71.29
|
| Rate for Payer: Multiplan Commercial |
$81.47
|
| Rate for Payer: Networks By Design Commercial |
$66.20
|
| Rate for Payer: Prime Health Services Commercial |
$86.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.92
|
| Rate for Payer: United Healthcare All Other HMO |
$50.92
|
| Rate for Payer: United Healthcare HMO Rider |
$50.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.56
|
| Rate for Payer: Vantage Medical Group Senior |
$86.56
|
|
|
HC CATH CLOSED SUCTION 5FR
|
Facility
|
IP
|
$101.84
|
|
| Hospital Charge Code |
901604306
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.37 |
| Max. Negotiated Rate |
$86.56 |
| Rate for Payer: Adventist Health Commercial |
$20.37
|
| Rate for Payer: Cash Price |
$45.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.74
|
| Rate for Payer: EPIC Health Plan Senior |
$40.74
|
| Rate for Payer: Galaxy Health WC |
$86.56
|
| Rate for Payer: Global Benefits Group Commercial |
$61.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.44
|
| Rate for Payer: Multiplan Commercial |
$81.47
|
| Rate for Payer: Networks By Design Commercial |
$66.20
|
| Rate for Payer: Prime Health Services Commercial |
$86.56
|
|
|
HC CATH CLOSED SUCTION 6FR
|
Facility
|
IP
|
$101.84
|
|
| Hospital Charge Code |
901604307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.37 |
| Max. Negotiated Rate |
$86.56 |
| Rate for Payer: Adventist Health Commercial |
$20.37
|
| Rate for Payer: Cash Price |
$45.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.74
|
| Rate for Payer: EPIC Health Plan Senior |
$40.74
|
| Rate for Payer: Galaxy Health WC |
$86.56
|
| Rate for Payer: Global Benefits Group Commercial |
$61.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.44
|
| Rate for Payer: Multiplan Commercial |
$81.47
|
| Rate for Payer: Networks By Design Commercial |
$66.20
|
| Rate for Payer: Prime Health Services Commercial |
$86.56
|
|
|
HC CATH CLOSED SUCTION 6FR
|
Facility
|
OP
|
$101.84
|
|
| Hospital Charge Code |
901604307
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.37 |
| Max. Negotiated Rate |
$86.56 |
| Rate for Payer: Adventist Health Commercial |
$20.37
|
| Rate for Payer: Aetna of CA HMO/PPO |
$66.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.54
|
| Rate for Payer: Cash Price |
$45.83
|
| Rate for Payer: Cigna of CA HMO |
$65.18
|
| Rate for Payer: Cigna of CA PPO |
$75.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.74
|
| Rate for Payer: EPIC Health Plan Senior |
$40.74
|
| Rate for Payer: Galaxy Health WC |
$86.56
|
| Rate for Payer: Global Benefits Group Commercial |
$61.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71.29
|
| Rate for Payer: Multiplan Commercial |
$81.47
|
| Rate for Payer: Networks By Design Commercial |
$66.20
|
| Rate for Payer: Prime Health Services Commercial |
$86.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.92
|
| Rate for Payer: United Healthcare All Other HMO |
$50.92
|
| Rate for Payer: United Healthcare HMO Rider |
$50.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.56
|
| Rate for Payer: Vantage Medical Group Senior |
$86.56
|
|
|
HC CATH CLOSED SUCTION 6FR ELBOW
|
Facility
|
IP
|
$104.96
|
|
| Hospital Charge Code |
901604317
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.99 |
| Max. Negotiated Rate |
$89.22 |
| Rate for Payer: Adventist Health Commercial |
$20.99
|
| Rate for Payer: Cash Price |
$47.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.98
|
| Rate for Payer: EPIC Health Plan Senior |
$41.98
|
| Rate for Payer: Galaxy Health WC |
$89.22
|
| Rate for Payer: Global Benefits Group Commercial |
$62.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.19
|
| Rate for Payer: Multiplan Commercial |
$83.97
|
| Rate for Payer: Networks By Design Commercial |
$68.22
|
| Rate for Payer: Prime Health Services Commercial |
$89.22
|
|
|
HC CATH CLOSED SUCTION 6FR ELBOW
|
Facility
|
OP
|
$104.96
|
|
| Hospital Charge Code |
901604317
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.99 |
| Max. Negotiated Rate |
$89.22 |
| Rate for Payer: Adventist Health Commercial |
$20.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$89.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$57.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$78.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.46
|
| Rate for Payer: Cash Price |
$47.23
|
| Rate for Payer: Cigna of CA HMO |
$67.17
|
| Rate for Payer: Cigna of CA PPO |
$77.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$89.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$89.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.98
