|
HC CATH MED ATTAIN SELECT 6238TEL
|
Facility
|
IP
|
$745.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812490
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$149.00 |
| Max. Negotiated Rate |
$633.25 |
| Rate for Payer: Adventist Health Commercial |
$149.00
|
| Rate for Payer: Cash Price |
$409.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$298.00
|
| Rate for Payer: EPIC Health Plan Senior |
$298.00
|
| Rate for Payer: Galaxy Health WC |
$633.25
|
| Rate for Payer: Global Benefits Group Commercial |
$447.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$496.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$283.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$461.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.80
|
| Rate for Payer: Multiplan Commercial |
$596.00
|
| Rate for Payer: Networks By Design Commercial |
$484.25
|
| Rate for Payer: Prime Health Services Commercial |
$633.25
|
|
|
HC CATH MED ATTAIN SELECT 6238TEL
|
Facility
|
OP
|
$745.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812490
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$149.00 |
| Max. Negotiated Rate |
$633.25 |
| Rate for Payer: Adventist Health Commercial |
$149.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$488.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$633.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$409.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$558.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.50
|
| Rate for Payer: Cash Price |
$409.75
|
| Rate for Payer: Cigna of CA HMO |
$476.80
|
| Rate for Payer: Cigna of CA PPO |
$551.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$633.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$633.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$633.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$298.00
|
| Rate for Payer: EPIC Health Plan Senior |
$298.00
|
| Rate for Payer: Galaxy Health WC |
$633.25
|
| Rate for Payer: Global Benefits Group Commercial |
$447.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$496.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$283.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$461.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$521.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$521.50
|
| Rate for Payer: Multiplan Commercial |
$596.00
|
| Rate for Payer: Networks By Design Commercial |
$484.25
|
| Rate for Payer: Prime Health Services Commercial |
$633.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$447.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$447.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$372.50
|
| Rate for Payer: United Healthcare All Other HMO |
$372.50
|
| Rate for Payer: United Healthcare HMO Rider |
$372.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$372.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$633.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$633.25
|
| Rate for Payer: Vantage Medical Group Senior |
$633.25
|
|
|
HC CATH MED ATTAIN SELECT II 6248
|
Facility
|
IP
|
$874.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812492
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.80 |
| Max. Negotiated Rate |
$742.90 |
| Rate for Payer: Adventist Health Commercial |
$174.80
|
| Rate for Payer: Cash Price |
$480.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.60
|
| Rate for Payer: EPIC Health Plan Senior |
$349.60
|
| Rate for Payer: Galaxy Health WC |
$742.90
|
| Rate for Payer: Global Benefits Group Commercial |
$524.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$582.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.76
|
| Rate for Payer: Multiplan Commercial |
$699.20
|
| Rate for Payer: Networks By Design Commercial |
$568.10
|
| Rate for Payer: Prime Health Services Commercial |
$742.90
|
|
|
HC CATH MED ATTAIN SELECT II 6248
|
Facility
|
OP
|
$874.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812492
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.80 |
| Max. Negotiated Rate |
$742.90 |
| Rate for Payer: Adventist Health Commercial |
$174.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$573.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$742.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$480.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$655.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$536.72
|
| Rate for Payer: Cash Price |
$480.70
|
| Rate for Payer: Cigna of CA HMO |
$559.36
|
| Rate for Payer: Cigna of CA PPO |
$646.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$742.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$742.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.60
|
| Rate for Payer: EPIC Health Plan Senior |
$349.60
|
| Rate for Payer: Galaxy Health WC |
$742.90
|
| Rate for Payer: Global Benefits Group Commercial |
$524.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$582.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$611.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$611.80
|
| Rate for Payer: Multiplan Commercial |
$699.20
|
| Rate for Payer: Networks By Design Commercial |
$568.10
|
| Rate for Payer: Prime Health Services Commercial |
$742.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$524.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$524.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$437.00
|
| Rate for Payer: United Healthcare All Other HMO |
$437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$437.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$437.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$742.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.90
|
| Rate for Payer: Vantage Medical Group Senior |
$742.90
|
|
|
HC CATH MED ATTAIN SELECT II 6248V
|
Facility
|
OP
|
$1,113.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$222.60 |
