|
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
|
|
|
HC CATH LNRD 10FR REPAIR SGMNT
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602644
|
|
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 LNRD 10FR REPAIR SGMNT
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901602644
|
|
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: Cash Price |
$1,035.00
|
| 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 |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
|
|
HC CATH LO FRIC 14FR COUDE
|
Facility
|
OP
|
$19.84
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$16.86 |
| Rate for Payer: Adventist Health Commercial |
$3.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.18
|
| Rate for Payer: Cash Price |
$8.93
|
| Rate for Payer: Cigna of CA HMO |
$12.70
|
| Rate for Payer: Cigna of CA PPO |
$14.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.94
|
| Rate for Payer: EPIC Health Plan Senior |
$7.94
|
| Rate for Payer: Galaxy Health WC |
$16.86
|
| Rate for Payer: Global Benefits Group Commercial |
$11.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.89
|
| Rate for Payer: Multiplan Commercial |
$15.87
|
| Rate for Payer: Networks By Design Commercial |
$12.90
|
| Rate for Payer: Prime Health Services Commercial |
$16.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.92
|
| Rate for Payer: United Healthcare All Other HMO |
$9.92
|
| Rate for Payer: United Healthcare HMO Rider |
$9.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.86
|
| Rate for Payer: Vantage Medical Group Senior |
$16.86
|
|
|
HC CATH LO FRIC 14FR COUDE
|
Facility
|
IP
|
$19.84
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.97 |
| Max. Negotiated Rate |
$16.86 |
| Rate for Payer: Adventist Health Commercial |
$3.97
|
| Rate for Payer: Cash Price |
$8.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.94
|
| Rate for Payer: EPIC Health Plan Senior |
$7.94
|
| Rate for Payer: Galaxy Health WC |
$16.86
|
| Rate for Payer: Global Benefits Group Commercial |
$11.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.76
|
| Rate for Payer: Multiplan Commercial |
$15.87
|
| Rate for Payer: Networks By Design Commercial |
$12.90
|
| Rate for Payer: Prime Health Services Commercial |
$16.86
|
|
|
HC CATH LO FRIC 14FR STRAIGHT
|
Facility
|
IP
|
$10.91
|
|
| Hospital Charge Code |
901604345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.27 |
| Rate for Payer: Adventist Health Commercial |
$2.18
|
| Rate for Payer: Cash Price |
$4.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.36
|
| Rate for Payer: Galaxy Health WC |
$9.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.62
|
| Rate for Payer: Multiplan Commercial |
$8.73
|
| Rate for Payer: Networks By Design Commercial |
$7.09
|
| Rate for Payer: Prime Health Services Commercial |
$9.27
|
|
|
HC CATH LO FRIC 14FR STRAIGHT
|
Facility
|
OP
|
$10.91
|
|
| Hospital Charge Code |
901604345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.27 |
| Rate for Payer: Adventist Health Commercial |
$2.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.70
|
| Rate for Payer: Cash Price |
$4.91
|
| Rate for Payer: Cigna of CA HMO |
$6.98
|
| Rate for Payer: Cigna of CA PPO |
$8.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.36
|
| Rate for Payer: Galaxy Health WC |
$9.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.64
|
| Rate for Payer: Multiplan Commercial |
$8.73
|
| Rate for Payer: Networks By Design Commercial |
$7.09
|
| Rate for Payer: Prime Health Services Commercial |
$9.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.46
|
| Rate for Payer: United Healthcare All Other HMO |
$5.46
|
| Rate for Payer: United Healthcare HMO Rider |
$5.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.27
|
| Rate for Payer: Vantage Medical Group Senior |
$9.27
|
|
|
HC CATH LO-FRIC HYDRO 12FR
|
Facility
|
IP
|
$30.09
|
|
| Hospital Charge Code |
901605820
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$25.58 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.22
|
| Rate for Payer: Multiplan Commercial |
$24.07
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
|
|
HC CATH LO-FRIC HYDRO 12FR
|
Facility
|
OP
|
$30.09
|
|
| Hospital Charge Code |
901605820
