|
HC CATH FOLEY SLCN 24FR 2WY 5CC
|
Facility
|
OP
|
$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: Aetna of CA HMO/PPO |
$26.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.42
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Cigna of CA HMO |
$25.45
|
| Rate for Payer: Cigna of CA PPO |
$29.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.80
|
| 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: Molina Healthcare of CA Medi-Cal |
$27.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.84
|
| 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
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.89
|
| Rate for Payer: United Healthcare All Other HMO |
$19.89
|
| Rate for Payer: United Healthcare HMO Rider |
$19.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.80
|
| Rate for Payer: Vantage Medical Group Senior |
$33.80
|
|
|
HC CATH FOLEY SLCN 24FR 30ML LF
|
Facility
|
IP
|
$32.31
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$27.46 |
| Rate for Payer: Adventist Health Commercial |
$6.46
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.92
|
| Rate for Payer: EPIC Health Plan Senior |
$12.92
|
| Rate for Payer: Galaxy Health WC |
$27.46
|
| Rate for Payer: Global Benefits Group Commercial |
$19.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.75
|
| Rate for Payer: Multiplan Commercial |
$25.85
|
| Rate for Payer: Networks By Design Commercial |
$21.00
|
| Rate for Payer: Prime Health Services Commercial |
$27.46
|
|
|
HC CATH FOLEY SLCN 24FR 30ML LF
|
Facility
|
OP
|
$32.31
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$27.46 |
| Rate for Payer: Adventist Health Commercial |
$6.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.84
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cigna of CA HMO |
$20.68
|
| Rate for Payer: Cigna of CA PPO |
$23.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.92
|
| Rate for Payer: EPIC Health Plan Senior |
$12.92
|
| Rate for Payer: Galaxy Health WC |
$27.46
|
| Rate for Payer: Global Benefits Group Commercial |
$19.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.62
|
| Rate for Payer: Multiplan Commercial |
$25.85
|
| Rate for Payer: Networks By Design Commercial |
$21.00
|
| Rate for Payer: Prime Health Services Commercial |
$27.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.16
|
| Rate for Payer: United Healthcare All Other HMO |
$16.16
|
| Rate for Payer: United Healthcare HMO Rider |
$16.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.46
|
| Rate for Payer: Vantage Medical Group Senior |
$27.46
|
|
|
HC CATH FOLEY SLCN 26FR 2WY 5CC
|
Facility
|
OP
|
$57.65
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$49.00 |
| Rate for Payer: Adventist Health Commercial |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$49.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35.40
|
| Rate for Payer: Cash Price |
$25.94
|
| Rate for Payer: Cigna of CA HMO |
$36.90
|
| Rate for Payer: Cigna of CA PPO |
$42.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$49.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$49.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$49.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.06
|
| Rate for Payer: EPIC Health Plan Senior |
$23.06
|
| Rate for Payer: Galaxy Health WC |
$49.00
|
| Rate for Payer: Global Benefits Group Commercial |
$34.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40.35
|
| Rate for Payer: Multiplan Commercial |
$46.12
|
| Rate for Payer: Networks By Design Commercial |
$37.47
|
| Rate for Payer: Prime Health Services Commercial |
$49.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.82
|
| Rate for Payer: United Healthcare All Other HMO |
$28.82
|
| Rate for Payer: United Healthcare HMO Rider |
$28.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$49.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$49.00
|
| Rate for Payer: Vantage Medical Group Senior |
$49.00
|
|
|
HC CATH FOLEY SLCN 26FR 2WY 5CC
|
Facility
|
IP
|
$57.65
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$49.00 |
| Rate for Payer: Adventist Health Commercial |
$11.53
|
| Rate for Payer: Cash Price |
$25.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.06
|
| Rate for Payer: EPIC Health Plan Senior |
$23.06
|
| Rate for Payer: Galaxy Health WC |
$49.00
|
| Rate for Payer: Global Benefits Group Commercial |
$34.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.84
|
| Rate for Payer: Multiplan Commercial |
$46.12
|
| Rate for Payer: Networks By Design Commercial |
$37.47
|
| Rate for Payer: Prime Health Services Commercial |
$49.00
|
|
|
HC CATH FOLEY SLCN 28FR 2WY 30CC
|
Facility
|
IP
|
$30.42
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.08 |
| Max. Negotiated Rate |
$25.86 |
| Rate for Payer: Adventist Health Commercial |
$6.08
|
| Rate for Payer: Cash Price |
$13.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.17
|
| Rate for Payer: EPIC Health Plan Senior |
$12.17
|
| Rate for Payer: Galaxy Health WC |
$25.86
|
| Rate for Payer: Global Benefits Group Commercial |
$18.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.30
|
| Rate for Payer: Multiplan Commercial |
$24.34
|
| Rate for Payer: Networks By Design Commercial |
$19.77
|
| Rate for Payer: Prime Health Services Commercial |
$25.86
|
|
|
HC CATH FOLEY SLCN 28FR 2WY 30CC
|
Facility
|
OP
|
$30.42
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.08 |
| Max. Negotiated Rate |
$25.86 |
| Rate for Payer: Adventist Health Commercial |
$6.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.68
|
| Rate for Payer: Cash Price |
$13.69
|
| Rate for Payer: Cigna of CA HMO |
$19.47
|
| Rate for Payer: Cigna of CA PPO |
$22.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.17