|
| Rate for Payer: EPIC Health Plan Senior |
$41.98
|
| Rate for Payer: Galaxy Health WC |
$89.22
|
| Rate for Payer: Global Benefits Group Commercial |
$62.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73.47
|
| Rate for Payer: Multiplan Commercial |
$83.97
|
| Rate for Payer: Networks By Design Commercial |
$68.22
|
| Rate for Payer: Prime Health Services Commercial |
$89.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$62.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$62.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.48
|
| Rate for Payer: United Healthcare All Other HMO |
$52.48
|
| Rate for Payer: United Healthcare HMO Rider |
$52.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$89.22
|
| Rate for Payer: Vantage Medical Group Senior |
$89.22
|
|
|
HC CATH CLOSED SUCTION 8FR
|
Facility
|
IP
|
$101.84
|
|
| Hospital Charge Code |
901604312
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.37 |
| Max. Negotiated Rate |
$86.56 |
| Rate for Payer: Adventist Health Commercial |
$20.37
|
| Rate for Payer: Cash Price |
$45.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.74
|
| Rate for Payer: EPIC Health Plan Senior |
$40.74
|
| Rate for Payer: Galaxy Health WC |
$86.56
|
| Rate for Payer: Global Benefits Group Commercial |
$61.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.44
|
| Rate for Payer: Multiplan Commercial |
$81.47
|
| Rate for Payer: Networks By Design Commercial |
$66.20
|
| Rate for Payer: Prime Health Services Commercial |
$86.56
|
|
|
HC CATH CLOSED SUCTION 8FR
|
Facility
|
OP
|
$101.84
|
|
| Hospital Charge Code |
901604312
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.37 |
| Max. Negotiated Rate |
$86.56 |
| Rate for Payer: Adventist Health Commercial |
$20.37
|
| Rate for Payer: Aetna of CA HMO/PPO |
$66.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.54
|
| Rate for Payer: Cash Price |
$45.83
|
| Rate for Payer: Cigna of CA HMO |
$65.18
|
| Rate for Payer: Cigna of CA PPO |
$75.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.74
|
| Rate for Payer: EPIC Health Plan Senior |
$40.74
|
| Rate for Payer: Galaxy Health WC |
$86.56
|
| Rate for Payer: Global Benefits Group Commercial |
$61.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71.29
|
| Rate for Payer: Multiplan Commercial |
$81.47
|
| Rate for Payer: Networks By Design Commercial |
$66.20
|
| Rate for Payer: Prime Health Services Commercial |
$86.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.92
|
| Rate for Payer: United Healthcare All Other HMO |
$50.92
|
| Rate for Payer: United Healthcare HMO Rider |
$50.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.56
|
| Rate for Payer: Vantage Medical Group Senior |
$86.56
|
|
|
HC CATH CLOSED SUCTION 8FRELBOW
|
Facility
|
OP
|
$104.96
|
|
| Hospital Charge Code |
901604320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.99 |
| Max. Negotiated Rate |
$89.22 |
| Rate for Payer: Adventist Health Commercial |
$20.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$68.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$89.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$57.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$78.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.46
|
| Rate for Payer: Cash Price |
$47.23
|
| Rate for Payer: Cigna of CA HMO |
$67.17
|
| Rate for Payer: Cigna of CA PPO |
$77.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$89.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$89.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.98
|
| Rate for Payer: EPIC Health Plan Senior |
$41.98
|
| Rate for Payer: Galaxy Health WC |
$89.22
|
| Rate for Payer: Global Benefits Group Commercial |
$62.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73.47
|
| Rate for Payer: Multiplan Commercial |
$83.97
|
| Rate for Payer: Networks By Design Commercial |
$68.22
|
| Rate for Payer: Prime Health Services Commercial |
$89.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$62.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$62.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.48
|
| Rate for Payer: United Healthcare All Other HMO |
$52.48
|
| Rate for Payer: United Healthcare HMO Rider |
$52.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$89.22
|
| Rate for Payer: Vantage Medical Group Senior |
$89.22
|
|
|
HC CATH CLOSED SUCTION 8FRELBOW
|
Facility
|
IP
|
$104.96
|
|
| Hospital Charge Code |
901604320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.99 |