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$25.58 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.48
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Cigna of CA HMO |
$19.26
|
| Rate for Payer: Cigna of CA PPO |
$22.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.06
|
| Rate for Payer: Multiplan Commercial |
$24.07
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.04
|
| Rate for Payer: United Healthcare All Other HMO |
$15.04
|
| Rate for Payer: United Healthcare HMO Rider |
$15.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.58
|
| Rate for Payer: Vantage Medical Group Senior |
$25.58
|
|
|
HC CATH LO-FRIC HYDRO 14FR
|
Facility
|
OP
|
$32.23
|
|
| Hospital Charge Code |
901605821
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.79
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Cigna of CA HMO |
$20.63
|
| Rate for Payer: Cigna of CA PPO |
$23.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.56
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.11
|
| Rate for Payer: United Healthcare All Other HMO |
$16.11
|
| Rate for Payer: United Healthcare HMO Rider |
$16.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.40
|
| Rate for Payer: Vantage Medical Group Senior |
$27.40
|
|
|
HC CATH LO-FRIC HYDRO 14FR
|
Facility
|
IP
|
$32.23
|
|
| Hospital Charge Code |
901605821
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
|
|
HC CATH LO-FRIC HYDRO 16FR
|
Facility
|
IP
|
$30.09
|
|
| Hospital Charge Code |
901605822
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$25.58 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.22
|
| Rate for Payer: Multiplan Commercial |
$24.07
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
|
|
HC CATH LO-FRIC HYDRO 16FR
|
Facility
|
OP
|
$30.09
|
|
| Hospital Charge Code |
901605822
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$25.58 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.48
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Cigna of CA HMO |
$19.26
|
| Rate for Payer: Cigna of CA PPO |
$22.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.06
|
| Rate for Payer: Multiplan Commercial |
$24.07
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.04
|
| Rate for Payer: United Healthcare All Other HMO |
$15.04
|
| Rate for Payer: United Healthcare HMO Rider |
$15.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.58
|
| Rate for Payer: Vantage Medical Group Senior |
$25.58
|
|
|
HC CATH LOFRIC HYDRO-KIT 16" MALE
|
Facility
|
IP
|
$32.23
|
|
| Hospital Charge Code |
901698159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
|
|
HC CATH LOFRIC HYDRO-KIT 16" MALE
|
Facility
|
OP
|
$32.23
|
|
| Hospital Charge Code |
901698159
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.79
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Cigna of CA HMO |
$20.63
|
| Rate for Payer: Cigna of CA PPO |
$23.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.56
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.11
|
| Rate for Payer: United Healthcare All Other HMO |
$16.11
|
| Rate for Payer: United Healthcare HMO Rider |
$16.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.40
|
| Rate for Payer: Vantage Medical Group Senior |
$27.40
|
|
|
HC CATH LO-FRIC PRIMO 12FR
|
Facility
|
OP
|
$13.69
|
|
| Hospital Charge Code |
901605823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$11.64 |
| Rate for Payer: Adventist Health Commercial |
$2.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.41
|
| Rate for Payer: Cash Price |
$6.16
|
| Rate for Payer: Cigna of CA HMO |
$8.76
|
| Rate for Payer: Cigna of CA PPO |
$10.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5.48
|
| Rate for Payer: Galaxy Health WC |
$11.64
|
| Rate for Payer: Global Benefits Group Commercial |
$8.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.58
|
| Rate for Payer: Multiplan Commercial |
$10.95
|
| Rate for Payer: Networks By Design Commercial |
$8.90
|
| Rate for Payer: Prime Health Services Commercial |
$11.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.84
|
| Rate for Payer: United Healthcare All Other HMO |
$6.84
|
| Rate for Payer: United Healthcare HMO Rider |
$6.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.64
|
