|
HC CATH INTRAAORTIC 7FR 30CC
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
901698488
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| 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 |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC CATH INTRAAORTIC 7FR 30CC
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
901698488
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,558.01
|
| 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 |
$2,394.99
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| 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 |
$2,535.00
|
| 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 |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| 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 INTRAAORTIC 8FR 50CC
|
Facility
|
IP
|
$3,771.50
|
|
| Hospital Charge Code |
901698486
|
|
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
|
|
|
HC CATH INTRAAORTIC 8FR 50CC
|
Facility
|
OP
|
$3,771.50
|
|
| Hospital Charge Code |
901698486
|
|
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 9FR 50ML
|
Facility
|
OP
|
$3,317.46
|
|
| Hospital Charge Code |
901608083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.49 |
| Max. Negotiated Rate |
$2,819.84 |
| Rate for Payer: Adventist Health Commercial |
$663.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,175.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,819.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,824.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,488.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,037.25
|
| Rate for Payer: Cash Price |
$1,492.86
|
| Rate for Payer: Cigna of CA HMO |
$2,123.17
|
| Rate for Payer: Cigna of CA PPO |
$2,454.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,819.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,819.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,819.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.98
|
| Rate for Payer: EPIC Health Plan Senior |
$1,326.98
|
| Rate for Payer: Galaxy Health WC |
$2,819.84
|
| Rate for Payer: Global Benefits Group Commercial |
$1,990.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,212.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,263.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,053.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$796.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,322.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,322.22
|
| Rate for Payer: Multiplan Commercial |
$2,653.97
|
| Rate for Payer: Networks By Design Commercial |
$2,156.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,819.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,990.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,990.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,658.73
|
| Rate for Payer: United Healthcare All Other HMO |
$1,658.73
|
| Rate for Payer: United Healthcare HMO Rider |
$1,658.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,658.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,819.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,819.84
|
| Rate for Payer: Vantage Medical Group Senior |
$2,819.84
|
|
|
HC CATH INTRAAORTIC 9FR 50ML
|
Facility
|
IP
|
$3,317.46
|
|
| Hospital Charge Code |
901608083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.49 |
| Max. Negotiated Rate |
$2,819.84 |
| Rate for Payer: Adventist Health Commercial |
$663.49
|
| Rate for Payer: Cash Price |
$1,492.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.98
|
| Rate for Payer: EPIC Health Plan Senior |
$1,326.98
|
| Rate for Payer: Galaxy Health WC |
$2,819.84
|
| Rate for Payer: Global Benefits Group Commercial |
$1,990.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,212.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,263.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,053.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$796.19
|
| Rate for Payer: Multiplan Commercial |
$2,653.97
|
| Rate for Payer: Networks By Design Commercial |
$2,156.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,819.84
|
|
|
HC CATH INTR COUDE 12FR, 16"
|
Facility
|
OP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607984
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$18.89 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.65
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Cigna of CA HMO |
$14.22
|
| Rate for Payer: Cigna of CA PPO |
$16.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.55
|
| Rate for Payer: Multiplan Commercial |
$17.78
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.11
|
| Rate for Payer: United Healthcare All Other HMO |
$11.11
|
| Rate for Payer: United Healthcare HMO Rider |
$11.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.89
|
| Rate for Payer: Vantage Medical Group Senior |
$18.89
|
|
|
HC CATH INTR COUDE 12FR, 16"
|
Facility
|
IP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607984
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$18.89 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Multiplan Commercial |
$17.78
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
|
|
HC CATH INTR COUDE 14FR, 16"
|
Facility
|
IP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607985
