|
HC CATHETER, MULTI MARKER
|
Facility
|
IP
|
$1,449.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909020085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$1,231.65 |
| Rate for Payer: Adventist Health Commercial |
$289.80
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: EPIC Health Plan Senior |
$579.60
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$966.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$552.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$896.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$347.76
|
| Rate for Payer: Multiplan Commercial |
$1,159.20
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
|
|
HC CATHETER, MULTI MARKER
|
Facility
|
OP
|
$1,449.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909020085
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$289.80 |
| Max. Negotiated Rate |
$1,231.65 |
| Rate for Payer: Adventist Health Commercial |
$289.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$950.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,231.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$796.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,086.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$889.83
|
| Rate for Payer: Cash Price |
$652.05
|
| Rate for Payer: Cigna of CA HMO |
$927.36
|
| Rate for Payer: Cigna of CA PPO |
$1,072.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,231.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,231.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,231.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$579.60
|
| Rate for Payer: EPIC Health Plan Senior |
$579.60
|
| Rate for Payer: Galaxy Health WC |
$1,231.65
|
| Rate for Payer: Global Benefits Group Commercial |
$869.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$966.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$552.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$896.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$347.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,014.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,014.30
|
| Rate for Payer: Multiplan Commercial |
$1,159.20
|
| Rate for Payer: Networks By Design Commercial |
$941.85
|
| Rate for Payer: Prime Health Services Commercial |
$1,231.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$869.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$869.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$724.50
|
| Rate for Payer: United Healthcare All Other HMO |
$724.50
|
| Rate for Payer: United Healthcare HMO Rider |
$724.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$724.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,231.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,231.65
|
| Rate for Payer: Vantage Medical Group Senior |
$1,231.65
|
|
|
HC CATHETER PIONEER
|
Facility
|
IP
|
$7,987.50
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
909020110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,597.50 |
| Max. Negotiated Rate |
$6,789.38 |
| Rate for Payer: Adventist Health Commercial |
$1,597.50
|
| Rate for Payer: Cash Price |
$3,594.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,195.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,195.00
|
| Rate for Payer: Galaxy Health WC |
$6,789.38
|
| Rate for Payer: Global Benefits Group Commercial |
$4,792.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,327.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,043.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,944.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,917.00
|
| Rate for Payer: Multiplan Commercial |
$6,390.00
|
| Rate for Payer: Networks By Design Commercial |
$5,191.88
|
| Rate for Payer: Prime Health Services Commercial |
$6,789.38
|
|
|
HC CATHETER PIONEER
|
Facility
|
OP
|
$7,987.50
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
909020110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,597.50 |
| Max. Negotiated Rate |
$6,789.38 |
| Rate for Payer: Adventist Health Commercial |
$1,597.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5,239.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,789.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,393.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5,990.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,905.12
|
| Rate for Payer: Cash Price |
$3,594.38
|
| Rate for Payer: Cigna of CA HMO |
$5,112.00
|
| Rate for Payer: Cigna of CA PPO |
$5,910.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,789.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$6,789.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,789.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,195.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,195.00
|
| Rate for Payer: Galaxy Health WC |
$6,789.38
|
| Rate for Payer: Global Benefits Group Commercial |
$4,792.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,327.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,043.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,944.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,917.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,591.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,591.25
|
| Rate for Payer: Multiplan Commercial |
$6,390.00
|
| Rate for Payer: Networks By Design Commercial |
$5,191.88
|
| Rate for Payer: Prime Health Services Commercial |
$6,789.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,792.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,792.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,993.75
|
| Rate for Payer: United Healthcare All Other HMO |
$3,993.75
|
| Rate for Payer: United Healthcare HMO Rider |
$3,993.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,993.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,789.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6,789.38
|
| Rate for Payer: Vantage Medical Group Senior |
$6,789.38
|
|
|
HC CATH FEMORAL ARTRY 18FR 4-1/4
|
Facility
|
OP
|
$101.61
|
|