| Max. Negotiated Rate |
$89.22 |
| Rate for Payer: Adventist Health Commercial |
$20.99
|
| Rate for Payer: Cash Price |
$47.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.98
|
| Rate for Payer: EPIC Health Plan Senior |
$41.98
|
| Rate for Payer: Galaxy Health WC |
$89.22
|
| Rate for Payer: Global Benefits Group Commercial |
$62.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.19
|
| Rate for Payer: Multiplan Commercial |
$83.97
|
| Rate for Payer: Networks By Design Commercial |
$68.22
|
| Rate for Payer: Prime Health Services Commercial |
$89.22
|
|
|
HC CATH CLOSED SUCTION SZ 7
|
Facility
|
IP
|
$101.84
|
|
| Hospital Charge Code |
901605069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.37 |
| Max. Negotiated Rate |
$86.56 |
| Rate for Payer: Adventist Health Commercial |
$20.37
|
| Rate for Payer: Cash Price |
$45.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.74
|
| Rate for Payer: EPIC Health Plan Senior |
$40.74
|
| Rate for Payer: Galaxy Health WC |
$86.56
|
| Rate for Payer: Global Benefits Group Commercial |
$61.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.44
|
| Rate for Payer: Multiplan Commercial |
$81.47
|
| Rate for Payer: Networks By Design Commercial |
$66.20
|
| Rate for Payer: Prime Health Services Commercial |
$86.56
|
|
|
HC CATH CLOSED SUCTION SZ 7
|
Facility
|
OP
|
$101.84
|
|
| Hospital Charge Code |
901605069
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.37 |
| Max. Negotiated Rate |
$86.56 |
| Rate for Payer: Adventist Health Commercial |
$20.37
|
| Rate for Payer: Aetna of CA HMO/PPO |
$66.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.54
|
| Rate for Payer: Cash Price |
$45.83
|
| Rate for Payer: Cigna of CA HMO |
$65.18
|
| Rate for Payer: Cigna of CA PPO |
$75.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.74
|
| Rate for Payer: EPIC Health Plan Senior |
$40.74
|
| Rate for Payer: Galaxy Health WC |
$86.56
|
| Rate for Payer: Global Benefits Group Commercial |
$61.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.80
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71.29
|
| Rate for Payer: Multiplan Commercial |
$81.47
|
| Rate for Payer: Networks By Design Commercial |
$66.20
|
| Rate for Payer: Prime Health Services Commercial |
$86.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.92
|
| Rate for Payer: United Healthcare All Other HMO |
$50.92
|
| Rate for Payer: United Healthcare HMO Rider |
$50.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.56
|
| Rate for Payer: Vantage Medical Group Senior |
$86.56
|
|
|
HC CATH CNTL VNS 7FR 6" TL TRAY
|
Facility
|
IP
|
$579.42
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607559
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$115.88 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$115.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$260.74
|
| Rate for Payer: Cash Price |
$260.74
|
| Rate for Payer: Cigna of CA HMO |
$405.59
|
| Rate for Payer: Cigna of CA PPO |
$405.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$231.77
|
| Rate for Payer: EPIC Health Plan Senior |
$231.77
|
| Rate for Payer: Galaxy Health WC |
$492.51
|
| Rate for Payer: Global Benefits Group Commercial |
$347.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$358.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.06
|
| Rate for Payer: Multiplan Commercial |
$463.54
|
| Rate for Payer: Networks By Design Commercial |
$289.71
|
| Rate for Payer: Prime Health Services Commercial |
$492.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.46
|
| Rate for Payer: United Healthcare All Other HMO |
$211.66
|
| Rate for Payer: United Healthcare HMO Rider |
$207.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.76
|
|
|
HC CATH CNTL VNS 7FR 6" TL TRAY
|
Facility
|
OP
|
$579.42
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607559
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$115.88 |
| Max. Negotiated Rate |
$492.51 |
| Rate for Payer: Adventist Health Commercial |
$115.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$492.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$318.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$434.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$335.60
|
| Rate for Payer: Blue Shield of California Commercial |
$427.61
|
| Rate for Payer: Blue Shield of California EPN |
$281.60
|
| Rate for Payer: Cash Price |
$260.74
|
| Rate for Payer: Cigna of CA HMO |
$405.59
|
| Rate for Payer: Cigna of CA PPO |