| Max. Negotiated Rate |
$946.05 |
| Rate for Payer: Adventist Health Commercial |
$222.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$730.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$946.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$612.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$834.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$683.49
|
| Rate for Payer: Cash Price |
$612.15
|
| Rate for Payer: Cigna of CA HMO |
$712.32
|
| Rate for Payer: Cigna of CA PPO |
$823.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$946.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$946.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$946.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$445.20
|
| Rate for Payer: EPIC Health Plan Senior |
$445.20
|
| Rate for Payer: Galaxy Health WC |
$946.05
|
| Rate for Payer: Global Benefits Group Commercial |
$667.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$742.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$424.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$688.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$267.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$779.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$779.10
|
| Rate for Payer: Multiplan Commercial |
$890.40
|
| Rate for Payer: Networks By Design Commercial |
$723.45
|
| Rate for Payer: Prime Health Services Commercial |
$946.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$667.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$667.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$556.50
|
| Rate for Payer: United Healthcare All Other HMO |
$556.50
|
| Rate for Payer: United Healthcare HMO Rider |
$556.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$556.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$946.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$946.05
|
| Rate for Payer: Vantage Medical Group Senior |
$946.05
|
|
|
HC CATH MED ATTAIN SELECT II 6248V
|
Facility
|
IP
|
$1,113.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812502
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$222.60 |
| Max. Negotiated Rate |
$946.05 |
| Rate for Payer: Adventist Health Commercial |
$222.60
|
| Rate for Payer: Cash Price |
$612.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$445.20
|
| Rate for Payer: EPIC Health Plan Senior |
$445.20
|
| Rate for Payer: Galaxy Health WC |
$946.05
|
| Rate for Payer: Global Benefits Group Commercial |
$667.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$742.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$424.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$688.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$267.12
|
| Rate for Payer: Multiplan Commercial |
$890.40
|
| Rate for Payer: Networks By Design Commercial |
$723.45
|
| Rate for Payer: Prime Health Services Commercial |
$946.05
|
|
|
HC CATH MED ATTAIN SYS 6250 VC VS
|
Facility
|
IP
|
$2,917.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812503
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$583.40 |
| Max. Negotiated Rate |
$2,479.45 |
| Rate for Payer: Adventist Health Commercial |
$583.40
|
| Rate for Payer: Cash Price |
$1,604.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,166.80
|
| Rate for Payer: Galaxy Health WC |
$2,479.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,750.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,945.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,111.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,805.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$700.08
|
| Rate for Payer: Multiplan Commercial |
$2,333.60
|
| Rate for Payer: Networks By Design Commercial |
$1,896.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,479.45
|
|
|
HC CATH MED ATTAIN SYS 6250 VC VS
|
Facility
|
OP
|
$2,917.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812503
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$583.40 |
| Max. Negotiated Rate |
$2,479.45 |
| Rate for Payer: Adventist Health Commercial |
$583.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,913.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,479.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,604.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,187.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,791.33
|
| Rate for Payer: Cash Price |
$1,604.35
|
| Rate for Payer: Cigna of CA HMO |
$1,866.88
|
| Rate for Payer: Cigna of CA PPO |
$2,158.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,479.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,479.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,479.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,166.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,166.80
|
| Rate for Payer: Galaxy Health WC |
$2,479.45
|
| Rate for Payer: Global Benefits Group Commercial |
$1,750.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,945.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,111.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,805.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$700.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,041.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,041.90
|
| Rate for Payer: Multiplan Commercial |
$2,333.60
|
| Rate for Payer: Networks By Design Commercial |
$1,896.05
|
| Rate for Payer: Prime Health Services Commercial |
$2,479.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,750.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,750.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,458.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,458.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1,458.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,458.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,479.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,479.45