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$18.89 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Multiplan Commercial |
$17.78
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
|
|
HC CATH INTR COUDE 14FR, 16"
|
Facility
|
OP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607985
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$18.89 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.65
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Cigna of CA HMO |
$14.22
|
| Rate for Payer: Cigna of CA PPO |
$16.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.55
|
| Rate for Payer: Multiplan Commercial |
$17.78
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.11
|
| Rate for Payer: United Healthcare All Other HMO |
$11.11
|
| Rate for Payer: United Healthcare HMO Rider |
$11.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.89
|
| Rate for Payer: Vantage Medical Group Senior |
$18.89
|
|
|
HC CATH INTR COUDE 16FR, 16"
|
Facility
|
OP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607986
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$18.89 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.65
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: Cigna of CA HMO |
$14.22
|
| Rate for Payer: Cigna of CA PPO |
$16.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.55
|
| Rate for Payer: Multiplan Commercial |
$17.78
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.11
|
| Rate for Payer: United Healthcare All Other HMO |
$11.11
|
| Rate for Payer: United Healthcare HMO Rider |
$11.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.89
|
| Rate for Payer: Vantage Medical Group Senior |
$18.89
|
|
|
HC CATH INTR COUDE 16FR, 16"
|
Facility
|
IP
|
$22.22
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607986
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$18.89 |
| Rate for Payer: Adventist Health Commercial |
$4.44
|
| Rate for Payer: Cash Price |
$10.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.89
|
| Rate for Payer: EPIC Health Plan Senior |
$8.89
|
| Rate for Payer: Galaxy Health WC |
$18.89
|
| Rate for Payer: Global Benefits Group Commercial |
$13.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.33
|
| Rate for Payer: Multiplan Commercial |
$17.78
|
| Rate for Payer: Networks By Design Commercial |
$14.44
|
| Rate for Payer: Prime Health Services Commercial |
$18.89
|
|
|
HC CATH INTRVASC U/S
|
Facility
|
OP
|
$5,250.00
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
909000267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,050.00 |
| Max. Negotiated Rate |
$4,462.50 |
| Rate for Payer: Adventist Health Commercial |
$1,050.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,462.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,887.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,937.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,040.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,874.50
|
| Rate for Payer: Blue Shield of California EPN |
$2,551.50
|
| Rate for Payer: Cash Price |
$2,362.50
|
| Rate for Payer: Cigna of CA HMO |
$3,675.00
|
| Rate for Payer: Cigna of CA PPO |
$3,675.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,462.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,462.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,462.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,100.00
|
| Rate for Payer: Galaxy Health WC |
$4,462.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,150.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,501.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,000.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,249.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,260.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,675.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,675.00
|
| Rate for Payer: Multiplan Commercial |
$4,200.00
|
| Rate for Payer: Networks By Design Commercial |
$2,625.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,462.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,150.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,150.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,970.33
|
| Rate for Payer: United Healthcare All Other HMO |
$1,917.83
|
| Rate for Payer: United Healthcare HMO Rider |
$1,876.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,719.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,462.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,462.50
|
| Rate for Payer: Vantage Medical Group Senior |
$4,462.50
|
|
|
HC CATH INTRVASC U/S
|
Facility
|
IP
|
$5,250.00
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
909000267
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,050.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$1,050.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$2,362.50
|
| Rate for Payer: Cash Price |
$2,362.50
|
| Rate for Payer: Cigna of CA HMO |
$3,675.00
|
| Rate for Payer: Cigna of CA PPO |
$3,675.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,100.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,100.00
|
| Rate for Payer: Galaxy Health WC |
$4,462.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,150.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,501.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,000.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,249.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,260.00