| Hospital Charge Code |
901602851
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.32 |
| Max. Negotiated Rate |
$86.37 |
| Rate for Payer: Adventist Health Commercial |
$20.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$66.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.40
|
| Rate for Payer: Cash Price |
$45.72
|
| Rate for Payer: Cigna of CA HMO |
$65.03
|
| Rate for Payer: Cigna of CA PPO |
$75.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.64
|
| Rate for Payer: EPIC Health Plan Senior |
$40.64
|
| Rate for Payer: Galaxy Health WC |
$86.37
|
| Rate for Payer: Global Benefits Group Commercial |
$60.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71.13
|
| Rate for Payer: Multiplan Commercial |
$81.29
|
| Rate for Payer: Networks By Design Commercial |
$66.05
|
| Rate for Payer: Prime Health Services Commercial |
$86.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$60.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$60.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.80
|
| Rate for Payer: United Healthcare All Other HMO |
$50.80
|
| Rate for Payer: United Healthcare HMO Rider |
$50.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.37
|
| Rate for Payer: Vantage Medical Group Senior |
$86.37
|
|
|
HC CATH FEMORAL ARTRY 18FR 4-1/4
|
Facility
|
IP
|
$101.61
|
|
| Hospital Charge Code |
901602851
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.32 |
| Max. Negotiated Rate |
$86.37 |
| Rate for Payer: Adventist Health Commercial |
$20.32
|
| Rate for Payer: Cash Price |
$45.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.64
|
| Rate for Payer: EPIC Health Plan Senior |
$40.64
|
| Rate for Payer: Galaxy Health WC |
$86.37
|
| Rate for Payer: Global Benefits Group Commercial |
$60.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.39
|
| Rate for Payer: Multiplan Commercial |
$81.29
|
| Rate for Payer: Networks By Design Commercial |
$66.05
|
| Rate for Payer: Prime Health Services Commercial |
$86.37
|
|
|
HC CATH FOGARTY 10FR
|
Facility
|
OP
|
$685.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$137.08 |
| Max. Negotiated Rate |
$582.59 |
| Rate for Payer: Adventist Health Commercial |
$137.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$449.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$582.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$376.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$514.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$420.90
|
| Rate for Payer: Cash Price |
$308.43
|
| Rate for Payer: Cigna of CA HMO |
$438.66
|
| Rate for Payer: Cigna of CA PPO |
$507.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$582.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$582.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$582.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$274.16
|
| Rate for Payer: EPIC Health Plan Senior |
$274.16
|
| Rate for Payer: Galaxy Health WC |
$582.59
|
| Rate for Payer: Global Benefits Group Commercial |
$411.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$457.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$261.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$424.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$479.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$479.78
|
| Rate for Payer: Multiplan Commercial |
$548.32
|
| Rate for Payer: Networks By Design Commercial |
$445.51
|
| Rate for Payer: Prime Health Services Commercial |
$582.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$411.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$411.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$342.70
|
| Rate for Payer: United Healthcare All Other HMO |
$342.70
|
| Rate for Payer: United Healthcare HMO Rider |
$342.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$342.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$582.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$582.59
|
| Rate for Payer: Vantage Medical Group Senior |
$582.59
|
|
|
HC CATH FOGARTY 10FR
|
Facility
|
IP
|
$685.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$137.08 |
| Max. Negotiated Rate |
$582.59 |
| Rate for Payer: Adventist Health Commercial |
$137.08
|
| Rate for Payer: Cash Price |
$308.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$274.16
|
| Rate for Payer: EPIC Health Plan Senior |
$274.16
|
| Rate for Payer: Galaxy Health WC |
$582.59
|
| Rate for Payer: Global Benefits Group Commercial |
$411.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$457.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$261.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$424.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$164.50
|
| Rate for Payer: Multiplan Commercial |
$548.32
|
| Rate for Payer: Networks By Design Commercial |
$445.51
|
| Rate for Payer: Prime Health Services Commercial |
$582.59
|
|
|
HC CATH FOGARTY 3FR APPLD MED
|
Facility
|
IP
|
$616.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601480
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.28 |
| Max. Negotiated Rate |
$523.94 |
| Rate for Payer: Adventist Health Commercial |
$123.28
|
| Rate for Payer: Cash Price |
$277.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$246.56
|
| Rate for Payer: EPIC Health Plan Senior |
$246.56
|
| Rate for Payer: Galaxy Health WC |
$523.94
|
| Rate for Payer: Global Benefits Group Commercial |
$369.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$411.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$234.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$381.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.94
|
| Rate for Payer: Multiplan Commercial |
$493.12
|
| Rate for Payer: Networks By Design Commercial |
$400.66
|
| Rate for Payer: Prime Health Services Commercial |
$523.94
|
|
|
HC CATH FOGARTY 3FR APPLD MED
|
Facility
|
OP
|
$616.40
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
901601480
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$123.28 |
| Max. Negotiated Rate |
