|
HC CATH EDWARDS MONITOR BAL
|
Facility
|
IP
|
$301.77
|
|
| Hospital Charge Code |
906812008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.35 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Adventist Health Commercial |
$60.35
|
| Rate for Payer: Cash Price |
$135.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$120.71
|
| Rate for Payer: EPIC Health Plan Senior |
$120.71
|
| Rate for Payer: Galaxy Health WC |
$256.50
|
| Rate for Payer: Global Benefits Group Commercial |
$181.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$201.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$114.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$186.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$72.42
|
| Rate for Payer: Multiplan Commercial |
$241.42
|
| Rate for Payer: Networks By Design Commercial |
$196.15
|
| Rate for Payer: Prime Health Services Commercial |
$256.50
|
|
|
HC CATH EDWARDS T/D BAL
|
Facility
|
OP
|
$340.34
|
|
| Hospital Charge Code |
906812010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.07 |
| Max. Negotiated Rate |
$289.29 |
| Rate for Payer: Adventist Health Commercial |
$68.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$223.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$289.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$187.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$255.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$209.00
|
| Rate for Payer: Cash Price |
$153.15
|
| Rate for Payer: Cigna of CA HMO |
$217.82
|
| Rate for Payer: Cigna of CA PPO |
$251.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$289.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$289.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$289.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.14
|
| Rate for Payer: EPIC Health Plan Senior |
$136.14
|
| Rate for Payer: Galaxy Health WC |
$289.29
|
| Rate for Payer: Global Benefits Group Commercial |
$204.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$227.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$210.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$238.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$238.24
|
| Rate for Payer: Multiplan Commercial |
$272.27
|
| Rate for Payer: Networks By Design Commercial |
$221.22
|
| Rate for Payer: Prime Health Services Commercial |
$289.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$204.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$204.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$170.17
|
| Rate for Payer: United Healthcare All Other HMO |
$170.17
|
| Rate for Payer: United Healthcare HMO Rider |
$170.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$170.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$289.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$289.29
|
| Rate for Payer: Vantage Medical Group Senior |
$289.29
|
|
|
HC CATH EDWARDS T/D BAL
|
Facility
|
IP
|
$340.34
|
|
| Hospital Charge Code |
906812010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$68.07 |
| Max. Negotiated Rate |
$289.29 |
| Rate for Payer: Adventist Health Commercial |
$68.07
|
| Rate for Payer: Cash Price |
$153.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$136.14
|
| Rate for Payer: EPIC Health Plan Senior |
$136.14
|
| Rate for Payer: Galaxy Health WC |
$289.29
|
| Rate for Payer: Global Benefits Group Commercial |
$204.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$227.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$129.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$210.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$81.68
|
| Rate for Payer: Multiplan Commercial |
$272.27
|
| Rate for Payer: Networks By Design Commercial |
$221.22
|
| Rate for Payer: Prime Health Services Commercial |
$289.29
|
|
|
HC CATH EDWARDS T/D BAL 6F 110CM
|
Facility
|
OP
|
$377.00
|
|
| Hospital Charge Code |
906812368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$320.45 |
| Rate for Payer: Adventist Health Commercial |
$75.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$247.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$282.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$231.52
|
| Rate for Payer: Cash Price |
$169.65
|
| Rate for Payer: Cigna of CA HMO |
$241.28
|
| Rate for Payer: Cigna of CA PPO |
$278.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$320.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$320.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: EPIC Health Plan Senior |
$150.80
|
| Rate for Payer: Galaxy Health WC |
$320.45
|
| Rate for Payer: Global Benefits Group Commercial |
$226.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$233.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$263.90
|
| Rate for Payer: Multiplan Commercial |
$301.60
|
| Rate for Payer: Networks By Design Commercial |
$245.05
|
| Rate for Payer: Prime Health Services Commercial |
$320.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$226.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$226.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$188.50
|
| Rate for Payer: United Healthcare All Other HMO |
$188.50
|
| Rate for Payer: United Healthcare HMO Rider |
$188.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$188.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$320.45
|
| Rate for Payer: Vantage Medical Group Senior |
$320.45
|
|
|
HC CATH EDWARDS T/D BAL 6F 110CM
|
Facility
|
IP
|
$377.00
|
|
| Hospital Charge Code |
906812368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$320.45 |
| Rate for Payer: Adventist Health Commercial |
$75.40
|
| Rate for Payer: Cash Price |
$169.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: EPIC Health Plan Senior |
$150.80
|
| Rate for Payer: Galaxy Health WC |
$320.45
|
| Rate for Payer: Global Benefits Group Commercial |
$226.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$233.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.48
|
| Rate for Payer: Multiplan Commercial |
$301.60
|
| Rate for Payer: Networks By Design Commercial |
$245.05
|
| Rate for Payer: Prime Health Services Commercial |
$320.45
|
|
|
HC CATH EDWARDS T/D BAL VIP
|
Facility
|
OP
|
$469.04
|
|
| Hospital Charge Code |
