|
HC CATH 2 LUMEN 5.5FR 50CM PICC
|
Facility
|
OP
|
$940.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.05 |
| Max. Negotiated Rate |
$799.20 |
| Rate for Payer: Adventist Health Commercial |
$188.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$799.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$517.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$705.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$569.13
|
| Rate for Payer: Blue Shield of California Commercial |
$476.70
|
| Rate for Payer: Blue Shield of California Commercial |
$723.04
|
| Rate for Payer: Cash Price |
$423.11
|
| Rate for Payer: Cigna of CA HMO |
$658.17
|
| Rate for Payer: Cigna of CA PPO |
$658.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$799.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$799.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$799.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$658.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.10
|
| Rate for Payer: EPIC Health Plan Senior |
$376.10
|
| Rate for Payer: Galaxy Health WC |
$799.20
|
| Rate for Payer: Global Benefits Group Commercial |
$564.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$597.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$341.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$554.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$658.17
|
| Rate for Payer: Multiplan Commercial |
$752.19
|
| Rate for Payer: Networks By Design Commercial |
$470.12
|
| Rate for Payer: Prime Health Services Commercial |
$799.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$564.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$564.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$352.87
|
| Rate for Payer: United Healthcare All Other HMO |
$343.47
|
| Rate for Payer: United Healthcare HMO Rider |
$336.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$307.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$799.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$799.20
|
| Rate for Payer: Vantage Medical Group Senior |
$799.20
|
|
|
HC CATH 2 LUMEN 5.5FR 55CM PICC
|
Facility
|
IP
|
$940.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.05 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Networks By Design Commercial |
$470.12
|
| Rate for Payer: Adventist Health Commercial |
$188.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$423.11
|
| Rate for Payer: Cash Price |
$423.11
|
| Rate for Payer: Cigna of CA HMO |
$658.17
|
| Rate for Payer: Cigna of CA PPO |
$658.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$658.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.10
|
| Rate for Payer: EPIC Health Plan Senior |
$376.10
|
| Rate for Payer: Galaxy Health WC |
$799.20
|
| Rate for Payer: Global Benefits Group Commercial |
$564.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$597.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$554.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.66
|
| Rate for Payer: Multiplan Commercial |
$752.19
|
| Rate for Payer: Prime Health Services Commercial |
$799.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$352.87
|
| Rate for Payer: United Healthcare All Other HMO |
$343.47
|
| Rate for Payer: United Healthcare HMO Rider |
$336.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$307.93
|
|
|
HC CATH 2 LUMEN 5.5FR 55CM PICC
|
Facility
|
OP
|
$940.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$188.05 |
| Max. Negotiated Rate |
$799.20 |
| Rate for Payer: Adventist Health Commercial |
$188.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$799.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$517.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$705.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$569.13
|
| Rate for Payer: Blue Shield of California Commercial |
$476.70
|
| Rate for Payer: Blue Shield of California Commercial |
$723.04
|
| Rate for Payer: Cash Price |
$423.11
|
| Rate for Payer: Cigna of CA HMO |
$658.17
|
| Rate for Payer: Cigna of CA PPO |
$658.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$799.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$799.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$799.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$658.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.10
|
| Rate for Payer: EPIC Health Plan Senior |
$376.10
|
| Rate for Payer: Galaxy Health WC |
$799.20
|
| Rate for Payer: Global Benefits Group Commercial |
$564.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$597.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$341.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$554.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$658.17
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$658.17
|
| Rate for Payer: Multiplan Commercial |
$752.19
|
| Rate for Payer: Networks By Design Commercial |
$470.12
|
| Rate for Payer: Prime Health Services Commercial |
$799.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$564.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$564.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$352.87
|
| Rate for Payer: United Healthcare All Other HMO |
$343.47
|
| Rate for Payer: United Healthcare HMO Rider |
$336.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$307.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$799.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$799.20
|
| Rate for Payer: Vantage Medical Group Senior |
$799.20
|
|
|
HC CATH 3.5FR UMBILICAL 1 LUMEN
|
Facility
|
OP
|
$110.20
|
|
| Hospital Charge Code |
901698606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.04 |
| Max. Negotiated Rate |
$93.67 |
| Rate for Payer: Adventist Health Commercial |
$22.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$72.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$60.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$82.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.72
|
| Rate for Payer: Cash Price |
$49.59
|
| Rate for Payer: Cigna of CA HMO |
$70.53
|
| Rate for Payer: Cigna of CA PPO |