|
| Rate for Payer: Vantage Medical Group Senior |
$2,479.45
|
|
|
HC CATH MED ATTAIN VENOGRAM BAL 6215
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
906812489
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$319.00
|
| 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 |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATH MED ATTAIN VENOGRAM BAL 6215
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
906812489
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$380.42
|
| 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 |
$356.18
|
| Rate for Payer: Cash Price |
$319.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| 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 |
$377.00
|
| 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 |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| 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 MED GUIDE 6248DEL90D
|
Facility
|
OP
|
$874.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.80 |
| Max. Negotiated Rate |
$742.90 |
| Rate for Payer: Adventist Health Commercial |
$174.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$573.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$742.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$480.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$655.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$536.72
|
| Rate for Payer: Cash Price |
$480.70
|
| Rate for Payer: Cigna of CA HMO |
$559.36
|
| Rate for Payer: Cigna of CA PPO |
$646.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$742.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$742.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.60
|
| Rate for Payer: EPIC Health Plan Senior |
$349.60
|
| Rate for Payer: Galaxy Health WC |
$742.90
|
| Rate for Payer: Global Benefits Group Commercial |
$524.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$582.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$611.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$611.80
|
| Rate for Payer: Multiplan Commercial |
$699.20
|
| Rate for Payer: Networks By Design Commercial |
$568.10
|
| Rate for Payer: Prime Health Services Commercial |
$742.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$524.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$524.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$437.00
|
| Rate for Payer: United Healthcare All Other HMO |
$437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$437.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$437.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$742.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.90
|
| Rate for Payer: Vantage Medical Group Senior |
$742.90
|
|
|
HC CATH MED GUIDE 6248DEL90D
|
Facility
|
IP
|
$874.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812493
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.80 |
| Max. Negotiated Rate |
$742.90 |
| Rate for Payer: Adventist Health Commercial |
$174.80
|
| Rate for Payer: Cash Price |
$480.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.60
|
| Rate for Payer: EPIC Health Plan Senior |
$349.60
|
| Rate for Payer: Galaxy Health WC |
$742.90
|
| Rate for Payer: Global Benefits Group Commercial |
$524.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$582.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$332.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$541.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.76
|
| Rate for Payer: Multiplan Commercial |
$699.20
|
| Rate for Payer: Networks By Design Commercial |
$568.10
|
| Rate for Payer: Prime Health Services Commercial |
$742.90
|
|
|
HC CATH MED HAWKONE ATHERECTOM
|
Facility
|
IP
|
$9,343.00
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
906812660
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,868.60 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$1,868.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$5,138.65
|
| Rate for Payer: Cash Price |
$5,138.65
|
| Rate for Payer: Cigna of CA HMO |
$6,540.10
|
| Rate for Payer: Cigna of CA PPO |
$6,540.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,737.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,737.20
|
| Rate for Payer: Galaxy Health WC |
$7,941.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,605.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,231.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,559.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,783.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,242.32
|
| Rate for Payer: Multiplan Commercial |
$7,474.40
|
| Rate for Payer: Networks By Design Commercial |
$4,671.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,941.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,506.43
|
| Rate for Payer: United Healthcare All Other HMO |
$3,413.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,339.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,059.83
|
|
|
HC CATH MED HAWKONE ATHERECTOM
|
Facility
|
OP
|
$9,343.00
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
906812660
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,868.60 |
| Max. Negotiated Rate |
$7,941.55 |
| Rate for Payer: Adventist Health Commercial |
$1,868.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7,941.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,138.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,007.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,411.47
|
| Rate for Payer: Blue Shield of California Commercial |
$6,895.13
|
| Rate for Payer: Blue Shield of California EPN |
$4,540.70
|
| Rate for Payer: Cash Price |
$5,138.65
|
| Rate for Payer: Cigna of CA HMO |
$6,540.10
|
| Rate for Payer: Cigna of CA PPO |