906812275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.81 |
| Max. Negotiated Rate |
$398.68 |
| Rate for Payer: Adventist Health Commercial |
$93.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$307.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$398.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$257.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$351.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$288.04
|
| Rate for Payer: Cash Price |
$211.07
|
| Rate for Payer: Cigna of CA HMO |
$300.19
|
| Rate for Payer: Cigna of CA PPO |
$347.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$398.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$398.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$398.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.62
|
| Rate for Payer: EPIC Health Plan Senior |
$187.62
|
| Rate for Payer: Galaxy Health WC |
$398.68
|
| Rate for Payer: Global Benefits Group Commercial |
$281.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$312.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$290.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$328.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$328.33
|
| Rate for Payer: Multiplan Commercial |
$375.23
|
| Rate for Payer: Networks By Design Commercial |
$304.88
|
| Rate for Payer: Prime Health Services Commercial |
$398.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$281.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$281.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$234.52
|
| Rate for Payer: United Healthcare All Other HMO |
$234.52
|
| Rate for Payer: United Healthcare HMO Rider |
$234.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$234.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$398.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$398.68
|
| Rate for Payer: Vantage Medical Group Senior |
$398.68
|
|
|
HC CATH EDWARDS T/D BAL VIP
|
Facility
|
IP
|
$469.04
|
|
| Hospital Charge Code |
906812275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$93.81 |
| Max. Negotiated Rate |
$398.68 |
| Rate for Payer: Adventist Health Commercial |
$93.81
|
| Rate for Payer: Cash Price |
$211.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$187.62
|
| Rate for Payer: EPIC Health Plan Senior |
$187.62
|
| Rate for Payer: Galaxy Health WC |
$398.68
|
| Rate for Payer: Global Benefits Group Commercial |
$281.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$312.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$290.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.57
|
| Rate for Payer: Multiplan Commercial |
$375.23
|
| Rate for Payer: Networks By Design Commercial |
$304.88
|
| Rate for Payer: Prime Health Services Commercial |
$398.68
|
|
|
HC CATH EDWARDS T/D CCO/SVO2/VIP
|
Facility
|
IP
|
$1,981.00
|
|
| Hospital Charge Code |
906812636
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$396.20 |
| Max. Negotiated Rate |
$1,683.85 |
| Rate for Payer: Adventist Health Commercial |
$396.20
|
| Rate for Payer: Cash Price |
$891.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$792.40
|
| Rate for Payer: EPIC Health Plan Senior |
$792.40
|
| Rate for Payer: Galaxy Health WC |
$1,683.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,188.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,321.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$754.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,226.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$475.44
|
| Rate for Payer: Multiplan Commercial |
$1,584.80
|
| Rate for Payer: Networks By Design Commercial |
$1,287.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,683.85
|
|
|
HC CATH EDWARDS T/D CCO/SVO2/VIP
|
Facility
|
OP
|
$1,981.00
|
|
| Hospital Charge Code |
906812636
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$396.20 |
| Max. Negotiated Rate |
$1,683.85 |
| Rate for Payer: Adventist Health Commercial |
$396.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,299.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,683.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,089.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,485.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,216.53
|
| Rate for Payer: Cash Price |
$891.45
|
| Rate for Payer: Cigna of CA HMO |
$1,267.84
|
| Rate for Payer: Cigna of CA PPO |
$1,465.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,683.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,683.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,683.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$792.40
|
| Rate for Payer: EPIC Health Plan Senior |
$792.40
|
| Rate for Payer: Galaxy Health WC |
$1,683.85
|
| Rate for Payer: Global Benefits Group Commercial |
$1,188.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,321.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$754.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,226.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$475.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,386.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,386.70
|
| Rate for Payer: Multiplan Commercial |
$1,584.80
|
| Rate for Payer: Networks By Design Commercial |
$1,287.65
|
| Rate for Payer: Prime Health Services Commercial |
$1,683.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,188.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,188.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$990.50
|
| Rate for Payer: United Healthcare All Other HMO |
$990.50
|
| Rate for Payer: United Healthcare HMO Rider |
$990.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$990.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,683.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,683.85
|
| Rate for Payer: Vantage Medical Group Senior |
$1,683.85
|
|
|
HC CATH EMBO TRELLIS
|
Facility
|
IP
|
$5,237.50
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909020053
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,047.50 |
| Max. Negotiated Rate |
$4,451.88 |
| Rate for Payer: Adventist Health Commercial |
$1,047.50
|
| Rate for Payer: Cash Price |
$2,356.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,095.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,095.00