|
| Rate for Payer: Multiplan Commercial |
$4,200.00
|
| Rate for Payer: Networks By Design Commercial |
$2,625.00
|
| Rate for Payer: Prime Health Services Commercial |
$4,462.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,970.33
|
| Rate for Payer: United Healthcare All Other HMO |
$1,917.83
|
| Rate for Payer: United Healthcare HMO Rider |
$1,876.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,719.38
|
|
|
HC CATH KIT BROVIAC CVC RPR 2.7FR
|
Facility
|
IP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$173.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Cigna of CA HMO |
$608.58
|
| Rate for Payer: Cigna of CA PPO |
$608.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Senior |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$538.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$208.66
|
| Rate for Payer: Multiplan Commercial |
$695.52
|
| Rate for Payer: Networks By Design Commercial |
$434.70
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$326.29
|
| Rate for Payer: United Healthcare All Other HMO |
$317.59
|
| Rate for Payer: United Healthcare HMO Rider |
$310.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$284.73
|
|
|
HC CATH KIT BROVIAC CVC RPR 2.7FR
|
Facility
|
OP
|
$869.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698663
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$738.99 |
| Rate for Payer: Adventist Health Commercial |
$173.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$478.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$652.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$503.56
|
| Rate for Payer: Blue Shield of California Commercial |
$641.62
|
| Rate for Payer: Blue Shield of California EPN |
$422.53
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Cigna of CA HMO |
$608.58
|
| Rate for Payer: Cigna of CA PPO |
$608.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$738.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$738.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$738.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Senior |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$538.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$208.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$608.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.58
|
| Rate for Payer: Multiplan Commercial |
$695.52
|
| Rate for Payer: Networks By Design Commercial |
$434.70
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$521.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$521.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$326.29
|
| Rate for Payer: United Healthcare All Other HMO |
$317.59
|
| Rate for Payer: United Healthcare HMO Rider |
$310.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$284.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$738.99
|
| Rate for Payer: Vantage Medical Group Senior |
$738.99
|
|
|
HC CATH KIT CNTRL VNS 5.5FR MULTI
|
Facility
|
OP
|
$467.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698604
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$93.47 |
| Max. Negotiated Rate |
$397.26 |
| Rate for Payer: Adventist Health Commercial |
$93.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$397.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$257.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$350.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$270.69
|
| Rate for Payer: Blue Shield of California Commercial |
$344.91
|
| Rate for Payer: Blue Shield of California EPN |
$227.14
|
| Rate for Payer: Cash Price |
$210.31
|
| Rate for Payer: Cigna of CA HMO |
$327.15
|
| Rate for Payer: Cigna of CA PPO |
$327.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$397.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$397.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$397.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$186.94
|
| Rate for Payer: EPIC Health Plan Senior |
$186.94
|
| Rate for Payer: Galaxy Health WC |
$397.26
|
| Rate for Payer: Global Benefits Group Commercial |
$280.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$311.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$289.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$327.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$327.15
|
| Rate for Payer: Multiplan Commercial |
$373.89
|
| Rate for Payer: Networks By Design Commercial |
$233.68
|
| Rate for Payer: Prime Health Services Commercial |
$397.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$280.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$280.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.40
|
| Rate for Payer: United Healthcare All Other HMO |
$170.73
|
| Rate for Payer: United Healthcare HMO Rider |
$167.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$153.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$397.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$397.26
|
| Rate for Payer: Vantage Medical Group Senior |
$397.26
|
|
|
HC CATH KIT CNTRL VNS 5.5FR MULTI
|
Facility
|
IP
|
$467.36
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698604
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$93.47 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$93.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$210.31