$405.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$492.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$492.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$492.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$231.77
|
| Rate for Payer: EPIC Health Plan Senior |
$231.77
|
| Rate for Payer: Galaxy Health WC |
$492.51
|
| Rate for Payer: Global Benefits Group Commercial |
$347.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$358.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$405.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$405.59
|
| Rate for Payer: Multiplan Commercial |
$463.54
|
| Rate for Payer: Networks By Design Commercial |
$289.71
|
| Rate for Payer: Prime Health Services Commercial |
$492.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$347.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$347.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.46
|
| Rate for Payer: United Healthcare All Other HMO |
$211.66
|
| Rate for Payer: United Healthcare HMO Rider |
$207.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$492.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$492.51
|
| Rate for Payer: Vantage Medical Group Senior |
$492.51
|
|
|
HC CATH CNTL VNS 8FR 6" DL TRAY
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607561
|
|
Hospital Revenue Code
|
272
|
| 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 CATH CNTL VNS 8FR 6" DL TRAY
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607561
|
|
Hospital Revenue Code
|
272
|
| 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 CATH CNTRL VNS 4FR
|
Facility
|
OP
|
$357.05
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901600383
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.41 |
| Max. Negotiated Rate |
$303.49 |
| Rate for Payer: Adventist Health Commercial |
$71.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$303.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$196.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$267.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$206.80
|
| Rate for Payer: Blue Shield of California Commercial |
$263.50
|
| Rate for Payer: Blue Shield of California EPN |
$173.53
|
| Rate for Payer: Cash Price |
$160.67
|
| Rate for Payer: Cigna of CA HMO |
$249.94
|
| Rate for Payer: Cigna of CA PPO |
$249.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$303.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$303.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$303.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.82
|
| Rate for Payer: EPIC Health Plan Senior |
$142.82
|
| Rate for Payer: Galaxy Health WC |
$303.49
|
| Rate for Payer: Global Benefits Group Commercial |
$214.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$238.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$221.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$85.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$249.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$249.94
|
| Rate for Payer: Multiplan Commercial |
$285.64
|
| Rate for Payer: Networks By Design Commercial |
$178.53
|
| Rate for Payer: Prime Health Services Commercial |
$303.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$214.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$214.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$134.00
|
| Rate for Payer: United Healthcare All Other HMO |
$130.43
|
| Rate for Payer: United Healthcare HMO Rider |
$127.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$116.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$303.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$303.49
|
| Rate for Payer: Vantage Medical Group Senior |
$303.49
|
|
|
HC CATH CNTRL VNS 4FR
|
Facility
|
IP
|
$357.05
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901600383
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$71.41 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$71.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$160.67
|
| Rate for Payer: Cash Price |
$160.67
|
| Rate for Payer: Cigna of CA HMO |
$249.94
|
| Rate for Payer: Cigna of CA PPO |
$249.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$142.82
|
| Rate for Payer: EPIC Health Plan Senior |
$142.82
|
| Rate for Payer: Galaxy Health WC |
$303.49
|
| Rate for Payer: Global Benefits Group Commercial |
$214.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$238.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$136.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$221.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$85.69
|
| Rate for Payer: Multiplan Commercial |
$285.64
