|
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
|
|
|
HC CATH FOLEY 22FR 5CC 2WAY
|
Facility
|
IP
|
$95.38
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$81.07 |
| Rate for Payer: Adventist Health Commercial |
$19.08
|
| Rate for Payer: Cash Price |
$42.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.15
|
| Rate for Payer: EPIC Health Plan Senior |
$38.15
|
| Rate for Payer: Galaxy Health WC |
$81.07
|
| Rate for Payer: Global Benefits Group Commercial |
$57.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.89
|
| Rate for Payer: Multiplan Commercial |
$76.30
|
| Rate for Payer: Networks By Design Commercial |
$62.00
|
| Rate for Payer: Prime Health Services Commercial |
$81.07
|
|
|
HC CATH FOLEY 22FR 5CC 2WAY
|
Facility
|
OP
|
$95.38
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$81.07 |
| Rate for Payer: Adventist Health Commercial |
$19.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$62.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$71.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.57
|
| Rate for Payer: Cash Price |
$42.92
|
| Rate for Payer: Cigna of CA HMO |
$61.04
|
| Rate for Payer: Cigna of CA PPO |
$70.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$81.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.15
|
| Rate for Payer: EPIC Health Plan Senior |
$38.15
|
| Rate for Payer: Galaxy Health WC |
$81.07
|
| Rate for Payer: Global Benefits Group Commercial |
$57.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66.77
|
| Rate for Payer: Multiplan Commercial |
$76.30
|
| Rate for Payer: Networks By Design Commercial |
$62.00
|
| Rate for Payer: Prime Health Services Commercial |
$81.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.69
|
| Rate for Payer: United Healthcare All Other HMO |
$47.69
|
| Rate for Payer: United Healthcare HMO Rider |
$47.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$81.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.07
|
| Rate for Payer: Vantage Medical Group Senior |
$81.07
|
|
|
HC CATH FOLEY 24FR 5CC 2 WAY
|
Facility
|
OP
|
$18.20
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$15.47 |
| Rate for Payer: Adventist Health Commercial |
$3.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.18
|
| Rate for Payer: Cash Price |
$8.19
|
| Rate for Payer: Cigna of CA HMO |
$11.65
|
| Rate for Payer: Cigna of CA PPO |
$13.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.28
|
| Rate for Payer: EPIC Health Plan Senior |
$7.28
|
| Rate for Payer: Galaxy Health WC |
$15.47
|
| Rate for Payer: Global Benefits Group Commercial |
$10.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.74
|
| Rate for Payer: Multiplan Commercial |
$14.56
|
| Rate for Payer: Networks By Design Commercial |
$11.83
|
| Rate for Payer: Prime Health Services Commercial |
$15.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.10
|
| Rate for Payer: United Healthcare All Other HMO |
$9.10
|
| Rate for Payer: United Healthcare HMO Rider |
$9.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.47
|
| Rate for Payer: Vantage Medical Group Senior |
$15.47
|
|
|
HC CATH FOLEY 24FR 5CC 2 WAY
|
Facility
|
IP
|
$18.20
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$15.47 |
| Rate for Payer: Adventist Health Commercial |
$3.64
|
| Rate for Payer: Cash Price |
$8.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.28
|
| Rate for Payer: EPIC Health Plan Senior |
$7.28
|
| Rate for Payer: Galaxy Health WC |
$15.47
|
| Rate for Payer: Global Benefits Group Commercial |
$10.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.37
|
| Rate for Payer: Multiplan Commercial |
$14.56
|
| Rate for Payer: Networks By Design Commercial |
$11.83
|
| Rate for Payer: Prime Health Services Commercial |
$15.47
|
|
|
HC CATH FOLEY 3WAY 16FR 30ML
|
Facility
|
IP
|
$61.66
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698649
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$52.41 |
| Rate for Payer: Adventist Health Commercial |
$12.33
|
| Rate for Payer: Cash Price |
$27.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.66
|
| Rate for Payer: EPIC Health Plan Senior |
$24.66
|
| Rate for Payer: Galaxy Health WC |
$52.41
|
| Rate for Payer: Global Benefits Group Commercial |
$37.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.80
|
| Rate for Payer: Multiplan Commercial |
$49.33
|
| Rate for Payer: Networks By Design Commercial |
$40.08
|
| Rate for Payer: Prime Health Services Commercial |
$52.41
|
|
|
HC CATH FOLEY 3WAY 16FR 30ML
|
Facility
|
OP
|
$61.66
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698649
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$52.41 |
| Rate for Payer: Adventist Health Commercial |
$12.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$46.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.87
|
| Rate for Payer: Cash Price |
$27.75
|
| Rate for Payer: Cigna of CA HMO |
$39.46
|
| Rate for Payer: Cigna of CA PPO |