|
| Rate for Payer: Cash Price |
$210.31
|
| Rate for Payer: Cigna of CA HMO |
$327.15
|
| Rate for Payer: Cigna of CA PPO |
$327.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$186.94
|
| Rate for Payer: EPIC Health Plan Senior |
$186.94
|
| Rate for Payer: Galaxy Health WC |
$397.26
|
| Rate for Payer: Global Benefits Group Commercial |
$280.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$311.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$289.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$112.17
|
| Rate for Payer: Multiplan Commercial |
$373.89
|
| Rate for Payer: Networks By Design Commercial |
$233.68
|
| Rate for Payer: Prime Health Services Commercial |
$397.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$175.40
|
| Rate for Payer: United Healthcare All Other HMO |
$170.73
|
| Rate for Payer: United Healthcare HMO Rider |
$167.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$153.06
|
|
|
HC CATH KIT CNTRL VNS 5FR 3 LUMEN
|
Facility
|
OP
|
$459.53
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698603
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$91.91 |
| Max. Negotiated Rate |
$390.60 |
| Rate for Payer: Adventist Health Commercial |
$91.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$390.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$252.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$344.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$266.16
|
| Rate for Payer: Blue Shield of California Commercial |
$339.13
|
| Rate for Payer: Blue Shield of California EPN |
$223.33
|
| Rate for Payer: Cash Price |
$206.79
|
| Rate for Payer: Cigna of CA HMO |
$321.67
|
| Rate for Payer: Cigna of CA PPO |
$321.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$390.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$390.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$390.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$183.81
|
| Rate for Payer: EPIC Health Plan Senior |
$183.81
|
| Rate for Payer: Galaxy Health WC |
$390.60
|
| Rate for Payer: Global Benefits Group Commercial |
$275.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$306.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$284.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$321.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$321.67
|
| Rate for Payer: Multiplan Commercial |
$367.62
|
| Rate for Payer: Networks By Design Commercial |
$229.76
|
| Rate for Payer: Prime Health Services Commercial |
$390.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$275.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$275.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$172.46
|
| Rate for Payer: United Healthcare All Other HMO |
$167.87
|
| Rate for Payer: United Healthcare HMO Rider |
$164.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$390.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$390.60
|
| Rate for Payer: Vantage Medical Group Senior |
$390.60
|
|
|
HC CATH KIT CNTRL VNS 5FR 3 LUMEN
|
Facility
|
IP
|
$459.53
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698603
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$91.91 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$91.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$206.79
|
| Rate for Payer: Cash Price |
$206.79
|
| Rate for Payer: Cigna of CA HMO |
$321.67
|
| Rate for Payer: Cigna of CA PPO |
$321.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$183.81
|
| Rate for Payer: EPIC Health Plan Senior |
$183.81
|
| Rate for Payer: Galaxy Health WC |
$390.60
|
| Rate for Payer: Global Benefits Group Commercial |
$275.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$306.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$175.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$284.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.29
|
| Rate for Payer: Multiplan Commercial |
$367.62
|
| Rate for Payer: Networks By Design Commercial |
$229.76
|
| Rate for Payer: Prime Health Services Commercial |
$390.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$172.46
|
| Rate for Payer: United Healthcare All Other HMO |
$167.87
|
| Rate for Payer: United Healthcare HMO Rider |
$164.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.50
|
|
|
HC CATH KIT PEDIATRIC SOFT 5FR
|
Facility
|
OP
|
$43.71
|
|
| Hospital Charge Code |
901698580
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$37.15 |
| Rate for Payer: Adventist Health Commercial |
$8.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$32.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.84
|
| Rate for Payer: Cash Price |
$19.67
|
| Rate for Payer: Cigna of CA HMO |
$27.97
|
| Rate for Payer: Cigna of CA PPO |
$32.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$37.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$37.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.48
|
| Rate for Payer: EPIC Health Plan Senior |
$17.48
|
| Rate for Payer: Galaxy Health WC |
$37.15
|
| Rate for Payer: Global Benefits Group Commercial |
$26.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30.60
|
| Rate for Payer: Multiplan Commercial |
$34.97
|
| Rate for Payer: Networks By Design Commercial |
$28.41
|