$523.94 |
| Rate for Payer: Adventist Health Commercial |
$123.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$404.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$523.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$339.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$462.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$378.53
|
| Rate for Payer: Cash Price |
$277.38
|
| Rate for Payer: Cigna of CA HMO |
$394.50
|
| Rate for Payer: Cigna of CA PPO |
$456.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$523.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$523.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$523.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$246.56
|
| Rate for Payer: EPIC Health Plan Senior |
$246.56
|
| Rate for Payer: Galaxy Health WC |
$523.94
|
| Rate for Payer: Global Benefits Group Commercial |
$369.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$411.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$234.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$381.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$431.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$431.48
|
| Rate for Payer: Multiplan Commercial |
$493.12
|
| Rate for Payer: Networks By Design Commercial |
$400.66
|
| Rate for Payer: Prime Health Services Commercial |
$523.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$369.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$369.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$308.20
|
| Rate for Payer: United Healthcare All Other HMO |
$308.20
|
| Rate for Payer: United Healthcare HMO Rider |
$308.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$308.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$523.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$523.94
|
| Rate for Payer: Vantage Medical Group Senior |
$523.94
|
|
|
HC CATH FOLEY 14FR COUDE 2WAY
|
Facility
|
OP
|
$136.88
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698874
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.38 |
| Max. Negotiated Rate |
$116.35 |
| Rate for Payer: Adventist Health Commercial |
$27.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$89.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$116.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$102.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.06
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cigna of CA HMO |
$87.60
|
| Rate for Payer: Cigna of CA PPO |
$101.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$116.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$116.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$116.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.75
|
| Rate for Payer: EPIC Health Plan Senior |
$54.75
|
| Rate for Payer: Galaxy Health WC |
$116.35
|
| Rate for Payer: Global Benefits Group Commercial |
$82.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95.82
|
| Rate for Payer: Multiplan Commercial |
$109.50
|
| Rate for Payer: Networks By Design Commercial |
$88.97
|
| Rate for Payer: Prime Health Services Commercial |
$116.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$68.44
|
| Rate for Payer: United Healthcare All Other HMO |
$68.44
|
| Rate for Payer: United Healthcare HMO Rider |
$68.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$116.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$116.35
|
| Rate for Payer: Vantage Medical Group Senior |
$116.35
|
|
|
HC CATH FOLEY 14FR COUDE 2WAY
|
Facility
|
OP
|
$27.14
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698708
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$23.07 |
| Rate for Payer: Adventist Health Commercial |
$5.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.67
|
| Rate for Payer: Cash Price |
$12.21
|
| Rate for Payer: Cigna of CA HMO |
$17.37
|
| Rate for Payer: Cigna of CA PPO |
$20.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.86
|
| Rate for Payer: EPIC Health Plan Senior |
$10.86
|
| Rate for Payer: Galaxy Health WC |
$23.07
|
| Rate for Payer: Global Benefits Group Commercial |
$16.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.00
|
| Rate for Payer: Multiplan Commercial |
$21.71
|
| Rate for Payer: Networks By Design Commercial |
$17.64
|
| Rate for Payer: Prime Health Services Commercial |
$23.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.57
|
| Rate for Payer: United Healthcare All Other HMO |
$13.57
|
| Rate for Payer: United Healthcare HMO Rider |
$13.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.07
|
| Rate for Payer: Vantage Medical Group Senior |
$23.07
|
|
|
HC CATH FOLEY 14FR COUDE 2WAY
|
Facility
|
IP
|
$27.14
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698708
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.43 |
| Max. Negotiated Rate |
$23.07 |
| Rate for Payer: Adventist Health Commercial |
$5.43
|
| Rate for Payer: Cash Price |
$12.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.86
|
| Rate for Payer: EPIC Health Plan Senior |
$10.86
|
| Rate for Payer: Galaxy Health WC |
$23.07
|
| Rate for Payer: Global Benefits Group Commercial |
$16.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.51
|
| Rate for Payer: Multiplan Commercial |
$21.71
|
| Rate for Payer: Networks By Design Commercial |
$17.64
|
| Rate for Payer: Prime Health Services Commercial |
$23.07
|
|
|
HC CATH FOLEY 14FR COUDE 2WAY
|
Facility
|
IP
|
$136.88
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698874
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.38 |
| Max. Negotiated Rate |
$116.35 |
| Rate for Payer: Adventist Health Commercial |
$27.38
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.75
|
| Rate for Payer: EPIC Health Plan Senior |
$54.75
|
| Rate for Payer: Galaxy Health WC |
$116.35
|
| Rate for Payer: Global Benefits Group Commercial |
$82.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$84.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.85
|
| Rate for Payer: Multiplan Commercial |
$109.50
|