|
| Rate for Payer: Galaxy Health WC |
$4,451.88
|
| Rate for Payer: Global Benefits Group Commercial |
$3,142.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,493.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,995.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,242.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,257.00
|
| Rate for Payer: Multiplan Commercial |
$4,190.00
|
| Rate for Payer: Networks By Design Commercial |
$3,404.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,451.88
|
|
|
HC CATH EMBO TRELLIS
|
Facility
|
OP
|
$5,237.50
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909020053
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,047.50 |
| Max. Negotiated Rate |
$4,451.88 |
| Rate for Payer: Adventist Health Commercial |
$1,047.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,435.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,451.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,880.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,928.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,216.35
|
| Rate for Payer: Cash Price |
$2,356.88
|
| Rate for Payer: Cigna of CA HMO |
$3,352.00
|
| Rate for Payer: Cigna of CA PPO |
$3,875.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,451.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,451.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,451.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,095.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,095.00
|
| Rate for Payer: Galaxy Health WC |
$4,451.88
|
| Rate for Payer: Global Benefits Group Commercial |
$3,142.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,493.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,995.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,242.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,257.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,666.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,666.25
|
| Rate for Payer: Multiplan Commercial |
$4,190.00
|
| Rate for Payer: Networks By Design Commercial |
$3,404.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,451.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,142.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,142.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,618.75
|
| Rate for Payer: United Healthcare All Other HMO |
$2,618.75
|
| Rate for Payer: United Healthcare HMO Rider |
$2,618.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,618.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,451.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,451.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,451.88
|
|
|
HC CATHERIZATION UMBILICAL ARTERY
|
Facility
|
OP
|
$264.00
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
988136660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$32,312.00 |
| Rate for Payer: Adventist Health Commercial |
$52.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32,312.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$224.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$145.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,398.00
|
| Rate for Payer: Blue Shield of California Commercial |
$11,230.65
|
| Rate for Payer: Blue Shield of California EPN |
$1,845.77
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cigna of CA HMO |
$168.96
|
| Rate for Payer: Cigna of CA PPO |
$195.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$224.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$224.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$224.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.60
|
| Rate for Payer: EPIC Health Plan Senior |
$105.60
|
| Rate for Payer: Galaxy Health WC |
$224.40
|
| Rate for Payer: Global Benefits Group Commercial |
$158.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$53.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$176.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$60.13
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.80
|
| Rate for Payer: Multiplan Commercial |
$211.20
|
| Rate for Payer: Networks By Design Commercial |
$171.60
|
| Rate for Payer: Prime Health Services Commercial |
$224.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$158.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4,341.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4,460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,374.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$224.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$224.40
|
| Rate for Payer: Vantage Medical Group Senior |
$224.40
|
|
|
HC CATHERIZATION UMBILICAL ARTERY
|
Facility
|
IP
|
$264.00
|
|
|
Service Code
|
CPT 36660
|
| Hospital Charge Code |
988136660
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$52.80 |
| Max. Negotiated Rate |
$224.40 |
| Rate for Payer: Adventist Health Commercial |
$52.80
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.60
|
| Rate for Payer: EPIC Health Plan Senior |
$105.60
|
| Rate for Payer: Galaxy Health WC |
$224.40
|
| Rate for Payer: Global Benefits Group Commercial |
$158.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$176.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.36
|
| Rate for Payer: Multiplan Commercial |
$211.20
|
| Rate for Payer: Networks By Design Commercial |
$171.60
|
| Rate for Payer: Prime Health Services Commercial |
$224.40
|
|
|
HC CATHETER CHAIT
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
909020082
|
|
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 CATHETER CHAIT
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
909020082
|
|
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 CATHETER/DIAGNOSTIC FLUSH
|
Facility
|
IP
|
$99.00
|
|
| Hospital Charge Code |
909081205
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$84.15 |
| Rate for Payer: Adventist Health Commercial |
$19.80
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.60
|
| Rate for Payer: EPIC Health Plan Senior |
$39.60
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.76
|
| Rate for Payer: Multiplan Commercial |
$79.20
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
|
|