$45.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$52.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.66
|
| Rate for Payer: EPIC Health Plan Senior |
$24.66
|
| Rate for Payer: Galaxy Health WC |
$52.41
|
| Rate for Payer: Global Benefits Group Commercial |
$37.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$41.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43.16
|
| Rate for Payer: Multiplan Commercial |
$49.33
|
| Rate for Payer: Networks By Design Commercial |
$40.08
|
| Rate for Payer: Prime Health Services Commercial |
$52.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.83
|
| Rate for Payer: United Healthcare All Other HMO |
$30.83
|
| Rate for Payer: United Healthcare HMO Rider |
$30.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.41
|
| Rate for Payer: Vantage Medical Group Senior |
$52.41
|
|
|
HC CATH FOLEY 3WAY 18FR 30ML
|
Facility
|
OP
|
$65.60
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.12 |
| Max. Negotiated Rate |
$55.76 |
| Rate for Payer: Adventist Health Commercial |
$13.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.28
|
| Rate for Payer: Cash Price |
$29.52
|
| Rate for Payer: Cigna of CA HMO |
$41.98
|
| Rate for Payer: Cigna of CA PPO |
$48.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.24
|
| Rate for Payer: EPIC Health Plan Senior |
$26.24
|
| Rate for Payer: Galaxy Health WC |
$55.76
|
| Rate for Payer: Global Benefits Group Commercial |
$39.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.92
|
| Rate for Payer: Multiplan Commercial |
$52.48
|
| Rate for Payer: Networks By Design Commercial |
$42.64
|
| Rate for Payer: Prime Health Services Commercial |
$55.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.80
|
| Rate for Payer: United Healthcare All Other HMO |
$32.80
|
| Rate for Payer: United Healthcare HMO Rider |
$32.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.76
|
| Rate for Payer: Vantage Medical Group Senior |
$55.76
|
|
|
HC CATH FOLEY 3WAY 18FR 30ML
|
Facility
|
IP
|
$65.60
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.12 |
| Max. Negotiated Rate |
$55.76 |
| Rate for Payer: Adventist Health Commercial |
$13.12
|
| Rate for Payer: Cash Price |
$29.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.24
|
| Rate for Payer: EPIC Health Plan Senior |
$26.24
|
| Rate for Payer: Galaxy Health WC |
$55.76
|
| Rate for Payer: Global Benefits Group Commercial |
$39.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.74
|
| Rate for Payer: Multiplan Commercial |
$52.48
|
| Rate for Payer: Networks By Design Commercial |
$42.64
|
| Rate for Payer: Prime Health Services Commercial |
$55.76
|
|
|
HC CATH FOLEY 3WAY 22FR 30ML
|
Facility
|
IP
|
$56.25
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$47.81 |
| Rate for Payer: Adventist Health Commercial |
$11.25
|
| Rate for Payer: Cash Price |
$25.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.50
|
| Rate for Payer: EPIC Health Plan Senior |
$22.50
|
| Rate for Payer: Galaxy Health WC |
$47.81
|
| Rate for Payer: Global Benefits Group Commercial |
$33.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.50
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$36.56
|
| Rate for Payer: Prime Health Services Commercial |
$47.81
|
|
|
HC CATH FOLEY 3WAY 22FR 30ML
|
Facility
|
OP
|
$56.25
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$47.81 |
| Rate for Payer: Adventist Health Commercial |
$11.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.54
|
| Rate for Payer: Cash Price |
$25.31
|
| Rate for Payer: Cigna of CA HMO |
$36.00
|
| Rate for Payer: Cigna of CA PPO |
$41.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.50
|
| Rate for Payer: EPIC Health Plan Senior |
$22.50
|
| Rate for Payer: Galaxy Health WC |
$47.81
|
| Rate for Payer: Global Benefits Group Commercial |
$33.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.38
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$36.56
|
| Rate for Payer: Prime Health Services Commercial |
$47.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.12
|
| Rate for Payer: United Healthcare All Other HMO |
$28.12
|
| Rate for Payer: United Healthcare HMO Rider |
$28.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.81
|
| Rate for Payer: Vantage Medical Group Senior |
$47.81
|
|
|
HC CATH FOLEY 3WAY 24FR 30ML
|
Facility
|
IP
|
$65.11
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607382
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.02 |
| Max. Negotiated Rate |
$55.34 |
| Rate for Payer: Adventist Health Commercial |
$13.02
|
| Rate for Payer: Cash Price |
$29.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.04
|
| Rate for Payer: EPIC Health Plan Senior |
$26.04
|
| Rate for Payer: Galaxy Health WC |
$55.34
|
| Rate for Payer: Global Benefits Group Commercial |
$39.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.63
|
| Rate for Payer: Multiplan Commercial |
$52.09
|
| Rate for Payer: Networks By Design Commercial |
$42.32
|
