|
HC CATH HICKMAN 7FR
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602466
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,508.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,412.43
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH HICKMAN 7FR EXT SEGMENT
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901603661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,332.16
|
| Rate for Payer: Blue Shield of California Commercial |
$1,697.40
|
| Rate for Payer: Blue Shield of California EPN |
$1,117.80
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH HICKMAN 7FR EXT SEGMENT
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901603661
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
|
|
HC CATH HICKMAN 9-10FR RPR SGMNT
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602465
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC CATH HICKMAN 9-10FR RPR SGMNT
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602465
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$335.94
|
| Rate for Payer: Blue Shield of California Commercial |
$428.04
|
| Rate for Payer: Blue Shield of California EPN |
$281.88
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH HMDYLYS KIT 8FR 2LUMEN
|
Facility
|
IP
|
$440.86
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698866
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.17 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$88.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$198.39
|
| Rate for Payer: Cash Price |
$198.39
|
| Rate for Payer: Cigna of CA HMO |
$308.60
|
| Rate for Payer: Cigna of CA PPO |
$308.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.34
|
| Rate for Payer: EPIC Health Plan Senior |
$176.34
|
| Rate for Payer: Galaxy Health WC |
$374.73
|
| Rate for Payer: Global Benefits Group Commercial |
$264.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$294.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$167.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$272.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.81
|
| Rate for Payer: Multiplan Commercial |
$352.69
|
| Rate for Payer: Networks By Design Commercial |
$220.43
|
| Rate for Payer: Prime Health Services Commercial |
$374.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$165.45
|
| Rate for Payer: United Healthcare All Other HMO |
$161.05
|
| Rate for Payer: United Healthcare HMO Rider |
$157.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.38
|
|
|
HC CATH HMDYLYS KIT 8FR 2LUMEN
|
Facility
|
OP
|
$440.86
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698866
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.17 |
| Max. Negotiated Rate |
$374.73 |
| Rate for Payer: Adventist Health Commercial |
$88.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$374.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$242.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$330.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$255.35
|
| Rate for Payer: Blue Shield of California Commercial |
$325.35
|
| Rate for Payer: Blue Shield of California EPN |
$214.26
|
| Rate for Payer: Cash Price |
$198.39
|
| Rate for Payer: Cigna of CA HMO |
$308.60
|
| Rate for Payer: Cigna of CA PPO |
$308.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$374.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$374.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$374.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.34
|
| Rate for Payer: EPIC Health Plan Senior |
$176.34
|
| Rate for Payer: Galaxy Health WC |
$374.73
|
| Rate for Payer: Global Benefits Group Commercial |
$264.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$294.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$167.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$272.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$308.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$308.60
|
| Rate for Payer: Multiplan Commercial |
$352.69
|
| Rate for Payer: Networks By Design Commercial |
$220.43
|
| Rate for Payer: Prime Health Services Commercial |
$374.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$264.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$264.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$165.45
|
| Rate for Payer: United Healthcare All Other HMO |
$161.05
|
| Rate for Payer: United Healthcare HMO Rider |
$157.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$374.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$374.73
|
| Rate for Payer: Vantage Medical Group Senior |
$374.73
|
|
|
HC CATH HYDRO-KIT 16" 12FR COUDE
|
Facility
|
OP
|
$21.48
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$18.26 |
| Rate for Payer: Adventist Health Commercial |
$4.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.19
|
| Rate for Payer: Cash Price |
$9.67
|
| Rate for Payer: Cigna of CA HMO |
$13.75
|
| Rate for Payer: Cigna of CA PPO |
$15.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.59
|
| Rate for Payer: EPIC Health Plan Senior |
$8.59
|
| Rate for Payer: Galaxy Health WC |
$18.26
|
| Rate for Payer: Global Benefits Group Commercial |
$12.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.04
|
| Rate for Payer: Multiplan Commercial |
$17.18
|
| Rate for Payer: Networks By Design Commercial |
$13.96
|
| Rate for Payer: Prime Health Services Commercial |
$18.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.74
|
| Rate for Payer: United Healthcare All Other HMO |
$10.74
|
| Rate for Payer: United Healthcare HMO Rider |
$10.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.26
|
| Rate for Payer: Vantage Medical Group Senior |
$18.26
|
|
|
HC CATH HYDRO-KIT 16" 12FR COUDE
|
Facility
|
IP
|
$21.48
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$18.26 |
| Rate for Payer: Adventist Health Commercial |
$4.30
|
| Rate for Payer: Cash Price |
$9.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.59