$81.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$93.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$93.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$77.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.08
|
| Rate for Payer: EPIC Health Plan Senior |
$44.08
|
| Rate for Payer: Galaxy Health WC |
$93.67
|
| Rate for Payer: Global Benefits Group Commercial |
$66.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$69.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$65.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77.14
|
| Rate for Payer: Multiplan Commercial |
$88.16
|
| Rate for Payer: Networks By Design Commercial |
$71.63
|
| Rate for Payer: Prime Health Services Commercial |
$93.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.10
|
| Rate for Payer: United Healthcare All Other HMO |
$55.10
|
| Rate for Payer: United Healthcare HMO Rider |
$55.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$93.67
|
| Rate for Payer: Vantage Medical Group Senior |
$93.67
|
|
|
HC CATH 3.5FR UMBILICAL 1 LUMEN
|
Facility
|
IP
|
$110.20
|
|
| Hospital Charge Code |
901698606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.04 |
| Max. Negotiated Rate |
$93.67 |
| Rate for Payer: Adventist Health Commercial |
$22.04
|
| Rate for Payer: Cash Price |
$49.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$77.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.08
|
| Rate for Payer: EPIC Health Plan Senior |
$44.08
|
| Rate for Payer: Galaxy Health WC |
$93.67
|
| Rate for Payer: Global Benefits Group Commercial |
$66.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$69.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$65.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.45
|
| Rate for Payer: Multiplan Commercial |
$88.16
|
| Rate for Payer: Networks By Design Commercial |
$71.63
|
| Rate for Payer: Prime Health Services Commercial |
$93.67
|
|
|
HC CATH 4 LUMEN 8.5FR X 6" PRS INJ
|
Facility
|
IP
|
$580.52
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698317
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.10 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$116.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$261.23
|
| Rate for Payer: Cash Price |
$261.23
|
| Rate for Payer: Cigna of CA HMO |
$406.36
|
| Rate for Payer: Cigna of CA PPO |
$406.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.21
|
| Rate for Payer: EPIC Health Plan Senior |
$232.21
|
| Rate for Payer: Galaxy Health WC |
$493.44
|
| Rate for Payer: Global Benefits Group Commercial |
$348.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.32
|
| Rate for Payer: Multiplan Commercial |
$464.42
|
| Rate for Payer: Networks By Design Commercial |
$290.26
|
| Rate for Payer: Prime Health Services Commercial |
$493.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.87
|
| Rate for Payer: United Healthcare All Other HMO |
$212.06
|
| Rate for Payer: United Healthcare HMO Rider |
$207.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$190.12
|
|
|
HC CATH 4 LUMEN 8.5FR X 6" PRS INJ
|
Facility
|
OP
|
$580.52
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698317
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.10 |
| Max. Negotiated Rate |
$493.44 |
| Rate for Payer: Adventist Health Commercial |
$116.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$351.39
|
| Rate for Payer: Blue Shield of California Commercial |
$294.32
|
| Rate for Payer: Blue Shield of California Commercial |
$446.42
|
| Rate for Payer: Cash Price |
$261.23
|
| Rate for Payer: Cigna of CA HMO |
$406.36
|
| Rate for Payer: Cigna of CA PPO |
$406.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$406.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.21
|
| Rate for Payer: EPIC Health Plan Senior |
$232.21
|
| Rate for Payer: Galaxy Health WC |
$493.44
|
| Rate for Payer: Global Benefits Group Commercial |
$348.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$368.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$210.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$342.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.36
|
| Rate for Payer: Multiplan Commercial |
$464.42
|
| Rate for Payer: Networks By Design Commercial |
$290.26
|
| Rate for Payer: Prime Health Services Commercial |
$493.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.87
|
| Rate for Payer: United Healthcare All Other HMO |
$212.06
|
| Rate for Payer: United Healthcare HMO Rider |
$207.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$190.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.44
|
| Rate for Payer: Vantage Medical Group Senior |
$493.44
|
|
|
HC CATH ACUTE PERITONEAL DIALYSS
|
Facility
|
OP
|
$990.15
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
901602939
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.03 |
| Max. Negotiated Rate |
$841.63 |
| Rate for Payer: Adventist Health Commercial |
$198.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$841.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$544.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$742.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$599.34
|
| Rate for Payer: Blue Shield of California Commercial |
$502.01
|
| Rate for Payer: Blue Shield of California Commercial |
$761.43
|
| Rate for Payer: Cash Price |
$445.57
|
| Rate for Payer: Cigna of CA HMO |
$693.11
|
| Rate for Payer: Cigna of CA PPO |
$693.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$841.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$841.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$841.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$693.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$396.06
|
| Rate for Payer: EPIC Health Plan Senior |
$396.06
|
| Rate for Payer: Galaxy Health WC |
$841.63
|
| Rate for Payer: Global Benefits Group Commercial |
$594.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$628.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$359.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$584.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$693.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$693.11
|
| Rate for Payer: Multiplan Commercial |
$792.12
|