|
| Rate for Payer: EPIC Health Plan Senior |
$12.17
|
| Rate for Payer: Galaxy Health WC |
$25.86
|
| Rate for Payer: Global Benefits Group Commercial |
$18.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.29
|
| Rate for Payer: Multiplan Commercial |
$24.34
|
| Rate for Payer: Networks By Design Commercial |
$19.77
|
| Rate for Payer: Prime Health Services Commercial |
$25.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.21
|
| Rate for Payer: United Healthcare All Other HMO |
$15.21
|
| Rate for Payer: United Healthcare HMO Rider |
$15.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.86
|
| Rate for Payer: Vantage Medical Group Senior |
$25.86
|
|
|
HC CATH FOLEY SLCN 6FR 1.5CC
|
Facility
|
IP
|
$131.78
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901602794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.36 |
| Max. Negotiated Rate |
$112.01 |
| Rate for Payer: Adventist Health Commercial |
$26.36
|
| Rate for Payer: Cash Price |
$59.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.71
|
| Rate for Payer: EPIC Health Plan Senior |
$52.71
|
| Rate for Payer: Galaxy Health WC |
$112.01
|
| Rate for Payer: Global Benefits Group Commercial |
$79.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$87.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.63
|
| Rate for Payer: Multiplan Commercial |
$105.42
|
| Rate for Payer: Networks By Design Commercial |
$85.66
|
| Rate for Payer: Prime Health Services Commercial |
$112.01
|
|
|
HC CATH FOLEY SLCN 6FR 1.5CC
|
Facility
|
OP
|
$131.78
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901602794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.36 |
| Max. Negotiated Rate |
$112.01 |
| Rate for Payer: Adventist Health Commercial |
$26.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$86.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$112.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$72.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$98.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80.93
|
| Rate for Payer: Cash Price |
$59.30
|
| Rate for Payer: Cigna of CA HMO |
$84.34
|
| Rate for Payer: Cigna of CA PPO |
$97.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$112.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$112.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$112.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.71
|
| Rate for Payer: EPIC Health Plan Senior |
$52.71
|
| Rate for Payer: Galaxy Health WC |
$112.01
|
| Rate for Payer: Global Benefits Group Commercial |
$79.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$87.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$92.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$92.25
|
| Rate for Payer: Multiplan Commercial |
$105.42
|
| Rate for Payer: Networks By Design Commercial |
$85.66
|
| Rate for Payer: Prime Health Services Commercial |
$112.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$79.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$65.89
|
| Rate for Payer: United Healthcare All Other HMO |
$65.89
|
| Rate for Payer: United Healthcare HMO Rider |
$65.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$65.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$112.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$112.01
|
| Rate for Payer: Vantage Medical Group Senior |
$112.01
|
|
|
HC CATH FOLEY SLCN 6FR 2WAY 1.5CC
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698667
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$28.30 |
| Rate for Payer: Adventist Health Commercial |
$6.66
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.32
|
| Rate for Payer: EPIC Health Plan Senior |
$13.32
|
| Rate for Payer: Galaxy Health WC |
$28.30
|
| Rate for Payer: Global Benefits Group Commercial |
$19.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.99
|
| Rate for Payer: Multiplan Commercial |
$26.63
|
| Rate for Payer: Networks By Design Commercial |
$21.64
|
| Rate for Payer: Prime Health Services Commercial |
$28.30
|
|
|
HC CATH FOLEY SLCN 6FR 2WAY 1.5CC
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698667
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$28.30 |
| Rate for Payer: Adventist Health Commercial |
$6.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.44
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cigna of CA HMO |
$21.31
|
| Rate for Payer: Cigna of CA PPO |
$24.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.32
|
| Rate for Payer: EPIC Health Plan Senior |
$13.32
|
| Rate for Payer: Galaxy Health WC |
$28.30
|
| Rate for Payer: Global Benefits Group Commercial |
$19.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.30
|
| Rate for Payer: Multiplan Commercial |
$26.63
|
| Rate for Payer: Networks By Design Commercial |
$21.64
|
| Rate for Payer: Prime Health Services Commercial |
$28.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.64
|
| Rate for Payer: United Healthcare All Other HMO |
$16.64
|
| Rate for Payer: United Healthcare HMO Rider |
$16.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.30
|
| Rate for Payer: Vantage Medical Group Senior |
$28.30
|
|
|
HC CATH FUHRMAN 10.2FR DRAIN SET
|
Facility
|
OP
|
$596.90
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$119.38 |
| Max. Negotiated Rate |
$507.37 |
| Rate for Payer: Adventist Health Commercial |
$119.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$507.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$328.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$447.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$345.72
|
| Rate for Payer: Blue Shield of California Commercial |
$440.51
|