|
| Rate for Payer: EPIC Health Plan Senior |
$8.59
|
| Rate for Payer: Galaxy Health WC |
$18.26
|
| Rate for Payer: Global Benefits Group Commercial |
$12.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.16
|
| Rate for Payer: Multiplan Commercial |
$17.18
|
| Rate for Payer: Networks By Design Commercial |
$13.96
|
| Rate for Payer: Prime Health Services Commercial |
$18.26
|
|
|
HC CATH HYDRO-KIT 16" 14FR COUDE
|
Facility
|
OP
|
$34.52
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$29.34 |
| Rate for Payer: Adventist Health Commercial |
$6.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.20
|
| Rate for Payer: Cash Price |
$15.53
|
| Rate for Payer: Cigna of CA HMO |
$22.09
|
| Rate for Payer: Cigna of CA PPO |
$25.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.81
|
| Rate for Payer: EPIC Health Plan Senior |
$13.81
|
| Rate for Payer: Galaxy Health WC |
$29.34
|
| Rate for Payer: Global Benefits Group Commercial |
$20.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.16
|
| Rate for Payer: Multiplan Commercial |
$27.62
|
| Rate for Payer: Networks By Design Commercial |
$22.44
|
| Rate for Payer: Prime Health Services Commercial |
$29.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.26
|
| Rate for Payer: United Healthcare All Other HMO |
$17.26
|
| Rate for Payer: United Healthcare HMO Rider |
$17.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.34
|
| Rate for Payer: Vantage Medical Group Senior |
$29.34
|
|
|
HC CATH HYDRO-KIT 16" 14FR COUDE
|
Facility
|
IP
|
$34.52
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$29.34 |
| Rate for Payer: Adventist Health Commercial |
$6.90
|
| Rate for Payer: Cash Price |
$15.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.81
|
| Rate for Payer: EPIC Health Plan Senior |
$13.81
|
| Rate for Payer: Galaxy Health WC |
$29.34
|
| Rate for Payer: Global Benefits Group Commercial |
$20.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.28
|
| Rate for Payer: Multiplan Commercial |
$27.62
|
| Rate for Payer: Networks By Design Commercial |
$22.44
|
| Rate for Payer: Prime Health Services Commercial |
$29.34
|
|
|
HC CATH IAB LIGHTWAVE
|
Facility
|
IP
|
$3,607.50
|
|
| Hospital Charge Code |
906812383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$721.50 |
| Max. Negotiated Rate |
$3,066.38 |
| Rate for Payer: Adventist Health Commercial |
$721.50
|
| Rate for Payer: Cash Price |
$1,623.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,443.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,443.00
|
| Rate for Payer: Galaxy Health WC |
$3,066.38
|
| Rate for Payer: Global Benefits Group Commercial |
$2,164.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,406.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,374.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,233.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$865.80
|
| Rate for Payer: Multiplan Commercial |
$2,886.00
|
| Rate for Payer: Networks By Design Commercial |
$2,344.88
|
| Rate for Payer: Prime Health Services Commercial |
$3,066.38
|
|
|
HC CATH IAB LIGHTWAVE
|
Facility
|
OP
|
$3,607.50
|
|
| Hospital Charge Code |
906812383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$721.50 |
| Max. Negotiated Rate |
$3,066.38 |
| Rate for Payer: Adventist Health Commercial |
$721.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,366.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,066.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,984.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,705.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,215.37
|
| Rate for Payer: Cash Price |
$1,623.38
|
| Rate for Payer: Cigna of CA HMO |
$2,308.80
|
| Rate for Payer: Cigna of CA PPO |
$2,669.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,066.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,066.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,066.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,443.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,443.00
|
| Rate for Payer: Galaxy Health WC |
$3,066.38
|
| Rate for Payer: Global Benefits Group Commercial |
$2,164.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,406.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,374.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,233.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$865.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,525.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,525.25
|
| Rate for Payer: Multiplan Commercial |
$2,886.00
|
| Rate for Payer: Networks By Design Commercial |
$2,344.88
|
| Rate for Payer: Prime Health Services Commercial |
$3,066.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,164.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,164.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,803.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,803.75
|
| Rate for Payer: United Healthcare HMO Rider |
$1,803.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,803.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,066.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,066.38
|
| Rate for Payer: Vantage Medical Group Senior |
$3,066.38
|
|
|
HC CATH, ICP MONITORING PRESSIO
|
Facility
|
IP
|
$3,802.50
|
|
| Hospital Charge Code |
901698600
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$760.50 |
| Max. Negotiated Rate |
$3,232.12 |
| Rate for Payer: Adventist Health Commercial |
$760.50
|
| Rate for Payer: Cash Price |
$1,711.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,521.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,521.00
|
| Rate for Payer: Galaxy Health WC |
$3,232.12
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,536.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,448.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,353.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$912.60
|
