|
HC CATH CONDOM EXTND SM 25MM SLCN
|
Facility
|
IP
|
$6.97
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698729
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$5.92 |
| Rate for Payer: Networks By Design Commercial |
$4.53
|
| Rate for Payer: Prime Health Services Commercial |
$5.92
|
| Rate for Payer: Adventist Health Commercial |
$1.39
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.79
|
| Rate for Payer: EPIC Health Plan Senior |
$2.79
|
| Rate for Payer: Galaxy Health WC |
$5.92
|
| Rate for Payer: Global Benefits Group Commercial |
$4.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.67
|
| Rate for Payer: Multiplan Commercial |
$5.58
|
|
|
HC CATH CONDOM EXTND SM 25MM SLCN
|
Facility
|
OP
|
$6.97
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698729
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$5.92 |
| Rate for Payer: Adventist Health Commercial |
$1.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.28
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Cigna of CA HMO |
$4.46
|
| Rate for Payer: Cigna of CA PPO |
$5.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.79
|
| Rate for Payer: EPIC Health Plan Senior |
$2.79
|
| Rate for Payer: Galaxy Health WC |
$5.92
|
| Rate for Payer: Global Benefits Group Commercial |
$4.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.88
|
| Rate for Payer: Multiplan Commercial |
$5.58
|
| Rate for Payer: Networks By Design Commercial |
$4.53
|
| Rate for Payer: Prime Health Services Commercial |
$5.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.48
|
| Rate for Payer: United Healthcare All Other HMO |
$3.48
|
| Rate for Payer: United Healthcare HMO Rider |
$3.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.92
|
| Rate for Payer: Vantage Medical Group Senior |
$5.92
|
|
|
HC CATH COOK CORONARY
|
Facility
|
IP
|
$252.00
|
|
| Hospital Charge Code |
906812005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Adventist Health Commercial |
$50.40
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.80
|
| Rate for Payer: EPIC Health Plan Senior |
$100.80
|
| Rate for Payer: Galaxy Health WC |
$214.20
|
| Rate for Payer: Global Benefits Group Commercial |
$151.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$168.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.48
|
| Rate for Payer: Multiplan Commercial |
$201.60
|
| Rate for Payer: Networks By Design Commercial |
$163.80
|
| Rate for Payer: Prime Health Services Commercial |
$214.20
|
|
|
HC CATH COOK CORONARY
|
Facility
|
OP
|
$252.00
|
|
| Hospital Charge Code |
906812005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Adventist Health Commercial |
$50.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$165.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$214.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$138.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$189.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.75
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Cigna of CA HMO |
$161.28
|
| Rate for Payer: Cigna of CA PPO |
$186.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$214.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$214.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.80
|
| Rate for Payer: EPIC Health Plan Senior |
$100.80
|
| Rate for Payer: Galaxy Health WC |
$214.20
|
| Rate for Payer: Global Benefits Group Commercial |
$151.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$168.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$96.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$155.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$176.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$176.40
|
| Rate for Payer: Multiplan Commercial |
$201.60
|
| Rate for Payer: Networks By Design Commercial |
$163.80
|
| Rate for Payer: Prime Health Services Commercial |
$214.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$151.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$151.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$126.00
|
| Rate for Payer: United Healthcare All Other HMO |
$126.00
|
| Rate for Payer: United Healthcare HMO Rider |
$126.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$214.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.20
|
| Rate for Payer: Vantage Medical Group Senior |
$214.20
|
|
|
HC CATH COOK PIGTAIL
|
Facility
|
IP
|
$148.96
|
|
| Hospital Charge Code |
906811757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$126.62 |
| Rate for Payer: Adventist Health Commercial |
$29.79
|
| Rate for Payer: Cash Price |
$67.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.58
|
| Rate for Payer: EPIC Health Plan Senior |
$59.58
|
| Rate for Payer: Galaxy Health WC |
$126.62
|
| Rate for Payer: Global Benefits Group Commercial |
$89.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$99.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.75
|
| Rate for Payer: Multiplan Commercial |
$119.17
|
| Rate for Payer: Networks By Design Commercial |
$96.82
|
| Rate for Payer: Prime Health Services Commercial |
$126.62
|
|
|
HC CATH COOK PIGTAIL
|
Facility
|
OP
|
$148.96
|
|
| Hospital Charge Code |
906811757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$126.62 |
| Rate for Payer: Adventist Health Commercial |
$29.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$97.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$126.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$81.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91.48
|
| Rate for Payer: Cash Price |
$67.03
|
| Rate for Payer: Cigna of CA HMO |
$95.33
|
| Rate for Payer: Cigna of CA PPO |
$110.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$126.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$126.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$126.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.58