| Rate for Payer: Networks By Design Commercial |
$88.97
|
| Rate for Payer: Prime Health Services Commercial |
$116.35
|
|
|
HC CATH FOLEY 16FR 2WY TEMP SNS
|
Facility
|
IP
|
$103.66
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698557
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$88.11 |
| Rate for Payer: Adventist Health Commercial |
$20.73
|
| Rate for Payer: Cash Price |
$46.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.46
|
| Rate for Payer: EPIC Health Plan Senior |
$41.46
|
| Rate for Payer: Galaxy Health WC |
$88.11
|
| Rate for Payer: Global Benefits Group Commercial |
$62.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$69.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.88
|
| Rate for Payer: Multiplan Commercial |
$82.93
|
| Rate for Payer: Networks By Design Commercial |
$67.38
|
| Rate for Payer: Prime Health Services Commercial |
$88.11
|
|
|
HC CATH FOLEY 16FR 2WY TEMP SNS
|
Facility
|
OP
|
$103.66
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698557
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$88.11 |
| Rate for Payer: Adventist Health Commercial |
$20.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$67.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$88.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$57.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$77.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.66
|
| Rate for Payer: Cash Price |
$46.65
|
| Rate for Payer: Cigna of CA HMO |
$66.34
|
| Rate for Payer: Cigna of CA PPO |
$76.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$88.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$88.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$88.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.46
|
| Rate for Payer: EPIC Health Plan Senior |
$41.46
|
| Rate for Payer: Galaxy Health WC |
$88.11
|
| Rate for Payer: Global Benefits Group Commercial |
$62.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$69.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$39.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$64.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$72.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$72.56
|
| Rate for Payer: Multiplan Commercial |
$82.93
|
| Rate for Payer: Networks By Design Commercial |
$67.38
|
| Rate for Payer: Prime Health Services Commercial |
$88.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$62.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$62.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.83
|
| Rate for Payer: United Healthcare All Other HMO |
$51.83
|
| Rate for Payer: United Healthcare HMO Rider |
$51.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$88.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$88.11
|
| Rate for Payer: Vantage Medical Group Senior |
$88.11
|
|
|
HC CATH FOLEY 16FR W/TEMP PROBE
|
Facility
|
IP
|
$104.96
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901604296
|
|
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 FOLEY 16FR W/TEMP PROBE
|
Facility
|
OP
|
$104.96
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901604296
|
|
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 FOLEY 16FR W TEMP SENSING
|
Facility
|
OP
|
$185.29
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698191
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.06 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Adventist Health Commercial |
$37.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$121.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$157.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$101.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$138.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$113.79
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Cigna of CA HMO |
$118.59
|
| Rate for Payer: Cigna of CA PPO |
$137.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$157.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$157.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$157.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.12
|
| Rate for Payer: EPIC Health Plan Senior |
$74.12
|
| Rate for Payer: Galaxy Health WC |
$157.50
|
| Rate for Payer: Global Benefits Group Commercial |
$111.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$123.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$114.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$129.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$129.70
|
| Rate for Payer: Multiplan Commercial |
$148.23
|
| Rate for Payer: Networks By Design Commercial |
$120.44
|
| Rate for Payer: Prime Health Services Commercial |
$157.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$111.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$111.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$92.64
|
| Rate for Payer: United Healthcare All Other HMO |
$92.64
|
| Rate for Payer: United Healthcare HMO Rider |
$92.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$92.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$157.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$157.50
|
| Rate for Payer: Vantage Medical Group Senior |
$157.50
|
|
|
HC CATH FOLEY 16FR W TEMP SENSING
|
Facility
|
IP
|
$185.29
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698191
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.06 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Adventist Health Commercial |
$37.06
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.12
|
| Rate for Payer: EPIC Health Plan Senior |
$74.12
|
| Rate for Payer: Galaxy Health WC |
$157.50
|
| Rate for Payer: Global Benefits Group Commercial |
$111.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$123.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$114.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.47
|
| Rate for Payer: Multiplan Commercial |
$148.23
|
| Rate for Payer: Networks By Design Commercial |
$120.44
|
| Rate for Payer: Prime Health Services Commercial |