$6,540.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7,941.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,941.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,941.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,737.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3,737.20
|
| Rate for Payer: Galaxy Health WC |
$7,941.55
|
| Rate for Payer: Global Benefits Group Commercial |
$5,605.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,231.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,559.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,783.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,242.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,540.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,540.10
|
| Rate for Payer: Multiplan Commercial |
$7,474.40
|
| Rate for Payer: Networks By Design Commercial |
$4,671.50
|
| Rate for Payer: Prime Health Services Commercial |
$7,941.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,605.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,605.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,506.43
|
| Rate for Payer: United Healthcare All Other HMO |
$3,413.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,339.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,059.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7,941.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,941.55
|
| Rate for Payer: Vantage Medical Group Senior |
$7,941.55
|
|
|
HC CATH MED INDIVIDUAL GUIDE 6218A
|
Facility
|
OP
|
$782.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.40 |
| Max. Negotiated Rate |
$664.70 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$512.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$430.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$586.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$480.23
|
| Rate for Payer: Cash Price |
$430.10
|
| Rate for Payer: Cigna of CA HMO |
$500.48
|
| Rate for Payer: Cigna of CA PPO |
$578.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$664.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$664.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$664.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Senior |
$312.80
|
| Rate for Payer: Galaxy Health WC |
$664.70
|
| Rate for Payer: Global Benefits Group Commercial |
$469.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$521.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$484.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$547.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$547.40
|
| Rate for Payer: Multiplan Commercial |
$625.60
|
| Rate for Payer: Networks By Design Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Commercial |
$664.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$469.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$469.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$391.00
|
| Rate for Payer: United Healthcare All Other HMO |
$391.00
|
| Rate for Payer: United Healthcare HMO Rider |
$391.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$391.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$664.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$664.70
|
| Rate for Payer: Vantage Medical Group Senior |
$664.70
|
|
|
HC CATH MED INDIVIDUAL GUIDE 6218A
|
Facility
|
IP
|
$782.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812491
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$156.40 |
| Max. Negotiated Rate |
$664.70 |
| Rate for Payer: Adventist Health Commercial |
$156.40
|
| Rate for Payer: Cash Price |
$430.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$312.80
|
| Rate for Payer: EPIC Health Plan Senior |
$312.80
|
| Rate for Payer: Galaxy Health WC |
$664.70
|
| Rate for Payer: Global Benefits Group Commercial |
$469.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$521.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$297.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$484.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$187.68
|
| Rate for Payer: Multiplan Commercial |
$625.60
|
| Rate for Payer: Networks By Design Commercial |
$508.30
|
| Rate for Payer: Prime Health Services Commercial |
$664.70
|
|
|
HC CATH MEDITECH GLIDECATH
|
Facility
|
IP
|
$298.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812316
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$253.30 |
| Rate for Payer: Adventist Health Commercial |
$59.60
|
| Rate for Payer: Cash Price |
$163.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Senior |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$198.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$184.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.52
|
| Rate for Payer: Multiplan Commercial |
$238.40
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
|
|
HC CATH MEDITECH GLIDECATH
|
Facility
|
OP
|
$298.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812316
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$59.60 |
| Max. Negotiated Rate |
$253.30 |
| Rate for Payer: Adventist Health Commercial |
$59.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$195.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$163.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$223.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$183.00
|
| Rate for Payer: Cash Price |
$163.90
|
| Rate for Payer: Cigna of CA HMO |
$190.72
|
| Rate for Payer: Cigna of CA PPO |
$220.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$253.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$253.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$253.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.20
|
| Rate for Payer: EPIC Health Plan Senior |
$119.20
|
| Rate for Payer: Galaxy Health WC |
$253.30
|
| Rate for Payer: Global Benefits Group Commercial |
$178.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$198.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$113.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$184.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$208.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$208.60