|
| Rate for Payer: EPIC Health Plan Senior |
$59.58
|
| Rate for Payer: Galaxy Health WC |
$126.62
|
| Rate for Payer: Global Benefits Group Commercial |
$89.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$99.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$104.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$104.27
|
| Rate for Payer: Multiplan Commercial |
$119.17
|
| Rate for Payer: Networks By Design Commercial |
$96.82
|
| Rate for Payer: Prime Health Services Commercial |
$126.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$89.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$89.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$74.48
|
| Rate for Payer: United Healthcare All Other HMO |
$74.48
|
| Rate for Payer: United Healthcare HMO Rider |
$74.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$74.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$126.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$126.62
|
| Rate for Payer: Vantage Medical Group Senior |
$126.62
|
|
|
HC CATH COOK POLYETHYLENE JB1
|
Facility
|
OP
|
$138.32
|
|
| Hospital Charge Code |
906812444
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.66 |
| Max. Negotiated Rate |
$117.57 |
| Rate for Payer: Adventist Health Commercial |
$27.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$90.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$117.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$76.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$103.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.94
|
| Rate for Payer: Cash Price |
$62.24
|
| Rate for Payer: Cigna of CA HMO |
$88.52
|
| Rate for Payer: Cigna of CA PPO |
$102.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$117.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$117.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$117.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.33
|
| Rate for Payer: EPIC Health Plan Senior |
$55.33
|
| Rate for Payer: Galaxy Health WC |
$117.57
|
| Rate for Payer: Global Benefits Group Commercial |
$82.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96.82
|
| Rate for Payer: Multiplan Commercial |
$110.66
|
| Rate for Payer: Networks By Design Commercial |
$89.91
|
| Rate for Payer: Prime Health Services Commercial |
$117.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$69.16
|
| Rate for Payer: United Healthcare All Other HMO |
$69.16
|
| Rate for Payer: United Healthcare HMO Rider |
$69.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$117.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$117.57
|
| Rate for Payer: Vantage Medical Group Senior |
$117.57
|
|
|
HC CATH COOK POLYETHYLENE JB1
|
Facility
|
IP
|
$138.32
|
|
| Hospital Charge Code |
906812444
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.66 |
| Max. Negotiated Rate |
$117.57 |
| Rate for Payer: Adventist Health Commercial |
$27.66
|
| Rate for Payer: Cash Price |
$62.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.33
|
| Rate for Payer: EPIC Health Plan Senior |
$55.33
|
| Rate for Payer: Galaxy Health WC |
$117.57
|
| Rate for Payer: Global Benefits Group Commercial |
$82.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.20
|
| Rate for Payer: Multiplan Commercial |
$110.66
|
| Rate for Payer: Networks By Design Commercial |
$89.91
|
| Rate for Payer: Prime Health Services Commercial |
$117.57
|
|
|
HC CATH COOK POLYETHYLENE PED
|
Facility
|
IP
|
$148.96
|
|
| Hospital Charge Code |
906812443
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$126.62 |
| Rate for Payer: Adventist Health Commercial |
$29.79
|
| Rate for Payer: Cash Price |
$67.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.58
|
| Rate for Payer: EPIC Health Plan Senior |
$59.58
|
| Rate for Payer: Galaxy Health WC |
$126.62
|
| Rate for Payer: Global Benefits Group Commercial |
$89.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$99.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.75
|
| Rate for Payer: Multiplan Commercial |
$119.17
|
| Rate for Payer: Networks By Design Commercial |
$96.82
|
| Rate for Payer: Prime Health Services Commercial |
$126.62
|
|
|
HC CATH COOK POLYETHYLENE PED
|
Facility
|
OP
|
$148.96
|
|
| Hospital Charge Code |
906812443
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$126.62 |
| Rate for Payer: Adventist Health Commercial |
$29.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$97.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$126.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$81.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$91.48
|
| Rate for Payer: Cash Price |
$67.03
|
| Rate for Payer: Cigna of CA HMO |
$95.33
|
| Rate for Payer: Cigna of CA PPO |
$110.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$126.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$126.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$126.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.58
|
| Rate for Payer: EPIC Health Plan Senior |
$59.58
|
| Rate for Payer: Galaxy Health WC |
$126.62
|
| Rate for Payer: Global Benefits Group Commercial |
$89.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$99.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$104.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$104.27
|
| Rate for Payer: Multiplan Commercial |
$119.17
|
| Rate for Payer: Networks By Design Commercial |
$96.82
|
| Rate for Payer: Prime Health Services Commercial |
$126.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$89.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$89.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$74.48
|
| Rate for Payer: United Healthcare All Other HMO |
$74.48
|
| Rate for Payer: United Healthcare HMO Rider |