|
| Rate for Payer: Networks By Design Commercial |
$178.53
|
| Rate for Payer: Prime Health Services Commercial |
$303.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$134.00
|
| Rate for Payer: United Healthcare All Other HMO |
$130.43
|
| Rate for Payer: United Healthcare HMO Rider |
$127.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$116.93
|
|
|
HC CATH CNTRL VNS 4FR PE 2-LUMEN
|
Facility
|
IP
|
$805.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698316
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Cigna of CA HMO |
$563.50
|
| Rate for Payer: Cigna of CA PPO |
$563.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.20
|
| Rate for Payer: Multiplan Commercial |
$644.00
|
| Rate for Payer: Networks By Design Commercial |
$402.50
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$302.12
|
| Rate for Payer: United Healthcare All Other HMO |
$294.07
|
| Rate for Payer: United Healthcare HMO Rider |
$287.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.64
|
|
|
HC CATH CNTRL VNS 4FR PE 2-LUMEN
|
Facility
|
OP
|
$805.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698316
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$684.25 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$442.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$603.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$466.26
|
| Rate for Payer: Blue Shield of California Commercial |
$594.09
|
| Rate for Payer: Blue Shield of California EPN |
$391.23
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Cigna of CA HMO |
$563.50
|
| Rate for Payer: Cigna of CA PPO |
$563.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$684.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$684.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$684.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$563.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$563.50
|
| Rate for Payer: Multiplan Commercial |
$644.00
|
| Rate for Payer: Networks By Design Commercial |
$402.50
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$483.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$483.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$302.12
|
| Rate for Payer: United Healthcare All Other HMO |
$294.07
|
| Rate for Payer: United Healthcare HMO Rider |
$287.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$263.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$684.25
|
| Rate for Payer: Vantage Medical Group Senior |
$684.25
|
|
|
HC CATH CNTRL VNS 5FR
|
Facility
|
OP
|
$350.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901604857
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$70.00 |
| Max. Negotiated Rate |
$297.50 |
| Rate for Payer: Adventist Health Commercial |
$70.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$192.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$262.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$202.72
|
| Rate for Payer: Blue Shield of California Commercial |
$258.30
|
| Rate for Payer: Blue Shield of California EPN |
$170.10
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna of CA HMO |
$245.00
|
| Rate for Payer: Cigna of CA PPO |
$245.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$297.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$297.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$297.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$140.00
|
| Rate for Payer: EPIC Health Plan Senior |
$140.00
|
| Rate for Payer: Galaxy Health WC |
$297.50
|
| Rate for Payer: Global Benefits Group Commercial |
$210.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$233.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$133.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$216.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$84.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$245.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$245.00
|
| Rate for Payer: Multiplan Commercial |
$280.00
|
| Rate for Payer: Networks By Design Commercial |
$175.00
|
| Rate for Payer: Prime Health Services Commercial |
$297.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$210.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$210.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.35
|
| Rate for Payer: United Healthcare All Other HMO |
$127.86
|
| Rate for Payer: United Healthcare HMO Rider |
$125.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$297.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$297.50
|
| Rate for Payer: Vantage Medical Group Senior |
$297.50
|
|