| Rate for Payer: Blue Shield of California EPN |
$290.09
|
| Rate for Payer: Cash Price |
$268.60
|
| Rate for Payer: Cigna of CA HMO |
$417.83
|
| Rate for Payer: Cigna of CA PPO |
$417.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$507.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$507.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$238.76
|
| Rate for Payer: EPIC Health Plan Senior |
$238.76
|
| Rate for Payer: Galaxy Health WC |
$507.37
|
| Rate for Payer: Global Benefits Group Commercial |
$358.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$369.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$417.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$417.83
|
| Rate for Payer: Multiplan Commercial |
$477.52
|
| Rate for Payer: Networks By Design Commercial |
$298.45
|
| Rate for Payer: Prime Health Services Commercial |
$507.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$358.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$224.02
|
| Rate for Payer: United Healthcare All Other HMO |
$218.05
|
| Rate for Payer: United Healthcare HMO Rider |
$213.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$195.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$507.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$507.37
|
| Rate for Payer: Vantage Medical Group Senior |
$507.37
|
|
|
HC CATH FUHRMAN 10.2FR DRAIN SET
|
Facility
|
IP
|
$596.90
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$119.38 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$119.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$268.60
|
| Rate for Payer: Cash Price |
$268.60
|
| Rate for Payer: Cigna of CA HMO |
$417.83
|
| Rate for Payer: Cigna of CA PPO |
$417.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$238.76
|
| Rate for Payer: EPIC Health Plan Senior |
$238.76
|
| Rate for Payer: Galaxy Health WC |
$507.37
|
| Rate for Payer: Global Benefits Group Commercial |
$358.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$369.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.26
|
| Rate for Payer: Multiplan Commercial |
$477.52
|
| Rate for Payer: Networks By Design Commercial |
$298.45
|
| Rate for Payer: Prime Health Services Commercial |
$507.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$224.02
|
| Rate for Payer: United Healthcare All Other HMO |
$218.05
|
| Rate for Payer: United Healthcare HMO Rider |
$213.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$195.48
|
|
|
HC CATH GUIDE CELLO
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909031887
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
|
|
HC CATH GUIDE CELLO
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909031887
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,258.88
|
| Rate for Payer: Blue Shield of California Commercial |
$2,878.20
|
| Rate for Payer: Blue Shield of California EPN |
$1,895.40
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC CATH GUIDT RAPIDO ADVANCE
|
Facility
|
OP
|
$1,062.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$902.70 |
| Rate for Payer: Adventist Health Commercial |
$212.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$696.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$902.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$584.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$796.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$652.17
|
| Rate for Payer: Cash Price |
$477.90
|
| Rate for Payer: Cigna of CA HMO |
$679.68
|
| Rate for Payer: Cigna of CA PPO |
$785.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$902.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$902.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$902.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$424.80
|
| Rate for Payer: EPIC Health Plan Senior |
$424.80
|
| Rate for Payer: Galaxy Health WC |
$902.70
|
| Rate for Payer: Global Benefits Group Commercial |
$637.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$708.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$404.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$657.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$254.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$743.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$743.40
|
| Rate for Payer: Multiplan Commercial |
$849.60
|
| Rate for Payer: Networks By Design Commercial |
$690.30
|
| Rate for Payer: Prime Health Services Commercial |
$902.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$637.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$637.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$531.00
|
| Rate for Payer: United Healthcare All Other HMO |
$531.00
|
| Rate for Payer: United Healthcare HMO Rider |
$531.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$531.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$902.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$902.70
|
| Rate for Payer: Vantage Medical Group Senior |
$902.70
|
|
|
HC CATH GUIDT RAPIDO ADVANCE
|
Facility
|
IP
|
$1,062.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812320
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.40 |
| Max. Negotiated Rate |
$902.70 |
| Rate for Payer: Adventist Health Commercial |
$212.40
|
| Rate for Payer: Cash Price |
$477.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$424.80
|
| Rate for Payer: EPIC Health Plan Senior |
$424.80
|
| Rate for Payer: Galaxy Health WC |
$902.70
|
| Rate for Payer: Global Benefits Group Commercial |
$637.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$708.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$404.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$657.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$254.88
