|
HC CATH FOLEY SLCN 12FR 10ML LF
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$21.68 |
| Rate for Payer: Adventist Health Commercial |
$5.10
|
| Rate for Payer: Cash Price |
$11.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.20
|
| Rate for Payer: EPIC Health Plan Senior |
$10.20
|
| Rate for Payer: Galaxy Health WC |
$21.68
|
| Rate for Payer: Global Benefits Group Commercial |
$15.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.12
|
| Rate for Payer: Multiplan Commercial |
$20.40
|
| Rate for Payer: Networks By Design Commercial |
$16.57
|
| Rate for Payer: Prime Health Services Commercial |
$21.68
|
|
|
HC CATH FOLEY SLCN 12FR 10ML LF
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$21.68 |
| Rate for Payer: Adventist Health Commercial |
$5.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.66
|
| Rate for Payer: Cash Price |
$11.47
|
| Rate for Payer: Cigna of CA HMO |
$16.32
|
| Rate for Payer: Cigna of CA PPO |
$18.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.20
|
| Rate for Payer: EPIC Health Plan Senior |
$10.20
|
| Rate for Payer: Galaxy Health WC |
$21.68
|
| Rate for Payer: Global Benefits Group Commercial |
$15.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.85
|
| Rate for Payer: Multiplan Commercial |
$20.40
|
| Rate for Payer: Networks By Design Commercial |
$16.57
|
| Rate for Payer: Prime Health Services Commercial |
$21.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.75
|
| Rate for Payer: United Healthcare All Other HMO |
$12.75
|
| Rate for Payer: United Healthcare HMO Rider |
$12.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.68
|
| Rate for Payer: Vantage Medical Group Senior |
$21.68
|
|
|
HC CATH FOLEY SLCN 14FR 10ML LF
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607519
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$21.82 |
| Rate for Payer: Adventist Health Commercial |
$5.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.76
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cigna of CA HMO |
$16.43
|
| Rate for Payer: Cigna of CA PPO |
$19.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Senior |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.97
|
| Rate for Payer: Multiplan Commercial |
$20.54
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.84
|
| Rate for Payer: United Healthcare All Other HMO |
$12.84
|
| Rate for Payer: United Healthcare HMO Rider |
$12.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.82
|
| Rate for Payer: Vantage Medical Group Senior |
$21.82
|
|
|
HC CATH FOLEY SLCN 14FR 10ML LF
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607519
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$21.82 |
| Rate for Payer: Adventist Health Commercial |
$5.13
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Senior |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.16
|
| Rate for Payer: Multiplan Commercial |
$20.54
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
|
|
HC CATH FOLEY SLCN 16FR 10ML LF
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$21.82 |
| Rate for Payer: Adventist Health Commercial |
$5.13
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Senior |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.16
|
| Rate for Payer: Multiplan Commercial |
$20.54
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
|
|
HC CATH FOLEY SLCN 16FR 10ML LF
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$21.82 |
| Rate for Payer: Adventist Health Commercial |
$5.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.76
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cigna of CA HMO |
$16.43
|
| Rate for Payer: Cigna of CA PPO |
$19.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Senior |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.97
|
| Rate for Payer: Multiplan Commercial |
$20.54
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.84
|
| Rate for Payer: United Healthcare All Other HMO |
$12.84
|
| Rate for Payer: United Healthcare HMO Rider |
$12.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.82
|
| Rate for Payer: Vantage Medical Group Senior |
$21.82
|
|
|
HC CATH FOLEY SLCN 16FR 30ML LF
|
Facility
|
OP
|
$30.50
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$25.93 |
| Rate for Payer: Adventist Health Commercial |
$6.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.73
|
| Rate for Payer: Cash Price |
$13.72
|
| Rate for Payer: Cigna of CA HMO |
$19.52
|
| Rate for Payer: Cigna of CA PPO |
$22.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12.20
|
| Rate for Payer: Galaxy Health WC |
$25.93
|
| Rate for Payer: Global Benefits Group Commercial |
$18.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.35
|
| Rate for Payer: Multiplan Commercial |
$24.40
|
| Rate for Payer: Networks By Design Commercial |
$19.82
|
| Rate for Payer: Prime Health Services Commercial |
$25.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.25
|
| Rate for Payer: United Healthcare All Other HMO |
$15.25
|