$74.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$74.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$126.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$126.62
|
| Rate for Payer: Vantage Medical Group Senior |
$126.62
|
|
|
HC CATH COOK RIM
|
Facility
|
IP
|
$112.94
|
|
| Hospital Charge Code |
906812510
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$22.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$50.82
|
| Rate for Payer: Cash Price |
$50.82
|
| Rate for Payer: Cigna of CA HMO |
$79.06
|
| Rate for Payer: Cigna of CA PPO |
$79.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Senior |
$45.18
|
| Rate for Payer: Galaxy Health WC |
$96.00
|
| Rate for Payer: Global Benefits Group Commercial |
$67.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$75.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.11
|
| Rate for Payer: Multiplan Commercial |
$90.35
|
| Rate for Payer: Networks By Design Commercial |
$56.47
|
| Rate for Payer: Prime Health Services Commercial |
$96.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$42.39
|
| Rate for Payer: United Healthcare All Other HMO |
$41.26
|
| Rate for Payer: United Healthcare HMO Rider |
$40.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$36.99
|
|
|
HC CATH COOK RIM
|
Facility
|
OP
|
$112.94
|
|
| Hospital Charge Code |
906812510
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$22.59 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Adventist Health Commercial |
$22.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$96.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$84.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.41
|
| Rate for Payer: Blue Shield of California Commercial |
$83.35
|
| Rate for Payer: Blue Shield of California EPN |
$54.89
|
| Rate for Payer: Cash Price |
$50.82
|
| Rate for Payer: Cigna of CA HMO |
$79.06
|
| Rate for Payer: Cigna of CA PPO |
$79.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$96.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$96.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.18
|
| Rate for Payer: EPIC Health Plan Senior |
$45.18
|
| Rate for Payer: Galaxy Health WC |
$96.00
|
| Rate for Payer: Global Benefits Group Commercial |
$67.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$75.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$43.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$79.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79.06
|
| Rate for Payer: Multiplan Commercial |
$90.35
|
| Rate for Payer: Networks By Design Commercial |
$56.47
|
| Rate for Payer: Prime Health Services Commercial |
$96.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$67.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$67.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$42.39
|
| Rate for Payer: United Healthcare All Other HMO |
$41.26
|
| Rate for Payer: United Healthcare HMO Rider |
$40.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$36.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$96.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.00
|
| Rate for Payer: Vantage Medical Group Senior |
$96.00
|
|
|
HC CATH COOK SLIP-CATH 80CM
|
Facility
|
OP
|
$389.47
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
906812441
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.89 |
| Max. Negotiated Rate |
$331.05 |
| Rate for Payer: Adventist Health Commercial |
$77.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$255.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$331.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$214.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$292.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$239.17
|
| Rate for Payer: Cash Price |
$175.26
|
| Rate for Payer: Cigna of CA HMO |
$249.26
|
| Rate for Payer: Cigna of CA PPO |
$288.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$331.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$331.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$331.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$155.79
|
| Rate for Payer: EPIC Health Plan Senior |
$155.79
|
| Rate for Payer: Galaxy Health WC |
$331.05
|
| Rate for Payer: Global Benefits Group Commercial |
$233.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$259.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$241.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$272.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$272.63
|
| Rate for Payer: Multiplan Commercial |
$311.58
|
| Rate for Payer: Networks By Design Commercial |
$253.16
|
| Rate for Payer: Prime Health Services Commercial |
$331.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$233.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$233.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$194.74
|
| Rate for Payer: United Healthcare All Other HMO |
$194.74
|
| Rate for Payer: United Healthcare HMO Rider |
$194.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$194.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$331.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$331.05
|
| Rate for Payer: Vantage Medical Group Senior |
$331.05
|
|
|
HC CATH COOK SLIP-CATH 80CM
|
Facility
|
IP
|
$389.47
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
906812441
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$77.89 |
| Max. Negotiated Rate |
$331.05 |
| Rate for Payer: Adventist Health Commercial |
$77.89
|
| Rate for Payer: Cash Price |
$175.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$155.79
|
| Rate for Payer: EPIC Health Plan Senior |
$155.79
|
| Rate for Payer: Galaxy Health WC |
$331.05
|
| Rate for Payer: Global Benefits Group Commercial |
$233.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$259.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$148.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$241.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$93.47