| Rate for Payer: Prime Health Services Commercial |
$55.34
|
|
|
HC CATH FOLEY 3WAY 24FR 30ML
|
Facility
|
OP
|
$65.11
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607382
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.02 |
| Max. Negotiated Rate |
$55.34 |
| Rate for Payer: Adventist Health Commercial |
$13.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39.98
|
| Rate for Payer: Cash Price |
$29.30
|
| Rate for Payer: Cigna of CA HMO |
$41.67
|
| Rate for Payer: Cigna of CA PPO |
$48.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.04
|
| Rate for Payer: EPIC Health Plan Senior |
$26.04
|
| Rate for Payer: Galaxy Health WC |
$55.34
|
| Rate for Payer: Global Benefits Group Commercial |
$39.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.58
|
| Rate for Payer: Multiplan Commercial |
$52.09
|
| Rate for Payer: Networks By Design Commercial |
$42.32
|
| Rate for Payer: Prime Health Services Commercial |
$55.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.55
|
| Rate for Payer: United Healthcare All Other HMO |
$32.55
|
| Rate for Payer: United Healthcare HMO Rider |
$32.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.34
|
| Rate for Payer: Vantage Medical Group Senior |
$55.34
|
|
|
HC CATH FOLEY 6FR LF
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901606996
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC CATH FOLEY 6FR LF
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901606996
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.36
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC CATH FOLEY 8FR 3ML 2WAY PEDS
|
Facility
|
OP
|
$36.82
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$31.30 |
| Rate for Payer: Adventist Health Commercial |
$7.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.61
|
| Rate for Payer: Cash Price |
$16.57
|
| Rate for Payer: Cigna of CA HMO |
$23.56
|
| Rate for Payer: Cigna of CA PPO |
$27.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.73
|
| Rate for Payer: EPIC Health Plan Senior |
$14.73
|
| Rate for Payer: Galaxy Health WC |
$31.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.77
|
| Rate for Payer: Multiplan Commercial |
$29.46
|
| Rate for Payer: Networks By Design Commercial |
$23.93
|
| Rate for Payer: Prime Health Services Commercial |
$31.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.41
|
| Rate for Payer: United Healthcare All Other HMO |
$18.41
|
| Rate for Payer: United Healthcare HMO Rider |
$18.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.30
|
| Rate for Payer: Vantage Medical Group Senior |
$31.30
|
|
|
HC CATH FOLEY 8FR 3ML 2WAY PEDS
|
Facility
|
IP
|
$36.82
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$31.30 |
| Rate for Payer: Adventist Health Commercial |
$7.36
|
| Rate for Payer: Cash Price |
$16.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.73
|
| Rate for Payer: EPIC Health Plan Senior |
$14.73
|
| Rate for Payer: Galaxy Health WC |
$31.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.84
|
| Rate for Payer: Multiplan Commercial |
$29.46
|
| Rate for Payer: Networks By Design Commercial |
$23.93
|
| Rate for Payer: Prime Health Services Commercial |
$31.30
|
|
|
HC CATH FOLEY COUDE 14FR 15CC
|
Facility
|
OP
|
$32.06
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$27.25 |
| Rate for Payer: Adventist Health Commercial |
$6.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.69
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: Cigna of CA HMO |
$20.52
|
| Rate for Payer: Cigna of CA PPO |
$23.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Senior |
$12.82
|
| Rate for Payer: Galaxy Health WC |
$27.25
|
| Rate for Payer: Global Benefits Group Commercial |
$19.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.44
|
| Rate for Payer: Multiplan Commercial |
$25.65
|
| Rate for Payer: Networks By Design Commercial |
$20.84
|
| Rate for Payer: Prime Health Services Commercial |
$27.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.03
|
| Rate for Payer: United Healthcare All Other HMO |
$16.03
|
| Rate for Payer: United Healthcare HMO Rider |
$16.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.25
|
| Rate for Payer: Vantage Medical Group Senior |
$27.25
|
|
|
HC CATH FOLEY COUDE 14FR 15CC
|
Facility
|
IP
|
$32.06
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$27.25 |
| Rate for Payer: Adventist Health Commercial |
$6.41
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Senior |
$12.82
|
| Rate for Payer: Galaxy Health WC |
$27.25
|
| Rate for Payer: Global Benefits Group Commercial |
$19.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.69
|
| Rate for Payer: Multiplan Commercial |
$25.65
|
| Rate for Payer: Networks By Design Commercial |
$20.84
|
| Rate for Payer: Prime Health Services Commercial |
$27.25
|
|
|
HC CATH FOLEY COUDE 16FR 10ML
|
Facility
|
IP
|
$39.69
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.94 |
| Max. Negotiated Rate |
$33.74 |