|
| Rate for Payer: Multiplan Commercial |
$238.40
|
| Rate for Payer: Networks By Design Commercial |
$193.70
|
| Rate for Payer: Prime Health Services Commercial |
$253.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$178.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$178.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$149.00
|
| Rate for Payer: United Healthcare All Other HMO |
$149.00
|
| Rate for Payer: United Healthcare HMO Rider |
$149.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$149.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$253.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$253.30
|
| Rate for Payer: Vantage Medical Group Senior |
$253.30
|
|
|
HC CATH MED LAUNCHER
|
Facility
|
OP
|
$377.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812406
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$320.45 |
| Rate for Payer: Adventist Health Commercial |
$75.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$247.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$282.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$231.52
|
| Rate for Payer: Cash Price |
$207.35
|
| Rate for Payer: Cigna of CA HMO |
$241.28
|
| Rate for Payer: Cigna of CA PPO |
$278.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$320.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$320.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: EPIC Health Plan Senior |
$150.80
|
| Rate for Payer: Galaxy Health WC |
$320.45
|
| Rate for Payer: Global Benefits Group Commercial |
$226.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$233.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$263.90
|
| Rate for Payer: Multiplan Commercial |
$301.60
|
| Rate for Payer: Networks By Design Commercial |
$245.05
|
| Rate for Payer: Prime Health Services Commercial |
$320.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$226.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$226.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$188.50
|
| Rate for Payer: United Healthcare All Other HMO |
$188.50
|
| Rate for Payer: United Healthcare HMO Rider |
$188.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$188.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$320.45
|
| Rate for Payer: Vantage Medical Group Senior |
$320.45
|
|
|
HC CATH MED LAUNCHER
|
Facility
|
IP
|
$377.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812406
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$320.45 |
| Rate for Payer: Adventist Health Commercial |
$75.40
|
| Rate for Payer: Cash Price |
$207.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: EPIC Health Plan Senior |
$150.80
|
| Rate for Payer: Galaxy Health WC |
$320.45
|
| Rate for Payer: Global Benefits Group Commercial |
$226.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$233.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.48
|
| Rate for Payer: Multiplan Commercial |
$301.60
|
| Rate for Payer: Networks By Design Commercial |
$245.05
|
| Rate for Payer: Prime Health Services Commercial |
$320.45
|
|
|
HC CATH MED NIH
|
Facility
|
OP
|
$531.00
|
|
| Hospital Charge Code |
906812344
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.20 |
| Max. Negotiated Rate |
$451.35 |
| Rate for Payer: Adventist Health Commercial |
$106.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$348.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$451.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$292.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$398.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$326.09
|
| Rate for Payer: Cash Price |
$292.05
|
| Rate for Payer: Cigna of CA HMO |
$339.84
|
| Rate for Payer: Cigna of CA PPO |
$392.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$451.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$451.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$451.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$212.40
|
| Rate for Payer: EPIC Health Plan Senior |
$212.40
|
| Rate for Payer: Galaxy Health WC |
$451.35
|
| Rate for Payer: Global Benefits Group Commercial |
$318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$354.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$202.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$328.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$371.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$371.70
|
| Rate for Payer: Multiplan Commercial |
$424.80
|
| Rate for Payer: Networks By Design Commercial |
$345.15
|
| Rate for Payer: Prime Health Services Commercial |
$451.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$318.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$318.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$265.50
|
| Rate for Payer: United Healthcare All Other HMO |
$265.50
|
| Rate for Payer: United Healthcare HMO Rider |
$265.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$265.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$451.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$451.35
|
| Rate for Payer: Vantage Medical Group Senior |
$451.35
|
|
|
HC CATH MED NIH
|
Facility
|
IP
|
$531.00
|
|
| Hospital Charge Code |
906812344
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$106.20 |
| Max. Negotiated Rate |
$451.35 |
| Rate for Payer: Adventist Health Commercial |
$106.20
|
| Rate for Payer: Cash Price |
$292.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$212.40
|
| Rate for Payer: EPIC Health Plan Senior |
$212.40
|
| Rate for Payer: Galaxy Health WC |
$451.35
|
| Rate for Payer: Global Benefits Group Commercial |
$318.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$354.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$202.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$328.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.44