|
| Rate for Payer: Multiplan Commercial |
$311.58
|
| Rate for Payer: Networks By Design Commercial |
$253.16
|
| Rate for Payer: Prime Health Services Commercial |
$331.05
|
|
|
HC CATH CORDIS BERENSTEIN
|
Facility
|
OP
|
$136.80
|
|
| Hospital Charge Code |
906812400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.36 |
| Max. Negotiated Rate |
$116.28 |
| Rate for Payer: Adventist Health Commercial |
$27.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$89.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$116.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$102.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.01
|
| Rate for Payer: Cash Price |
$61.56
|
| Rate for Payer: Cigna of CA HMO |
$87.55
|
| Rate for Payer: Cigna of CA PPO |
$101.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$116.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$116.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$116.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.72
|
| Rate for Payer: EPIC Health Plan Senior |
$54.72
|
| Rate for Payer: Galaxy Health WC |
$116.28
|
| Rate for Payer: Global Benefits Group Commercial |
$82.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95.76
|
| Rate for Payer: Multiplan Commercial |
$109.44
|
| Rate for Payer: Networks By Design Commercial |
$88.92
|
| Rate for Payer: Prime Health Services Commercial |
$116.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$68.40
|
| Rate for Payer: United Healthcare All Other HMO |
$68.40
|
| Rate for Payer: United Healthcare HMO Rider |
$68.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$116.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$116.28
|
| Rate for Payer: Vantage Medical Group Senior |
$116.28
|
|
|
HC CATH CORDIS BERENSTEIN
|
Facility
|
IP
|
$136.80
|
|
| Hospital Charge Code |
906812400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.36 |
| Max. Negotiated Rate |
$116.28 |
| Rate for Payer: Adventist Health Commercial |
$27.36
|
| Rate for Payer: Cash Price |
$61.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.72
|
| Rate for Payer: EPIC Health Plan Senior |
$54.72
|
| Rate for Payer: Galaxy Health WC |
$116.28
|
| Rate for Payer: Global Benefits Group Commercial |
$82.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.83
|
| Rate for Payer: Multiplan Commercial |
$109.44
|
| Rate for Payer: Networks By Design Commercial |
$88.92
|
| Rate for Payer: Prime Health Services Commercial |
$116.28
|
|
|
HC CATH CORDIS PTCA GUIDE PEDS
|
Facility
|
OP
|
$695.52
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.10 |
| Max. Negotiated Rate |
$591.19 |
| Rate for Payer: Adventist Health Commercial |
$139.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$456.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$591.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$382.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$521.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$427.12
|
| Rate for Payer: Cash Price |
$312.98
|
| Rate for Payer: Cigna of CA HMO |
$445.13
|
| Rate for Payer: Cigna of CA PPO |
$514.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$591.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$591.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$591.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$278.21
|
| Rate for Payer: EPIC Health Plan Senior |
$278.21
|
| Rate for Payer: Galaxy Health WC |
$591.19
|
| Rate for Payer: Global Benefits Group Commercial |
$417.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$463.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$264.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$430.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$486.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$486.86
|
| Rate for Payer: Multiplan Commercial |
$556.42
|
| Rate for Payer: Networks By Design Commercial |
$452.09
|
| Rate for Payer: Prime Health Services Commercial |
$591.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$417.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$417.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$347.76
|
| Rate for Payer: United Healthcare All Other HMO |
$347.76
|
| Rate for Payer: United Healthcare HMO Rider |
$347.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$347.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$591.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$591.19
|
| Rate for Payer: Vantage Medical Group Senior |
$591.19
|
|
|
HC CATH CORDIS PTCA GUIDE PEDS
|
Facility
|
IP
|
$695.52
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.10 |
| Max. Negotiated Rate |
$591.19 |
| Rate for Payer: Adventist Health Commercial |
$139.10
|
| Rate for Payer: Cash Price |
$312.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$278.21
|
| Rate for Payer: EPIC Health Plan Senior |
$278.21
|
| Rate for Payer: Galaxy Health WC |
$591.19
|
| Rate for Payer: Global Benefits Group Commercial |
$417.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$463.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$264.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$430.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.92
|
| Rate for Payer: Multiplan Commercial |
$556.42
|
| Rate for Payer: Networks By Design Commercial |
$452.09
|
| Rate for Payer: Prime Health Services Commercial |
$591.19
|
|
|
HC CATH CORDIS PTCA VSTA BRITE IG
|
Facility
|
IP
|
$481.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
906812751
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$96.20 |
| Max. Negotiated Rate |
$408.85 |
| Rate for Payer: Adventist Health Commercial |
$96.20
|
| Rate for Payer: Cash Price |
$216.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.40
|