HC CATHETER/DIAGNOSTIC FLUSH
|
Facility
|
OP
|
$99.00
|
|
| Hospital Charge Code |
909081205
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.80 |
| Max. Negotiated Rate |
$84.15 |
| Rate for Payer: Adventist Health Commercial |
$19.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$64.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$84.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$54.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$74.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.80
|
| Rate for Payer: Cash Price |
$44.55
|
| Rate for Payer: Cigna of CA HMO |
$63.36
|
| Rate for Payer: Cigna of CA PPO |
$73.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$84.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$84.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$84.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.60
|
| Rate for Payer: EPIC Health Plan Senior |
$39.60
|
| Rate for Payer: Galaxy Health WC |
$84.15
|
| Rate for Payer: Global Benefits Group Commercial |
$59.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$66.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$61.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$69.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69.30
|
| Rate for Payer: Multiplan Commercial |
$79.20
|
| Rate for Payer: Networks By Design Commercial |
$64.35
|
| Rate for Payer: Prime Health Services Commercial |
$84.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.50
|
| Rate for Payer: United Healthcare All Other HMO |
$49.50
|
| Rate for Payer: United Healthcare HMO Rider |
$49.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$84.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$84.15
|
| Rate for Payer: Vantage Medical Group Senior |
$84.15
|
|
|
HC CATHETER DOUBLE LUMEN (COOK)
|
Facility
|
IP
|
$155.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909001063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$31.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$69.75
|
| Rate for Payer: Cash Price |
$69.75
|
| Rate for Payer: Cigna of CA HMO |
$108.50
|
| Rate for Payer: Cigna of CA PPO |
$108.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.00
|
| Rate for Payer: EPIC Health Plan Senior |
$62.00
|
| Rate for Payer: Galaxy Health WC |
$131.75
|
| Rate for Payer: Global Benefits Group Commercial |
$93.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$103.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$95.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.20
|
| Rate for Payer: Multiplan Commercial |
$124.00
|
| Rate for Payer: Networks By Design Commercial |
$77.50
|
| Rate for Payer: Prime Health Services Commercial |
$131.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.17
|
| Rate for Payer: United Healthcare All Other HMO |
$56.62
|
| Rate for Payer: United Healthcare HMO Rider |
$55.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.76
|
|
|
HC CATHETER DOUBLE LUMEN (COOK)
|
Facility
|
OP
|
$155.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
909001063
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$131.75 |
| Rate for Payer: Adventist Health Commercial |
$31.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$131.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$85.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$116.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.78
|
| Rate for Payer: Blue Shield of California Commercial |
$114.39
|
| Rate for Payer: Blue Shield of California EPN |
$75.33
|
| Rate for Payer: Cash Price |
$69.75
|
| Rate for Payer: Cigna of CA HMO |
$108.50
|
| Rate for Payer: Cigna of CA PPO |
$108.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$131.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$131.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$131.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.00
|
| Rate for Payer: EPIC Health Plan Senior |
$62.00
|
| Rate for Payer: Galaxy Health WC |
$131.75
|
| Rate for Payer: Global Benefits Group Commercial |
$93.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$103.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$59.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$95.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$108.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$108.50
|
| Rate for Payer: Multiplan Commercial |
$124.00
|
| Rate for Payer: Networks By Design Commercial |
$77.50
|
| Rate for Payer: Prime Health Services Commercial |
$131.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$93.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$93.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.17
|
| Rate for Payer: United Healthcare All Other HMO |
$56.62
|
| Rate for Payer: United Healthcare HMO Rider |
$55.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$131.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$131.75
|
| Rate for Payer: Vantage Medical Group Senior |
$131.75
|
|
|
HC CATHETER/GUIDING
|
Facility
|
OP
|
$180.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Adventist Health Commercial |
$36.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$118.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$153.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$99.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.54
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: Cigna of CA HMO |
$115.20
|
| Rate for Payer: Cigna of CA PPO |
$133.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$153.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$153.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$153.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Senior |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$126.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$126.00
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
| Rate for Payer: Networks By Design Commercial |
$117.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$108.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$108.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$90.00
|
| Rate for Payer: United Healthcare All Other HMO |
$90.00
|
| Rate for Payer: United Healthcare HMO Rider |