| Rate for Payer: Vantage Medical Group Senior |
$11.64
|
|
|
HC CATH LO-FRIC PRIMO 12FR
|
Facility
|
IP
|
$13.69
|
|
| Hospital Charge Code |
901605823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.74 |
| Max. Negotiated Rate |
$11.64 |
| Rate for Payer: Adventist Health Commercial |
$2.74
|
| Rate for Payer: Cash Price |
$6.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.48
|
| Rate for Payer: EPIC Health Plan Senior |
$5.48
|
| Rate for Payer: Galaxy Health WC |
$11.64
|
| Rate for Payer: Global Benefits Group Commercial |
$8.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.29
|
| Rate for Payer: Multiplan Commercial |
$10.95
|
| Rate for Payer: Networks By Design Commercial |
$8.90
|
| Rate for Payer: Prime Health Services Commercial |
$11.64
|
|
|
HC CATH LO-FRIC PRIMO 16FR
|
Facility
|
OP
|
$89.30
|
|
| Hospital Charge Code |
901605825
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.86 |
| Max. Negotiated Rate |
$75.91 |
| Rate for Payer: Adventist Health Commercial |
$17.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$58.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$75.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$49.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$66.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$54.84
|
| Rate for Payer: Cash Price |
$40.19
|
| Rate for Payer: Cigna of CA HMO |
$57.15
|
| Rate for Payer: Cigna of CA PPO |
$66.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$75.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$75.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$75.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.72
|
| Rate for Payer: EPIC Health Plan Senior |
$35.72
|
| Rate for Payer: Galaxy Health WC |
$75.91
|
| Rate for Payer: Global Benefits Group Commercial |
$53.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$62.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$62.51
|
| Rate for Payer: Multiplan Commercial |
$71.44
|
| Rate for Payer: Networks By Design Commercial |
$58.05
|
| Rate for Payer: Prime Health Services Commercial |
$75.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$53.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$53.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$44.65
|
| Rate for Payer: United Healthcare All Other HMO |
$44.65
|
| Rate for Payer: United Healthcare HMO Rider |
$44.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$75.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$75.91
|
| Rate for Payer: Vantage Medical Group Senior |
$75.91
|
|
|
HC CATH LO-FRIC PRIMO 16FR
|
Facility
|
IP
|
$89.30
|
|
| Hospital Charge Code |
901605825
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$17.86 |
| Max. Negotiated Rate |
$75.91 |
| Rate for Payer: Adventist Health Commercial |
$17.86
|
| Rate for Payer: Cash Price |
$40.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.72
|
| Rate for Payer: EPIC Health Plan Senior |
$35.72
|
| Rate for Payer: Galaxy Health WC |
$75.91
|
| Rate for Payer: Global Benefits Group Commercial |
$53.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$34.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.43
|
| Rate for Payer: Multiplan Commercial |
$71.44
|
| Rate for Payer: Networks By Design Commercial |
$58.05
|
| Rate for Payer: Prime Health Services Commercial |
$75.91
|
|
|
HC CATH LO-FRIC PRIMO FML 12FR
|
Facility
|
IP
|
$24.60
|
|
| Hospital Charge Code |
901605833
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.92 |
| Max. Negotiated Rate |
$20.91 |
| Rate for Payer: Adventist Health Commercial |
$4.92
|
| Rate for Payer: Cash Price |
$11.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.84
|
| Rate for Payer: EPIC Health Plan Senior |
$9.84
|
| Rate for Payer: Galaxy Health WC |
$20.91
|
| Rate for Payer: Global Benefits Group Commercial |
$14.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.90
|
| Rate for Payer: Multiplan Commercial |
$19.68
|
| Rate for Payer: Networks By Design Commercial |
$15.99
|
| Rate for Payer: Prime Health Services Commercial |
$20.91
|
|
|
HC CATH LO-FRIC PRIMO FML 12FR
|
Facility
|
OP
|
$24.60
|
|
| Hospital Charge Code |
901605833
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.92 |
| Max. Negotiated Rate |