| Rate for Payer: United Healthcare HMO Rider |
$15.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: Vantage Medical Group Senior |
$25.93
|
|
|
HC CATH FOLEY SLCN 16FR 30ML LF
|
Facility
|
IP
|
$30.50
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$25.93 |
| Rate for Payer: Adventist Health Commercial |
$6.10
|
| Rate for Payer: Cash Price |
$13.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12.20
|
| Rate for Payer: Galaxy Health WC |
$25.93
|
| Rate for Payer: Global Benefits Group Commercial |
$18.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.32
|
| Rate for Payer: Multiplan Commercial |
$24.40
|
| Rate for Payer: Networks By Design Commercial |
$19.82
|
| Rate for Payer: Prime Health Services Commercial |
$25.93
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5CC
|
Facility
|
OP
|
$70.36
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901605366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.07 |
| Max. Negotiated Rate |
$59.81 |
| Rate for Payer: Adventist Health Commercial |
$14.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$46.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$59.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.21
|
| Rate for Payer: Cash Price |
$31.66
|
| Rate for Payer: Cigna of CA HMO |
$45.03
|
| Rate for Payer: Cigna of CA PPO |
$52.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$59.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$59.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$59.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.14
|
| Rate for Payer: EPIC Health Plan Senior |
$28.14
|
| Rate for Payer: Galaxy Health WC |
$59.81
|
| Rate for Payer: Global Benefits Group Commercial |
$42.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.25
|
| Rate for Payer: Multiplan Commercial |
$56.29
|
| Rate for Payer: Networks By Design Commercial |
$45.73
|
| Rate for Payer: Prime Health Services Commercial |
$59.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$35.18
|
| Rate for Payer: United Healthcare All Other HMO |
$35.18
|
| Rate for Payer: United Healthcare HMO Rider |
$35.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$35.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$59.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$59.81
|
| Rate for Payer: Vantage Medical Group Senior |
$59.81
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5CC
|
Facility
|
IP
|
$70.36
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901605366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.07 |
| Max. Negotiated Rate |
$59.81 |
| Rate for Payer: Adventist Health Commercial |
$14.07
|
| Rate for Payer: Cash Price |
$31.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.14
|
| Rate for Payer: EPIC Health Plan Senior |
$28.14
|
| Rate for Payer: Galaxy Health WC |
$59.81
|
| Rate for Payer: Global Benefits Group Commercial |
$42.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$46.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.89
|
| Rate for Payer: Multiplan Commercial |
$56.29
|
| Rate for Payer: Networks By Design Commercial |
$45.73
|
| Rate for Payer: Prime Health Services Commercial |
$59.81
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5ML
|
Facility
|
IP
|
$111.64
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698402
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.33 |
| Max. Negotiated Rate |
$94.89 |
| Rate for Payer: Adventist Health Commercial |
$22.33
|
| Rate for Payer: Cash Price |
$50.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.66
|
| Rate for Payer: EPIC Health Plan Senior |
$44.66
|
| Rate for Payer: Galaxy Health WC |
$94.89
|
| Rate for Payer: Global Benefits Group Commercial |
$66.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.79
|
| Rate for Payer: Multiplan Commercial |
$89.31
|
| Rate for Payer: Networks By Design Commercial |
$72.57
|
| Rate for Payer: Prime Health Services Commercial |
$94.89
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5ML
|
Facility
|
OP
|
$111.64
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698402
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.33 |
| Max. Negotiated Rate |
$94.89 |
| Rate for Payer: Adventist Health Commercial |
$22.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$73.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$94.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$61.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.56
|
| Rate for Payer: Cash Price |
$50.24
|
| Rate for Payer: Cigna of CA HMO |
$71.45
|
| Rate for Payer: Cigna of CA PPO |
$82.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$94.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$94.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$94.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.66
|
| Rate for Payer: EPIC Health Plan Senior |
$44.66
|
| Rate for Payer: Galaxy Health WC |
$94.89
|
| Rate for Payer: Global Benefits Group Commercial |