| Rate for Payer: EPIC Health Plan Senior |
$192.40
|
| Rate for Payer: Galaxy Health WC |
$408.85
|
| Rate for Payer: Global Benefits Group Commercial |
$288.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$320.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$297.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.44
|
| Rate for Payer: Multiplan Commercial |
$384.80
|
| Rate for Payer: Networks By Design Commercial |
$312.65
|
| Rate for Payer: Prime Health Services Commercial |
$408.85
|
|
|
HC CATH CORDIS PTCA VSTA BRITE IG
|
Facility
|
OP
|
$481.00
|
|
|
Service Code
|
CPT C1894
|
| Hospital Charge Code |
906812751
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$96.20 |
| Max. Negotiated Rate |
$408.85 |
| Rate for Payer: Adventist Health Commercial |
$96.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$315.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$408.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$264.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$360.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$295.38
|
| Rate for Payer: Cash Price |
$216.45
|
| Rate for Payer: Cigna of CA HMO |
$307.84
|
| Rate for Payer: Cigna of CA PPO |
$355.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$408.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$408.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$408.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.40
|
| Rate for Payer: EPIC Health Plan Senior |
$192.40
|
| Rate for Payer: Galaxy Health WC |
$408.85
|
| Rate for Payer: Global Benefits Group Commercial |
$288.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$320.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$183.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$297.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$336.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$336.70
|
| Rate for Payer: Multiplan Commercial |
$384.80
|
| Rate for Payer: Networks By Design Commercial |
$312.65
|
| Rate for Payer: Prime Health Services Commercial |
$408.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$288.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$288.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$240.50
|
| Rate for Payer: United Healthcare All Other HMO |
$240.50
|
| Rate for Payer: United Healthcare HMO Rider |
$240.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$240.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$408.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$408.85
|
| Rate for Payer: Vantage Medical Group Senior |
$408.85
|
|
|
HC CATH CORDIS TEMP AQUA
|
Facility
|
IP
|
$298.00
|
|
| Hospital Charge Code |
906812658
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$253.30 |
| Rate for Payer: Adventist Health Commercial |
$59.60
|
| Rate for Payer: Cash Price |
$134.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Senior |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$198.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$184.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.52
|
| Rate for Payer: Multiplan Commercial |
$238.40
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
|
|
HC CATH CORDIS TEMP AQUA
|
Facility
|
OP
|
$298.00
|
|
| Hospital Charge Code |
906812658
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$253.30 |
| Rate for Payer: Adventist Health Commercial |
$59.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$195.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$163.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$223.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$183.00
|
| Rate for Payer: Cash Price |
$134.10
|
| Rate for Payer: Cigna of CA HMO |
$190.72
|
| Rate for Payer: Cigna of CA PPO |
$220.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$253.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$253.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$253.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Senior |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$198.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$184.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$208.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$208.60
|
| Rate for Payer: Multiplan Commercial |
$238.40
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$178.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$178.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$149.00
|
| Rate for Payer: United Healthcare All Other HMO |
$149.00
|
| Rate for Payer: United Healthcare HMO Rider |
$149.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$149.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$253.30
|
| Rate for Payer: Vantage Medical Group Senior |
$253.30
|
|
|
HC CATH COUDE 12FR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$30.95 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Multiplan Commercial |
$29.13
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
|
|
HC CATH COUDE 12FR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$30.95 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.36
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Cigna of CA HMO |
$23.30
|
| Rate for Payer: Cigna of CA PPO |
$26.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.49
|
| Rate for Payer: Multiplan Commercial |
$29.13
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.20
|
| Rate for Payer: United Healthcare All Other HMO |
$18.20
|
| Rate for Payer: United Healthcare HMO Rider |
$18.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.95
|
| Rate for Payer: Vantage Medical Group Senior |
$30.95
|
|
|
HC CATH COUDE 14FR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$30.95 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Multiplan Commercial |
$29.13
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
|