|
| Rate for Payer: Multiplan Commercial |
$424.80
|
| Rate for Payer: Networks By Design Commercial |
$345.15
|
| Rate for Payer: Prime Health Services Commercial |
$451.35
|
|
|
HC CATH MED RIGHTSITE C315HIS02
|
Facility
|
OP
|
$1,720.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812696
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$344.00 |
| Max. Negotiated Rate |
$1,462.00 |
| Rate for Payer: Adventist Health Commercial |
$344.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,462.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$946.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,290.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$996.22
|
| Rate for Payer: Blue Shield of California Commercial |
$1,269.36
|
| Rate for Payer: Blue Shield of California EPN |
$835.92
|
| Rate for Payer: Cash Price |
$946.00
|
| Rate for Payer: Cigna of CA HMO |
$1,204.00
|
| Rate for Payer: Cigna of CA PPO |
$1,204.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,462.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,462.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,462.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$688.00
|
| Rate for Payer: EPIC Health Plan Senior |
$688.00
|
| Rate for Payer: Galaxy Health WC |
$1,462.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,032.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,147.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$655.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,064.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$412.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,204.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,204.00
|
| Rate for Payer: Multiplan Commercial |
$1,376.00
|
| Rate for Payer: Networks By Design Commercial |
$860.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,462.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,032.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,032.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$645.52
|
| Rate for Payer: United Healthcare All Other HMO |
$628.32
|
| Rate for Payer: United Healthcare HMO Rider |
$614.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$563.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,462.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,462.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,462.00
|
|
|
HC CATH MED RIGHTSITE C315HIS02
|
Facility
|
IP
|
$1,720.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812696
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$344.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$344.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$946.00
|
| Rate for Payer: Cash Price |
$946.00
|
| Rate for Payer: Cigna of CA HMO |
$1,204.00
|
| Rate for Payer: Cigna of CA PPO |
$1,204.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$688.00
|
| Rate for Payer: EPIC Health Plan Senior |
$688.00
|
| Rate for Payer: Galaxy Health WC |
$1,462.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,032.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,147.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$655.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,064.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$412.80
|
| Rate for Payer: Multiplan Commercial |
$1,376.00
|
| Rate for Payer: Networks By Design Commercial |
$860.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,462.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$645.52
|
| Rate for Payer: United Healthcare All Other HMO |
$628.32
|
| Rate for Payer: United Healthcare HMO Rider |
$614.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$563.30
|
|
|
HC CATH MED SELECTSITE C315
|
Facility
|
OP
|
$1,380.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812500
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$276.00 |
| Max. Negotiated Rate |
$1,173.00 |
| Rate for Payer: Adventist Health Commercial |
$276.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$905.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,173.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$759.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,035.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$847.46
|
| Rate for Payer: Cash Price |
$759.00
|
| Rate for Payer: Cigna of CA HMO |
$883.20
|
| Rate for Payer: Cigna of CA PPO |
$1,021.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,173.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,173.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,173.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$552.00
|
| Rate for Payer: EPIC Health Plan Senior |
$552.00
|
| Rate for Payer: Galaxy Health WC |
$1,173.00
|
| Rate for Payer: Global Benefits Group Commercial |
$828.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$920.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$525.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$854.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$966.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$966.00
|
| Rate for Payer: Multiplan Commercial |
$1,104.00
|
| Rate for Payer: Networks By Design Commercial |
$897.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,173.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$828.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$828.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$690.00
|
| Rate for Payer: United Healthcare All Other HMO |
$690.00
|
| Rate for Payer: United Healthcare HMO Rider |
$690.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$690.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,173.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,173.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,173.00
|
|