$66.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$74.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$42.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78.15
|
| Rate for Payer: Multiplan Commercial |
$89.31
|
| Rate for Payer: Networks By Design Commercial |
$72.57
|
| Rate for Payer: Prime Health Services Commercial |
$94.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.82
|
| Rate for Payer: United Healthcare All Other HMO |
$55.82
|
| Rate for Payer: United Healthcare HMO Rider |
$55.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$94.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$94.89
|
| Rate for Payer: Vantage Medical Group Senior |
$94.89
|
|
|
HC CATH FOLEY SLCN 18FR 10ML LF
|
Facility
|
IP
|
$25.75
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$21.89 |
| Rate for Payer: Adventist Health Commercial |
$5.15
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$21.89
|
| Rate for Payer: Global Benefits Group Commercial |
$15.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.18
|
| Rate for Payer: Multiplan Commercial |
$20.60
|
| Rate for Payer: Networks By Design Commercial |
$16.74
|
| Rate for Payer: Prime Health Services Commercial |
$21.89
|
|
|
HC CATH FOLEY SLCN 18FR 10ML LF
|
Facility
|
OP
|
$25.75
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$21.89 |
| Rate for Payer: Adventist Health Commercial |
$5.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.81
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: Cigna of CA HMO |
$16.48
|
| Rate for Payer: Cigna of CA PPO |
$19.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$21.89
|
| Rate for Payer: Global Benefits Group Commercial |
$15.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.02
|
| Rate for Payer: Multiplan Commercial |
$20.60
|
| Rate for Payer: Networks By Design Commercial |
$16.74
|
| Rate for Payer: Prime Health Services Commercial |
$21.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO |
$12.88
|
| Rate for Payer: United Healthcare HMO Rider |
$12.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.89
|
| Rate for Payer: Vantage Medical Group Senior |
$21.89
|
|
|
HC CATH FOLEY SLCN 18FR 2WY30CC
|
Facility
|
OP
|
$53.05
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$45.09 |
| Rate for Payer: Adventist Health Commercial |
$10.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$45.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.58
|
| Rate for Payer: Cash Price |
$23.87
|
| Rate for Payer: Cigna of CA HMO |
$33.95
|
| Rate for Payer: Cigna of CA PPO |
$39.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$45.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$45.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.22
|
| Rate for Payer: EPIC Health Plan Senior |
$21.22
|
| Rate for Payer: Galaxy Health WC |
$45.09
|
| Rate for Payer: Global Benefits Group Commercial |
$31.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37.13
|
| Rate for Payer: Multiplan Commercial |
$42.44
|
| Rate for Payer: Networks By Design Commercial |
$34.48
|
| Rate for Payer: Prime Health Services Commercial |
$45.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.52
|
| Rate for Payer: United Healthcare All Other HMO |
$26.52
|
| Rate for Payer: United Healthcare HMO Rider |
$26.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$45.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.09
|
| Rate for Payer: Vantage Medical Group Senior |
$45.09
|
|
|
HC CATH FOLEY SLCN 18FR 2WY30CC
|
Facility
|
IP
|
$53.05
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$45.09 |
| Rate for Payer: Adventist Health Commercial |
$10.61
|
| Rate for Payer: Cash Price |
$23.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.22
|
| Rate for Payer: EPIC Health Plan Senior |
$21.22
|
| Rate for Payer: Galaxy Health WC |
$45.09
|
| Rate for Payer: Global Benefits Group Commercial |
$31.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.73
|
| Rate for Payer: Multiplan Commercial |
$42.44
|
| Rate for Payer: Networks By Design Commercial |
$34.48
|
| Rate for Payer: Prime Health Services Commercial |
$45.09
|
|
|
HC CATH FOLEY SLCN 20FR 10ML LF
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607389
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$21.82 |
| Rate for Payer: Adventist Health Commercial |
$5.13
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Senior |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.16
|
| Rate for Payer: Multiplan Commercial |
$20.54
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
|
|
HC CATH FOLEY SLCN 20FR 10ML LF
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607389
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$21.82 |
| Rate for Payer: Adventist Health Commercial |
$5.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.76
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cigna of CA HMO |
$16.43
|
| Rate for Payer: Cigna of CA PPO |
$19.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Senior |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.97