| Rate for Payer: Networks By Design Commercial |
$495.07
|
| Rate for Payer: Prime Health Services Commercial |
$841.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$594.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$594.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$371.60
|
| Rate for Payer: United Healthcare All Other HMO |
$361.70
|
| Rate for Payer: United Healthcare HMO Rider |
$353.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$324.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$841.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$841.63
|
| Rate for Payer: Vantage Medical Group Senior |
$841.63
|
|
|
HC CATH ACUTE PERITONEAL DIALYSS
|
Facility
|
IP
|
$990.15
|
|
|
Service Code
|
CPT C1750
|
| Hospital Charge Code |
901602939
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$198.03 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$198.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$445.57
|
| Rate for Payer: Cash Price |
$445.57
|
| Rate for Payer: Cigna of CA HMO |
$693.11
|
| Rate for Payer: Cigna of CA PPO |
$693.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$693.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$396.06
|
| Rate for Payer: EPIC Health Plan Senior |
$396.06
|
| Rate for Payer: Galaxy Health WC |
$841.63
|
| Rate for Payer: Global Benefits Group Commercial |
$594.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$628.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$584.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.64
|
| Rate for Payer: Multiplan Commercial |
$792.12
|
| Rate for Payer: Networks By Design Commercial |
$495.07
|
| Rate for Payer: Prime Health Services Commercial |
$841.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$371.60
|
| Rate for Payer: United Healthcare All Other HMO |
$361.70
|
| Rate for Payer: United Healthcare HMO Rider |
$353.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$324.27
|
|
|
HC CATH AGA EXCHANGE SYS
|
Facility
|
IP
|
$2,355.60
|
|
| Hospital Charge Code |
906812241
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$471.12 |
| Max. Negotiated Rate |
$2,002.26 |
| Rate for Payer: Adventist Health Commercial |
$471.12
|
| Rate for Payer: Cash Price |
$1,060.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,648.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$942.24
|
| Rate for Payer: EPIC Health Plan Senior |
$942.24
|
| Rate for Payer: Galaxy Health WC |
$2,002.26
|
| Rate for Payer: Global Benefits Group Commercial |
$1,413.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,495.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,389.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$565.34
|
| Rate for Payer: Multiplan Commercial |
$1,884.48
|
| Rate for Payer: Networks By Design Commercial |
$1,531.14
|
| Rate for Payer: Prime Health Services Commercial |
$2,002.26
|
|
|
HC CATH AGA EXCHANGE SYS
|
Facility
|
OP
|
$2,355.60
|
|
| Hospital Charge Code |
906812241
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$471.12 |
| Max. Negotiated Rate |
$2,002.26 |
| Rate for Payer: Adventist Health Commercial |
$471.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,545.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,002.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,295.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,766.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,511.59
|
| Rate for Payer: Cash Price |
$1,060.02
|
| Rate for Payer: Cigna of CA HMO |
$1,507.58
|
| Rate for Payer: Cigna of CA PPO |
$1,743.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,002.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,002.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,002.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,648.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$942.24
|
| Rate for Payer: EPIC Health Plan Senior |
$942.24
|
| Rate for Payer: Galaxy Health WC |
$2,002.26
|
| Rate for Payer: Global Benefits Group Commercial |
$1,413.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,495.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$855.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,389.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$565.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,648.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,648.92
|
| Rate for Payer: Multiplan Commercial |
$1,884.48
|
| Rate for Payer: Networks By Design Commercial |
$1,531.14
|
| Rate for Payer: Prime Health Services Commercial |
$2,002.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,413.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,413.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,177.80
|
| Rate for Payer: United Healthcare All Other HMO |
$1,177.80
|
| Rate for Payer: United Healthcare HMO Rider |
$1,177.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,177.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,002.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,002.26
|
| Rate for Payer: Vantage Medical Group Senior |
$2,002.26
|
|
|
HC CATH AIRWAY EXCHANGE 11FR
|
Facility
|
OP
|
$393.18
|
|
| Hospital Charge Code |
901603694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$334.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$216.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$252.30
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: Cigna of CA HMO |
$251.64
|
| Rate for Payer: Cigna of CA PPO |
$290.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$334.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$334.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$334.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$249.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$142.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$275.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$275.23
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$235.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$235.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$196.59
|
| Rate for Payer: United Healthcare All Other HMO |
$196.59
|
| Rate for Payer: United Healthcare HMO Rider |