|
| Rate for Payer: Multiplan Commercial |
$849.60
|
| Rate for Payer: Networks By Design Commercial |
$690.30
|
| Rate for Payer: Prime Health Services Commercial |
$902.70
|
|
|
HC CATH GUIDT RAPIDO CUT-AWAY
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812321
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$382.50 |
| Rate for Payer: Adventist Health Commercial |
$90.00
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Senior |
$180.00
|
| Rate for Payer: Galaxy Health WC |
$382.50
|
| Rate for Payer: Global Benefits Group Commercial |
$270.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$300.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$278.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$108.00
|
| Rate for Payer: Multiplan Commercial |
$360.00
|
| Rate for Payer: Networks By Design Commercial |
$292.50
|
| Rate for Payer: Prime Health Services Commercial |
$382.50
|
|
|
HC CATH GUIDT RAPIDO CUT-AWAY
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812321
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$382.50 |
| Rate for Payer: Adventist Health Commercial |
$90.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$295.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$382.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$247.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$276.35
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Cigna of CA HMO |
$288.00
|
| Rate for Payer: Cigna of CA PPO |
$333.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$382.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$382.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$382.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Senior |
$180.00
|
| Rate for Payer: Galaxy Health WC |
$382.50
|
| Rate for Payer: Global Benefits Group Commercial |
$270.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$300.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$278.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$108.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$315.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$315.00
|
| Rate for Payer: Multiplan Commercial |
$360.00
|
| Rate for Payer: Networks By Design Commercial |
$292.50
|
| Rate for Payer: Prime Health Services Commercial |
$382.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$270.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$270.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO |
$225.00
|
| Rate for Payer: United Healthcare HMO Rider |
$225.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$382.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$382.50
|
| Rate for Payer: Vantage Medical Group Senior |
$382.50
|
|
|
HC CATH GUIDT RAPIDO INNER
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812319
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$382.50 |
| Rate for Payer: Adventist Health Commercial |
$90.00
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Senior |
$180.00
|
| Rate for Payer: Galaxy Health WC |
$382.50
|
| Rate for Payer: Global Benefits Group Commercial |
$270.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$300.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$278.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$108.00
|
| Rate for Payer: Multiplan Commercial |
$360.00
|
| Rate for Payer: Networks By Design Commercial |
$292.50
|
| Rate for Payer: Prime Health Services Commercial |
$382.50
|
|
|
HC CATH GUIDT RAPIDO INNER
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812319
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$382.50 |
| Rate for Payer: Adventist Health Commercial |
$90.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$295.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$382.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$247.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$276.35
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Cigna of CA HMO |
$288.00
|
| Rate for Payer: Cigna of CA PPO |
$333.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$382.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$382.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$382.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Senior |
$180.00
|
| Rate for Payer: Galaxy Health WC |
$382.50
|
| Rate for Payer: Global Benefits Group Commercial |
$270.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$300.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$171.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$278.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$108.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$315.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$315.00
|
| Rate for Payer: Multiplan Commercial |
$360.00
|
| Rate for Payer: Networks By Design Commercial |
$292.50
|
| Rate for Payer: Prime Health Services Commercial |
$382.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$270.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$270.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO |
$225.00
|
| Rate for Payer: United Healthcare HMO Rider |
$225.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$225.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$382.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$382.50
|
| Rate for Payer: Vantage Medical Group Senior |
$382.50
|
|
|
HC CATH GUIDT SWIFT NINJA
|
Facility
|
OP
|
$4,875.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909001769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$4,143.75 |
| Rate for Payer: Adventist Health Commercial |