| Rate for Payer: Multiplan Commercial |
$3,042.00
|
| Rate for Payer: Networks By Design Commercial |
$2,471.62
|
| Rate for Payer: Prime Health Services Commercial |
$3,232.12
|
|
|
HC CATH, ICP MONITORING PRESSIO
|
Facility
|
OP
|
$3,802.50
|
|
| Hospital Charge Code |
901698600
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$760.50 |
| Max. Negotiated Rate |
$3,232.12 |
| Rate for Payer: Adventist Health Commercial |
$760.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,494.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,232.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,091.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,851.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,335.12
|
| Rate for Payer: Cash Price |
$1,711.12
|
| Rate for Payer: Cigna of CA HMO |
$2,433.60
|
| Rate for Payer: Cigna of CA PPO |
$2,813.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,232.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,232.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,232.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,521.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,521.00
|
| Rate for Payer: Galaxy Health WC |
$3,232.12
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,536.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,448.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,353.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$912.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,661.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,661.75
|
| Rate for Payer: Multiplan Commercial |
$3,042.00
|
| Rate for Payer: Networks By Design Commercial |
$2,471.62
|
| Rate for Payer: Prime Health Services Commercial |
$3,232.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,281.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,281.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,901.25
|
| Rate for Payer: United Healthcare All Other HMO |
$1,901.25
|
| Rate for Payer: United Healthcare HMO Rider |
$1,901.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,901.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,232.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,232.12
|
| Rate for Payer: Vantage Medical Group Senior |
$3,232.12
|
|
|
HC CATH INDIGO THROM
|
Facility
|
OP
|
$4,875.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000007
|
|
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 INDIGO THROM
|
Facility
|
IP
|
$4,875.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000007
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Multiplan Commercial |
$3,900.00
|
| 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: 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 INFUSION SL 7FR 16CM SL
|
Facility
|
IP
|
$85.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.05 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$17.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Cigna of CA HMO |
$59.69
|
| Rate for Payer: Cigna of CA PPO |
$59.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.11
|
| Rate for Payer: EPIC Health Plan Senior |
$34.11
|
| Rate for Payer: Galaxy Health WC |
$72.48
|
| Rate for Payer: Global Benefits Group Commercial |
$51.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.46
|
| Rate for Payer: Multiplan Commercial |
$68.22
|
| Rate for Payer: Networks By Design Commercial |
$42.63
|
| Rate for Payer: Prime Health Services Commercial |
$72.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31.15
|
| Rate for Payer: United Healthcare HMO Rider |
$30.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.93
|
|
|
HC CATH INFUSION SL 7FR 16CM SL
|
Facility
|
OP
|
$85.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.05 |
| Max. Negotiated Rate |
$72.48 |
| Rate for Payer: Adventist Health Commercial |
$17.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$63.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$49.39
|
| Rate for Payer: Blue Shield of California Commercial |
$62.93
|
| Rate for Payer: Blue Shield of California EPN |
$41.44
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Cigna of CA HMO |
$59.69
|
| Rate for Payer: Cigna of CA PPO |
$59.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$72.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$72.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.11
|
| Rate for Payer: EPIC Health Plan Senior |
$34.11
|
| Rate for Payer: Galaxy Health WC |
$72.48
|
| Rate for Payer: Global Benefits Group Commercial |
$51.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$52.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59.69
|
| Rate for Payer: Multiplan Commercial |
$68.22
|
| Rate for Payer: Networks By Design Commercial |
$42.63
|
| Rate for Payer: Prime Health Services Commercial |
$72.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31.15
|
| Rate for Payer: United Healthcare HMO Rider |
$30.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$72.48
|
| Rate for Payer: Vantage Medical Group Senior |
$72.48
|
|
|
HC CATH INLINE SUCTION 5FR 3.0MM
|
Facility
|
IP
|
$101.69
|
|
| Hospital Charge Code |
901604236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.34 |
| Max. Negotiated Rate |
$86.44 |
| Rate for Payer: Adventist Health Commercial |
$20.34
|
| Rate for Payer: Cash Price |
$45.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.68
|
| Rate for Payer: EPIC Health Plan Senior |
$40.68
|
| Rate for Payer: Galaxy Health WC |
$86.44
|
| Rate for Payer: Global Benefits Group Commercial |
$61.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.41
|
| Rate for Payer: Multiplan Commercial |
$81.35
|
| Rate for Payer: Networks By Design Commercial |
$66.10
|
| Rate for Payer: Prime Health Services Commercial |
$86.44
|
|
|
HC CATH INLINE SUCTION 5FR 3.0MM
|
Facility
|
OP
|
$101.69
|
|
| Hospital Charge Code |
901604236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.34 |