$196.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$334.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$334.20
|
| Rate for Payer: Vantage Medical Group Senior |
$334.20
|
|
|
HC CATH AIRWAY EXCHANGE 11FR
|
Facility
|
IP
|
$393.18
|
|
| Hospital Charge Code |
901603694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$249.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
|
|
HC CATH AIRWAY EXCHANGE 14FR
|
Facility
|
OP
|
$393.18
|
|
| Hospital Charge Code |
901603695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$334.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$216.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$252.30
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: Cigna of CA HMO |
$251.64
|
| Rate for Payer: Cigna of CA PPO |
$290.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$334.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$334.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$334.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$249.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$142.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$275.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$275.23
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$235.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$235.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$196.59
|
| Rate for Payer: United Healthcare All Other HMO |
$196.59
|
| Rate for Payer: United Healthcare HMO Rider |
$196.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$334.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$334.20
|
| Rate for Payer: Vantage Medical Group Senior |
$334.20
|
|
|
HC CATH AIRWAY EXCHANGE 14FR
|
Facility
|
IP
|
$393.18
|
|
| Hospital Charge Code |
901603695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$249.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
|
|
HC CATH AIRWAY EXCHANGE 19FR
|
Facility
|
IP
|
$393.18
|
|
| Hospital Charge Code |
901604178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$249.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
|
|
HC CATH AIRWAY EXCHANGE 19FR
|
Facility
|
OP
|
$393.18
|
|
| Hospital Charge Code |
901604178
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$334.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$216.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$252.30
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: Cigna of CA HMO |
$251.64
|
| Rate for Payer: Cigna of CA PPO |
$290.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$334.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$334.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$334.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$249.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$142.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$275.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$275.23
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$235.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$235.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$196.59
|
| Rate for Payer: United Healthcare All Other HMO |
$196.59
|
| Rate for Payer: United Healthcare HMO Rider |
$196.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$334.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$334.20
|
| Rate for Payer: Vantage Medical Group Senior |
$334.20
|
|
|
HC CATH AIRWAY EXCHANGE 8FR
|
Facility
|
IP
|
$393.18
|
|
| Hospital Charge Code |
901603693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$249.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
|
|
HC CATH AIRWAY EXCHANGE 8FR
|
Facility
|
OP
|
$393.18
|
|
| Hospital Charge Code |
901603693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$78.64 |
| Max. Negotiated Rate |
$334.20 |
| Rate for Payer: Adventist Health Commercial |
$78.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$257.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$334.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$216.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$294.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$252.30
|
| Rate for Payer: Cash Price |
$176.93
|
| Rate for Payer: Cigna of CA HMO |
$251.64
|
| Rate for Payer: Cigna of CA PPO |
$290.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$334.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$334.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$334.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$275.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$157.27
|
| Rate for Payer: EPIC Health Plan Senior |
$157.27
|
| Rate for Payer: Galaxy Health WC |
$334.20
|
| Rate for Payer: Global Benefits Group Commercial |
$235.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$249.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$142.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$231.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$275.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$275.23
|
| Rate for Payer: Multiplan Commercial |
$314.54
|
| Rate for Payer: Networks By Design Commercial |
$255.57
|
| Rate for Payer: Prime Health Services Commercial |
$334.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$235.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$235.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$196.59
|
| Rate for Payer: United Healthcare All Other HMO |
$196.59
|
| Rate for Payer: United Healthcare HMO Rider |
$196.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$334.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$334.20
|
| Rate for Payer: Vantage Medical Group Senior |
$334.20
|
|
|
HC CATH ARGON T/D BAL
|
Facility
|
OP
|
$537.37
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
906811756
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$107.47 |
| Max. Negotiated Rate |
$1,155.59 |
| Rate for Payer: Adventist Health Commercial |
$107.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,155.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$456.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$295.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$403.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$344.83