$975.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,681.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,656.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,823.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3,597.75
|
| Rate for Payer: Blue Shield of California EPN |
$2,369.25
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Cigna of CA HMO |
$3,412.50
|
| Rate for Payer: Cigna of CA PPO |
$3,412.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,143.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,143.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,251.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,857.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,017.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,170.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,412.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,412.50
|
| Rate for Payer: Multiplan Commercial |
$3,900.00
|
| Rate for Payer: Networks By Design Commercial |
$2,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,925.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,925.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,829.59
|
| Rate for Payer: United Healthcare All Other HMO |
$1,780.84
|
| Rate for Payer: United Healthcare HMO Rider |
$1,742.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,596.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,143.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4,143.75
|
|
|
HC CATH GUIDT SWIFT NINJA
|
Facility
|
IP
|
$4,875.00
|
|
|
Service Code
|
CPT C1769
|
| Hospital Charge Code |
909001769
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$975.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Cigna of CA HMO |
$3,412.50
|
| Rate for Payer: Cigna of CA PPO |
$3,412.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,251.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,857.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,017.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,170.00
|
| Rate for Payer: Multiplan Commercial |
$3,900.00
|
| Rate for Payer: Networks By Design Commercial |
$2,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,829.59
|
| Rate for Payer: United Healthcare All Other HMO |
$1,780.84
|
| Rate for Payer: United Healthcare HMO Rider |
$1,742.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,596.56
|
|
|
HC CATH HDA TRAY 12.5FRX16CM
|
Facility
|
IP
|
$922.39
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698320
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$184.48 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$184.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$415.08
|
| Rate for Payer: Cash Price |
$415.08
|
| Rate for Payer: Cigna of CA HMO |
$645.67
|
| Rate for Payer: Cigna of CA PPO |
$645.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$368.96
|
| Rate for Payer: EPIC Health Plan Senior |
$368.96
|
| Rate for Payer: Galaxy Health WC |
$784.03
|
| Rate for Payer: Global Benefits Group Commercial |
$553.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$615.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$351.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$570.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.37
|
| Rate for Payer: Multiplan Commercial |
$737.91
|
| Rate for Payer: Networks By Design Commercial |
$461.19
|
| Rate for Payer: Prime Health Services Commercial |
$784.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$346.17
|
| Rate for Payer: United Healthcare All Other HMO |
$336.95
|
| Rate for Payer: United Healthcare HMO Rider |
$329.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$302.08
|
|
|
HC CATH HDA TRAY 12.5FRX16CM
|
Facility
|
OP
|
$922.39
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698320
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$184.48 |
| Max. Negotiated Rate |
$784.03 |
| Rate for Payer: Adventist Health Commercial |
$184.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$784.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$507.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$691.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$534.25
|
| Rate for Payer: Blue Shield of California Commercial |
$680.72
|
| Rate for Payer: Blue Shield of California EPN |
$448.28
|
| Rate for Payer: Cash Price |
$415.08
|
| Rate for Payer: Cigna of CA HMO |
$645.67
|
| Rate for Payer: Cigna of CA PPO |
$645.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$784.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$784.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$784.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$368.96
|
| Rate for Payer: EPIC Health Plan Senior |
$368.96
|
| Rate for Payer: Galaxy Health WC |
$784.03
|
| Rate for Payer: Global Benefits Group Commercial |
$553.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$615.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$351.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$570.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$645.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$645.67
|
| Rate for Payer: Multiplan Commercial |
$737.91
|
| Rate for Payer: Networks By Design Commercial |
$461.19
|
| Rate for Payer: Prime Health Services Commercial |
$784.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$553.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$553.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$346.17
|
| Rate for Payer: United Healthcare All Other HMO |
$336.95
|
| Rate for Payer: United Healthcare HMO Rider |
$329.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$302.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$784.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$784.03
|
| Rate for Payer: Vantage Medical Group Senior |
$784.03
|
|