$157.50
|
|
|
HC CATH FOLEY 16FR W/TEMP SENSING
|
Facility
|
OP
|
$207.27
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901608089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.45 |
| Max. Negotiated Rate |
$176.18 |
| Rate for Payer: Adventist Health Commercial |
$41.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$135.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$176.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$114.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$155.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$127.28
|
| Rate for Payer: Cash Price |
$93.27
|
| Rate for Payer: Cigna of CA HMO |
$132.65
|
| Rate for Payer: Cigna of CA PPO |
$153.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$176.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$176.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$176.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.91
|
| Rate for Payer: EPIC Health Plan Senior |
$82.91
|
| Rate for Payer: Galaxy Health WC |
$176.18
|
| Rate for Payer: Global Benefits Group Commercial |
$124.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$138.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$145.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$145.09
|
| Rate for Payer: Multiplan Commercial |
$165.82
|
| Rate for Payer: Networks By Design Commercial |
$134.73
|
| Rate for Payer: Prime Health Services Commercial |
$176.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$124.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$124.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$103.64
|
| Rate for Payer: United Healthcare All Other HMO |
$103.64
|
| Rate for Payer: United Healthcare HMO Rider |
$103.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$103.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$176.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$176.18
|
| Rate for Payer: Vantage Medical Group Senior |
$176.18
|
|
|
HC CATH FOLEY 16FR W/TEMP SENSING
|
Facility
|
IP
|
$207.27
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901608089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.45 |
| Max. Negotiated Rate |
$176.18 |
| Rate for Payer: Adventist Health Commercial |
$41.45
|
| Rate for Payer: Cash Price |
$93.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.91
|
| Rate for Payer: EPIC Health Plan Senior |
$82.91
|
| Rate for Payer: Galaxy Health WC |
$176.18
|
| Rate for Payer: Global Benefits Group Commercial |
$124.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$138.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$78.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$128.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.74
|
| Rate for Payer: Multiplan Commercial |
$165.82
|
| Rate for Payer: Networks By Design Commercial |
$134.73
|
| Rate for Payer: Prime Health Services Commercial |
$176.18
|
|
|
HC CATH FOLEY 18FR 30ML 3WAY
|
Facility
|
OP
|
$117.42
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698709
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.48 |
| Max. Negotiated Rate |
$99.81 |
| Rate for Payer: Adventist Health Commercial |
$23.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$77.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$99.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$88.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.11
|
| Rate for Payer: Cash Price |
$52.84
|
| Rate for Payer: Cigna of CA HMO |
$75.15
|
| Rate for Payer: Cigna of CA PPO |
$86.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$99.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$99.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$99.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.97
|
| Rate for Payer: EPIC Health Plan Senior |
$46.97
|
| Rate for Payer: Galaxy Health WC |
$99.81
|
| Rate for Payer: Global Benefits Group Commercial |
$70.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82.19
|
| Rate for Payer: Multiplan Commercial |
$93.94
|
| Rate for Payer: Networks By Design Commercial |
$76.32
|
| Rate for Payer: Prime Health Services Commercial |
$99.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.71
|
| Rate for Payer: United Healthcare All Other HMO |
$58.71
|
| Rate for Payer: United Healthcare HMO Rider |
$58.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$58.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$99.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$99.81
|
| Rate for Payer: Vantage Medical Group Senior |
$99.81
|
|
|
HC CATH FOLEY 18FR 30ML 3WAY
|
Facility
|
IP
|
$117.42
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698709
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.48 |
| Max. Negotiated Rate |
$99.81 |
| Rate for Payer: Adventist Health Commercial |
$23.48
|
| Rate for Payer: Cash Price |
$52.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.97
|
| Rate for Payer: EPIC Health Plan Senior |
$46.97
|
| Rate for Payer: Galaxy Health WC |
$99.81
|
| Rate for Payer: Global Benefits Group Commercial |
$70.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.18
|
| Rate for Payer: Multiplan Commercial |
$93.94
|
| Rate for Payer: Networks By Design Commercial |
$76.32
|
| Rate for Payer: Prime Health Services Commercial |
$99.81
|
|
|
HC CATH FOLEY 18FR COUDE TIP 2WAY
|
Facility
|
IP
|
$27.06
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698754
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$23.00 |
| Rate for Payer: Adventist Health Commercial |
$5.41
|
| Rate for Payer: Cash Price |
$12.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.82
|
| Rate for Payer: EPIC Health Plan Senior |
$10.82
|
| Rate for Payer: Galaxy Health WC |
$23.00
|
| Rate for Payer: Global Benefits Group Commercial |
$16.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.49
|
| Rate for Payer: Multiplan Commercial |
$21.65
|
| Rate for Payer: Networks By Design Commercial |
$17.59
|
| Rate for Payer: Prime Health Services Commercial |
$23.00
|
|