$20.91 |
| Rate for Payer: Adventist Health Commercial |
$4.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.11
|
| Rate for Payer: Cash Price |
$11.07
|
| Rate for Payer: Cigna of CA HMO |
$15.74
|
| Rate for Payer: Cigna of CA PPO |
$18.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.84
|
| Rate for Payer: EPIC Health Plan Senior |
$9.84
|
| Rate for Payer: Galaxy Health WC |
$20.91
|
| Rate for Payer: Global Benefits Group Commercial |
$14.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.22
|
| Rate for Payer: Multiplan Commercial |
$19.68
|
| Rate for Payer: Networks By Design Commercial |
$15.99
|
| Rate for Payer: Prime Health Services Commercial |
$20.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.30
|
| Rate for Payer: United Healthcare All Other HMO |
$12.30
|
| Rate for Payer: United Healthcare HMO Rider |
$12.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.91
|
| Rate for Payer: Vantage Medical Group Senior |
$20.91
|
|
|
HC CATH LO-FRIC PRIMO FML 14FR
|
Facility
|
OP
|
$10.91
|
|
| Hospital Charge Code |
901605834
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.27 |
| Rate for Payer: Adventist Health Commercial |
$2.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.70
|
| Rate for Payer: Cash Price |
$4.91
|
| Rate for Payer: Cigna of CA HMO |
$6.98
|
| Rate for Payer: Cigna of CA PPO |
$8.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.36
|
| Rate for Payer: Galaxy Health WC |
$9.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.64
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.64
|
| Rate for Payer: Multiplan Commercial |
$8.73
|
| Rate for Payer: Networks By Design Commercial |
$7.09
|
| Rate for Payer: Prime Health Services Commercial |
$9.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.46
|
| Rate for Payer: United Healthcare All Other HMO |
$5.46
|
| Rate for Payer: United Healthcare HMO Rider |
$5.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.27
|
| Rate for Payer: Vantage Medical Group Senior |
$9.27
|
|
|
HC CATH LO-FRIC PRIMO FML 14FR
|
Facility
|
IP
|
$10.91
|
|
| Hospital Charge Code |
901605834
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.18 |
| Max. Negotiated Rate |
$9.27 |
| Rate for Payer: Adventist Health Commercial |
$2.18
|
| Rate for Payer: Cash Price |
$4.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.36
|
| Rate for Payer: Galaxy Health WC |
$9.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.62
|
| Rate for Payer: Multiplan Commercial |
$8.73
|
| Rate for Payer: Networks By Design Commercial |
$7.09
|
| Rate for Payer: Prime Health Services Commercial |
$9.27
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
OP
|
$32.23
|
|
| Hospital Charge Code |
901605906
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.45 |
| Max. Negotiated Rate |
$27.40 |
| Rate for Payer: Adventist Health Commercial |
$6.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.79
|
| Rate for Payer: Cash Price |
$14.50
|
| Rate for Payer: Cigna of CA HMO |
$20.63
|
| Rate for Payer: Cigna of CA PPO |
$23.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.89
|
| Rate for Payer: EPIC Health Plan Senior |
$12.89
|
| Rate for Payer: Galaxy Health WC |
$27.40
|
| Rate for Payer: Global Benefits Group Commercial |
$19.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.56
|
| Rate for Payer: Multiplan Commercial |
$25.78
|
| Rate for Payer: Networks By Design Commercial |
$20.95
|
| Rate for Payer: Prime Health Services Commercial |
$27.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.11
|
| Rate for Payer: United Healthcare All Other HMO |
$16.11
|
| Rate for Payer: United Healthcare HMO Rider |
$16.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.40
|
| Rate for Payer: Vantage Medical Group Senior |
$27.40
|
|
|
HC CATH LO-FRIC PRIMO FML 16FR
|
Facility
|
IP
|
$30.09
|
|
| Hospital Charge Code |
901605907
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$25.58 |
| Rate for Payer: Adventist Health Commercial |
$6.02
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Senior |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.22
|
| Rate for Payer: Multiplan Commercial |
$24.07
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
|