|
| Rate for Payer: Multiplan Commercial |
$20.54
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.84
|
| Rate for Payer: United Healthcare All Other HMO |
$12.84
|
| Rate for Payer: United Healthcare HMO Rider |
$12.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.82
|
| Rate for Payer: Vantage Medical Group Senior |
$21.82
|
|
|
HC CATH FOLEY SLCN 20FR 30ML LF
|
Facility
|
OP
|
$30.34
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$25.79 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.63
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Cigna of CA HMO |
$19.42
|
| Rate for Payer: Cigna of CA PPO |
$22.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Senior |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.24
|
| Rate for Payer: Multiplan Commercial |
$24.27
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.17
|
| Rate for Payer: United Healthcare All Other HMO |
$15.17
|
| Rate for Payer: United Healthcare HMO Rider |
$15.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.79
|
| Rate for Payer: Vantage Medical Group Senior |
$25.79
|
|
|
HC CATH FOLEY SLCN 20FR 30ML LF
|
Facility
|
IP
|
$30.34
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$25.79 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Senior |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Multiplan Commercial |
$24.27
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
|
|
HC CATH FOLEY SLCN 22FR 10ML LF
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607388
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$21.82 |
| Rate for Payer: Adventist Health Commercial |
$5.13
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Senior |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.16
|
| Rate for Payer: Multiplan Commercial |
$20.54
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
|
|
HC CATH FOLEY SLCN 22FR 10ML LF
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607388
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$21.82 |
| Rate for Payer: Adventist Health Commercial |
$5.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.76
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cigna of CA HMO |
$16.43
|
| Rate for Payer: Cigna of CA PPO |
$19.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Senior |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.97
|
| Rate for Payer: Multiplan Commercial |
$20.54
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.84
|
| Rate for Payer: United Healthcare All Other HMO |
$12.84
|
| Rate for Payer: United Healthcare HMO Rider |
$12.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.82
|
| Rate for Payer: Vantage Medical Group Senior |
$21.82
|
|
|
HC CATH FOLEY SLCN 22FR 2WY 30C
|
Facility
|
IP
|
$31.65
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$26.90 |
| Rate for Payer: Adventist Health Commercial |
$6.33
|
| Rate for Payer: Cash Price |
$14.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.66
|
| Rate for Payer: EPIC Health Plan Senior |
$12.66
|
| Rate for Payer: Galaxy Health WC |
$26.90
|
| Rate for Payer: Global Benefits Group Commercial |
$18.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.60
|
| Rate for Payer: Multiplan Commercial |
$25.32
|
| Rate for Payer: Networks By Design Commercial |
$20.57
|
| Rate for Payer: Prime Health Services Commercial |
$26.90
|
|
|
HC CATH FOLEY SLCN 22FR 2WY 30C
|
Facility
|
OP
|
$31.65
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$26.90 |
| Rate for Payer: Adventist Health Commercial |
$6.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.44
|
| Rate for Payer: Cash Price |
$14.24
|
| Rate for Payer: Cigna of CA HMO |
$20.26
|
| Rate for Payer: Cigna of CA PPO |
$23.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.66
|
| Rate for Payer: EPIC Health Plan Senior |
$12.66
|
| Rate for Payer: Galaxy Health WC |
$26.90
|
| Rate for Payer: Global Benefits Group Commercial |
$18.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.16
|
| Rate for Payer: Multiplan Commercial |
$25.32
|
| Rate for Payer: Networks By Design Commercial |
$20.57
|
| Rate for Payer: Prime Health Services Commercial |
$26.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.82
|
| Rate for Payer: United Healthcare All Other HMO |
$15.82
|
| Rate for Payer: United Healthcare HMO Rider |
$15.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.90
|
| Rate for Payer: Vantage Medical Group Senior |
$26.90
|
|
|
HC CATH FOLEY SLCN 24FR 2WY 5CC
|
Facility
|
IP
|
$39.77
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$33.80 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.91
|
| Rate for Payer: EPIC Health Plan Senior |
$15.91
|
| Rate for Payer: Galaxy Health WC |
$33.80
|
| Rate for Payer: Global Benefits Group Commercial |
$23.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.54
|
| Rate for Payer: Multiplan Commercial |
$31.82
|
| Rate for Payer: Networks By Design Commercial |
$25.85
|
| Rate for Payer: Prime Health Services Commercial |
$33.80
|
|