| Rate for Payer: Adventist Health Commercial |
$7.94
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.88
|
| Rate for Payer: EPIC Health Plan Senior |
$15.88
|
| Rate for Payer: Galaxy Health WC |
$33.74
|
| Rate for Payer: Global Benefits Group Commercial |
$23.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.53
|
| Rate for Payer: Multiplan Commercial |
$31.75
|
| Rate for Payer: Networks By Design Commercial |
$25.80
|
| Rate for Payer: Prime Health Services Commercial |
$33.74
|
|
|
HC CATH FOLEY COUDE 16FR 10ML
|
Facility
|
OP
|
$39.69
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.94 |
| Max. Negotiated Rate |
$33.74 |
| Rate for Payer: Adventist Health Commercial |
$7.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.37
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Cigna of CA HMO |
$25.40
|
| Rate for Payer: Cigna of CA PPO |
$29.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.88
|
| Rate for Payer: EPIC Health Plan Senior |
$15.88
|
| Rate for Payer: Galaxy Health WC |
$33.74
|
| Rate for Payer: Global Benefits Group Commercial |
$23.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.78
|
| Rate for Payer: Multiplan Commercial |
$31.75
|
| Rate for Payer: Networks By Design Commercial |
$25.80
|
| Rate for Payer: Prime Health Services Commercial |
$33.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.84
|
| Rate for Payer: United Healthcare All Other HMO |
$19.84
|
| Rate for Payer: United Healthcare HMO Rider |
$19.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.74
|
| Rate for Payer: Vantage Medical Group Senior |
$33.74
|
|
|
HC CATH FOLEY COUDE 16FR 5-15CC
|
Facility
|
IP
|
$32.06
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604698
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$27.25 |
| Rate for Payer: Adventist Health Commercial |
$6.41
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Senior |
$12.82
|
| Rate for Payer: Galaxy Health WC |
$27.25
|
| Rate for Payer: Global Benefits Group Commercial |
$19.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.69
|
| Rate for Payer: Multiplan Commercial |
$25.65
|
| Rate for Payer: Networks By Design Commercial |
$20.84
|
| Rate for Payer: Prime Health Services Commercial |
$27.25
|
|
|
HC CATH FOLEY COUDE 16FR 5-15CC
|
Facility
|
OP
|
$32.06
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604698
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$27.25 |
| Rate for Payer: Adventist Health Commercial |
$6.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.69
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: Cigna of CA HMO |
$20.52
|
| Rate for Payer: Cigna of CA PPO |
$23.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Senior |
$12.82
|
| Rate for Payer: Galaxy Health WC |
$27.25
|
| Rate for Payer: Global Benefits Group Commercial |
$19.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.44
|
| Rate for Payer: Multiplan Commercial |
$25.65
|
| Rate for Payer: Networks By Design Commercial |
$20.84
|
| Rate for Payer: Prime Health Services Commercial |
$27.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.03
|
| Rate for Payer: United Healthcare All Other HMO |
$16.03
|
| Rate for Payer: United Healthcare HMO Rider |
$16.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.25
|
| Rate for Payer: Vantage Medical Group Senior |
$27.25
|
|
|
HC CATH FOLEY COUDE 18FR 5-15CC
|
Facility
|
OP
|
$32.06
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$27.25 |
| Rate for Payer: Adventist Health Commercial |
$6.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.69
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: Cigna of CA HMO |
$20.52
|
| Rate for Payer: Cigna of CA PPO |
$23.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Senior |
$12.82
|
| Rate for Payer: Galaxy Health WC |
$27.25
|
| Rate for Payer: Global Benefits Group Commercial |
$19.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.44
|
| Rate for Payer: Multiplan Commercial |
$25.65
|
| Rate for Payer: Networks By Design Commercial |
$20.84
|
| Rate for Payer: Prime Health Services Commercial |
$27.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.03
|
| Rate for Payer: United Healthcare All Other HMO |
$16.03
|
| Rate for Payer: United Healthcare HMO Rider |
$16.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.25
|
| Rate for Payer: Vantage Medical Group Senior |
$27.25
|
|
|
HC CATH FOLEY COUDE 18FR 5-15CC
|
Facility
|
IP
|
$32.06
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$27.25 |
| Rate for Payer: Adventist Health Commercial |
$6.41
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Senior |
$12.82
|
| Rate for Payer: Galaxy Health WC |
$27.25
|
| Rate for Payer: Global Benefits Group Commercial |
$19.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.69
|
| Rate for Payer: Multiplan Commercial |
$25.65
|
| Rate for Payer: Networks By Design Commercial |
$20.84
|
| Rate for Payer: Prime Health Services Commercial |
$27.25
|
|