| Max. Negotiated Rate |
$86.44 |
| Rate for Payer: Adventist Health Commercial |
$20.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$66.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$62.45
|
| Rate for Payer: Cash Price |
$45.76
|
| Rate for Payer: Cigna of CA HMO |
$65.08
|
| Rate for Payer: Cigna of CA PPO |
$75.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.68
|
| Rate for Payer: EPIC Health Plan Senior |
$40.68
|
| Rate for Payer: Galaxy Health WC |
$86.44
|
| Rate for Payer: Global Benefits Group Commercial |
$61.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$67.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$38.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$62.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71.18
|
| Rate for Payer: Multiplan Commercial |
$81.35
|
| Rate for Payer: Networks By Design Commercial |
$66.10
|
| Rate for Payer: Prime Health Services Commercial |
$86.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.84
|
| Rate for Payer: United Healthcare All Other HMO |
$50.84
|
| Rate for Payer: United Healthcare HMO Rider |
$50.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.44
|
| Rate for Payer: Vantage Medical Group Senior |
$86.44
|
|
|
HC CATH INTERMITTENT 14FR FEMALE
|
Facility
|
OP
|
$3.20
|
|
| Hospital Charge Code |
901602782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$2.72 |
| Rate for Payer: Adventist Health Commercial |
$0.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.97
|
| Rate for Payer: Cash Price |
$1.44
|
| Rate for Payer: Cigna of CA HMO |
$2.05
|
| Rate for Payer: Cigna of CA PPO |
$2.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.28
|
| Rate for Payer: EPIC Health Plan Senior |
$1.28
|
| Rate for Payer: Galaxy Health WC |
$2.72
|
| Rate for Payer: Global Benefits Group Commercial |
$1.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.24
|
| Rate for Payer: Multiplan Commercial |
$2.56
|
| Rate for Payer: Networks By Design Commercial |
$2.08
|
| Rate for Payer: Prime Health Services Commercial |
$2.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.72
|
| Rate for Payer: Vantage Medical Group Senior |
$2.72
|
|
|
HC CATH INTERMITTENT 14FR FEMALE
|
Facility
|
IP
|
$3.20
|
|
| Hospital Charge Code |
901602782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$2.72 |
| Rate for Payer: Adventist Health Commercial |
$0.64
|
| Rate for Payer: Cash Price |
$1.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.28
|
| Rate for Payer: EPIC Health Plan Senior |
$1.28
|
| Rate for Payer: Galaxy Health WC |
$2.72
|
| Rate for Payer: Global Benefits Group Commercial |
$1.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Multiplan Commercial |
$2.56
|
| Rate for Payer: Networks By Design Commercial |
$2.08
|
| Rate for Payer: Prime Health Services Commercial |
$2.72
|
|
|
HC CATH INTRAAORTIC 7.5FR 40CC
|
Facility
|
OP
|
$3,771.50
|
|
| Hospital Charge Code |
901698487
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$754.30 |
| Max. Negotiated Rate |
$3,205.78 |
| Rate for Payer: Adventist Health Commercial |
$754.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,473.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,205.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,074.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,828.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,316.08
|
| Rate for Payer: Cash Price |
$1,697.17
|
| Rate for Payer: Cigna of CA HMO |
$2,413.76
|
| Rate for Payer: Cigna of CA PPO |
$2,790.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,205.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,205.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,205.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,508.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,508.60
|
| Rate for Payer: Galaxy Health WC |
$3,205.78
|
| Rate for Payer: Global Benefits Group Commercial |
$2,262.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,515.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,436.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,334.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$905.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,640.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,640.05
|
| Rate for Payer: Multiplan Commercial |
$3,017.20
|
| Rate for Payer: Networks By Design Commercial |
$2,451.47
|
| Rate for Payer: Prime Health Services Commercial |
$3,205.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,262.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,262.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,885.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,885.75
|
| Rate for Payer: United Healthcare HMO Rider |
$1,885.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,885.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,205.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,205.78
|
| Rate for Payer: Vantage Medical Group Senior |
$3,205.78
|
|
|
HC CATH INTRAAORTIC 7.5FR 40CC
|
Facility
|
IP
|
$3,771.50
|
|
| Hospital Charge Code |
901698487
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$754.30 |
| Max. Negotiated Rate |
$3,205.78 |
| Rate for Payer: Adventist Health Commercial |
$754.30
|
| Rate for Payer: Cash Price |
$1,697.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,508.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,508.60
|
| Rate for Payer: Galaxy Health WC |
$3,205.78
|
| Rate for Payer: Global Benefits Group Commercial |
$2,262.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,515.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,436.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,334.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$905.16
|
| Rate for Payer: Multiplan Commercial |
$3,017.20
|
| Rate for Payer: Networks By Design Commercial |
$2,451.47
|
| Rate for Payer: Prime Health Services Commercial |
$3,205.78
|
|