$90.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$90.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$153.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$153.00
|
| Rate for Payer: Vantage Medical Group Senior |
$153.00
|
|
|
HC CATHETER/GUIDING
|
Facility
|
IP
|
$180.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909081285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Adventist Health Commercial |
$36.00
|
| Rate for Payer: Cash Price |
$81.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Senior |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.20
|
| Rate for Payer: Multiplan Commercial |
$144.00
|
| Rate for Payer: Networks By Design Commercial |
$117.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
|
|
HC CATHETERIZATION-SPECIMEN ONLY
|
Facility
|
OP
|
$167.00
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
907201169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.43 |
| Max. Negotiated Rate |
$3,429.00 |
| Rate for Payer: Adventist Health Commercial |
$33.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,429.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$102.55
|
| Rate for Payer: Blue Shield of California Commercial |
$111.72
|
| Rate for Payer: Blue Shield of California EPN |
$73.81
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: Cigna of CA HMO |
$106.88
|
| Rate for Payer: Cigna of CA PPO |
$123.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.27
|
| Rate for Payer: EPIC Health Plan Senior |
$9.09
|
| Rate for Payer: Galaxy Health WC |
$141.95
|
| Rate for Payer: Global Benefits Group Commercial |
$100.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.18
|
| Rate for Payer: Multiplan Commercial |
$133.60
|
| Rate for Payer: Networks By Design Commercial |
$108.55
|
| Rate for Payer: Prime Health Services Commercial |
$141.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$100.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$100.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.43
|
| Rate for Payer: United Healthcare All Other HMO |
$2.43
|
| Rate for Payer: United Healthcare HMO Rider |
$2.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.43
|
| Rate for Payer: Upland Medical Group Pediatric |
$9.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.00
|
| Rate for Payer: Vantage Medical Group Senior |
$9.09
|
|
|
HC CATHETERIZATION-SPECIMEN ONLY
|
Facility
|
IP
|
$167.00
|
|
|
Service Code
|
CPT P9612
|
| Hospital Charge Code |
907201169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.40 |
| Max. Negotiated Rate |
$141.95 |
| Rate for Payer: Adventist Health Commercial |
$33.40
|
| Rate for Payer: Cash Price |
$75.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.80
|
| Rate for Payer: EPIC Health Plan Senior |
$66.80
|
| Rate for Payer: Galaxy Health WC |
$141.95
|
| Rate for Payer: Global Benefits Group Commercial |
$100.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$111.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$103.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.08
|
| Rate for Payer: Multiplan Commercial |
$133.60
|
| Rate for Payer: Networks By Design Commercial |
$108.55
|
| Rate for Payer: Prime Health Services Commercial |
$141.95
|
|
|
HC CATHETER MEDTRONIC ASPIRATION
|
Facility
|
OP
|
$2,710.50
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$542.10 |
| Max. Negotiated Rate |
$2,303.93 |
| Rate for Payer: Adventist Health Commercial |
$542.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,777.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,303.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,490.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,032.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,664.52
|
| Rate for Payer: Cash Price |
$1,219.73
|
| Rate for Payer: Cigna of CA HMO |
$1,734.72
|
| Rate for Payer: Cigna of CA PPO |
$2,005.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,303.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,303.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,303.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,084.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,084.20
|
| Rate for Payer: Galaxy Health WC |
$2,303.93
|
| Rate for Payer: Global Benefits Group Commercial |
$1,626.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,807.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,032.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,677.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$650.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,897.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,897.35
|
| Rate for Payer: Multiplan Commercial |
$2,168.40
|
| Rate for Payer: Networks By Design Commercial |
$1,761.83
|
| Rate for Payer: Prime Health Services Commercial |
$2,303.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,626.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,626.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,355.25
|
| Rate for Payer: United Healthcare All Other HMO |
$1,355.25
|
| Rate for Payer: United Healthcare HMO Rider |
$1,355.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,355.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,303.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,303.93
|
| Rate for Payer: Vantage Medical Group Senior |
$2,303.93
|
|
|
HC CATHETER MEDTRONIC ASPIRATION
|
Facility
|
IP
|
$2,710.50
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$542.10 |
| Max. Negotiated Rate |
$2,303.93 |
| Rate for Payer: Adventist Health Commercial |
$542.10
|
| Rate for Payer: Cash Price |
$1,219.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,084.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,084.20
|
| Rate for Payer: Galaxy Health WC |
$2,303.93
|
| Rate for Payer: Global Benefits Group Commercial |
$1,626.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,807.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,032.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,677.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$650.52
|
| Rate for Payer: Multiplan Commercial |
$2,168.40
|
| Rate for Payer: Networks By Design Commercial |
$1,761.83
|
| Rate for Payer: Prime Health Services Commercial |
$2,303.93
|
|