| Rate for Payer: Prime Health Services Commercial |
$37.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.86
|
| Rate for Payer: United Healthcare All Other HMO |
$21.86
|
| Rate for Payer: United Healthcare HMO Rider |
$21.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$37.15
|
| Rate for Payer: Vantage Medical Group Senior |
$37.15
|
|
|
HC CATH KIT PEDIATRIC SOFT 5FR
|
Facility
|
IP
|
$43.71
|
|
| Hospital Charge Code |
901698580
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$37.15 |
| Rate for Payer: Adventist Health Commercial |
$8.74
|
| Rate for Payer: Cash Price |
$19.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.48
|
| Rate for Payer: EPIC Health Plan Senior |
$17.48
|
| Rate for Payer: Galaxy Health WC |
$37.15
|
| Rate for Payer: Global Benefits Group Commercial |
$26.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.49
|
| Rate for Payer: Multiplan Commercial |
$34.97
|
| Rate for Payer: Networks By Design Commercial |
$28.41
|
| Rate for Payer: Prime Health Services Commercial |
$37.15
|
|
|
HC CATH KIT RPR HICKMAN 2LUMN 9FR
|
Facility
|
OP
|
$961.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.28 |
| Max. Negotiated Rate |
$817.19 |
| Rate for Payer: Adventist Health Commercial |
$192.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$817.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$528.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$721.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$556.84
|
| Rate for Payer: Blue Shield of California Commercial |
$709.51
|
| Rate for Payer: Blue Shield of California EPN |
$467.24
|
| Rate for Payer: Cash Price |
$432.63
|
| Rate for Payer: Cigna of CA HMO |
$672.98
|
| Rate for Payer: Cigna of CA PPO |
$672.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$817.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$817.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$817.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$384.56
|
| Rate for Payer: EPIC Health Plan Senior |
$384.56
|
| Rate for Payer: Galaxy Health WC |
$817.19
|
| Rate for Payer: Global Benefits Group Commercial |
$576.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$641.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$366.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$595.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$672.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$672.98
|
| Rate for Payer: Multiplan Commercial |
$769.12
|
| Rate for Payer: Networks By Design Commercial |
$480.70
|
| Rate for Payer: Prime Health Services Commercial |
$817.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$576.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$576.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$360.81
|
| Rate for Payer: United Healthcare All Other HMO |
$351.20
|
| Rate for Payer: United Healthcare HMO Rider |
$343.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$314.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$817.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$817.19
|
| Rate for Payer: Vantage Medical Group Senior |
$817.19
|
|
|
HC CATH KIT RPR HICKMAN 2LUMN 9FR
|
Facility
|
IP
|
$961.40
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698664
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.28 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$192.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$432.63
|
| Rate for Payer: Cash Price |
$432.63
|
| Rate for Payer: Cigna of CA HMO |
$672.98
|
| Rate for Payer: Cigna of CA PPO |
$672.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$384.56
|
| Rate for Payer: EPIC Health Plan Senior |
$384.56
|
| Rate for Payer: Galaxy Health WC |
$817.19
|
| Rate for Payer: Global Benefits Group Commercial |
$576.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$641.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$366.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$595.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$230.74
|
| Rate for Payer: Multiplan Commercial |
$769.12
|
| Rate for Payer: Networks By Design Commercial |
$480.70
|
| Rate for Payer: Prime Health Services Commercial |
$817.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$360.81
|
| Rate for Payer: United Healthcare All Other HMO |
$351.20
|
| Rate for Payer: United Healthcare HMO Rider |
$343.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$314.86
|
|
|
HC CATH KIT VASCU-PICC 2.6FR SL
|
Facility
|
IP
|
$1,062.60
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$212.52 |
| Max. Negotiated Rate |
$903.21 |
| Rate for Payer: Adventist Health Commercial |
$212.52
|
| Rate for Payer: Cash Price |
$478.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.04
|
| Rate for Payer: EPIC Health Plan Senior |
$425.04
|
| Rate for Payer: Galaxy Health WC |
$903.21
|
| Rate for Payer: Global Benefits Group Commercial |
$637.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$708.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$404.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$657.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$255.02
|
| Rate for Payer: Multiplan Commercial |
$850.08
|
| Rate for Payer: Networks By Design Commercial |
$690.69
|
| Rate for Payer: Prime Health Services Commercial |
$903.21
|
|