|
| Rate for Payer: Cash Price |
$241.82
|
| Rate for Payer: Cash Price |
$241.82
|
| Rate for Payer: Cigna of CA HMO |
$343.92
|
| Rate for Payer: Cigna of CA PPO |
$397.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$456.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$456.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$456.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$376.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$214.95
|
| Rate for Payer: EPIC Health Plan Senior |
$214.95
|
| Rate for Payer: Galaxy Health WC |
$456.76
|
| Rate for Payer: Global Benefits Group Commercial |
$322.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$341.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$195.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$317.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$376.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$376.16
|
| Rate for Payer: Multiplan Commercial |
$429.90
|
| Rate for Payer: Networks By Design Commercial |
$349.29
|
| Rate for Payer: Prime Health Services Commercial |
$456.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$322.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$322.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$268.69
|
| Rate for Payer: United Healthcare All Other HMO |
$268.69
|
| Rate for Payer: United Healthcare HMO Rider |
$268.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$268.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$456.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$456.76
|
| Rate for Payer: Vantage Medical Group Senior |
$456.76
|
|
|
HC CATH ARGON T/D BAL
|
Facility
|
IP
|
$537.37
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
906811756
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$107.47 |
| Max. Negotiated Rate |
$456.76 |
| Rate for Payer: Adventist Health Commercial |
$107.47
|
| Rate for Payer: Cash Price |
$241.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$376.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$214.95
|
| Rate for Payer: EPIC Health Plan Senior |
$214.95
|
| Rate for Payer: Galaxy Health WC |
$456.76
|
| Rate for Payer: Global Benefits Group Commercial |
$322.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$341.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$317.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.97
|
| Rate for Payer: Multiplan Commercial |
$429.90
|
| Rate for Payer: Networks By Design Commercial |
$349.29
|
| Rate for Payer: Prime Health Services Commercial |
$456.76
|
|
|
HC CATH ARROW ANGIO BAL
|
Facility
|
IP
|
$247.87
|
|
| Hospital Charge Code |
906812007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.57 |
| Max. Negotiated Rate |
$210.69 |
| Rate for Payer: Adventist Health Commercial |
$49.57
|
| Rate for Payer: Cash Price |
$111.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$173.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.15
|
| Rate for Payer: EPIC Health Plan Senior |
$99.15
|
| Rate for Payer: Galaxy Health WC |
$210.69
|
| Rate for Payer: Global Benefits Group Commercial |
$148.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$157.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$146.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.49
|
| Rate for Payer: Multiplan Commercial |
$198.30
|
| Rate for Payer: Networks By Design Commercial |
$161.12
|
| Rate for Payer: Prime Health Services Commercial |
$210.69
|
|
|
HC CATH ARROW ANGIO BAL
|
Facility
|
OP
|
$247.87
|
|
| Hospital Charge Code |
906812007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.57 |
| Max. Negotiated Rate |
$210.69 |
| Rate for Payer: Adventist Health Commercial |
$49.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$162.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$210.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$185.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$159.06
|
| Rate for Payer: Cash Price |
$111.54
|
| Rate for Payer: Cigna of CA HMO |
$158.64
|
| Rate for Payer: Cigna of CA PPO |
$183.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$210.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$210.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$210.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$173.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.15
|
| Rate for Payer: EPIC Health Plan Senior |
$99.15
|
| Rate for Payer: Galaxy Health WC |
$210.69
|
| Rate for Payer: Global Benefits Group Commercial |
$148.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$157.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$89.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$146.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$173.51
|
| Rate for Payer: Multiplan Commercial |
$198.30
|
| Rate for Payer: Networks By Design Commercial |
$161.12
|
| Rate for Payer: Prime Health Services Commercial |
$210.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$148.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$148.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.94
|
| Rate for Payer: United Healthcare All Other HMO |
$123.94
|
| Rate for Payer: United Healthcare HMO Rider |
$123.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$210.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$210.69
|
| Rate for Payer: Vantage Medical Group Senior |
$210.69
|
|
|
HC CATH ARROW T/D BAL
|
Facility
|
OP
|
$334.04
|
|
| Hospital Charge Code |
906812009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.81 |
| Max. Negotiated Rate |
$283.93 |
| Rate for Payer: Adventist Health Commercial |
$66.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$219.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$283.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$183.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$214.35
|
| Rate for Payer: Cash Price |
$150.32
|
| Rate for Payer: Cigna of CA HMO |
$213.79
|
| Rate for Payer: Cigna of CA PPO |
$247.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$283.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$283.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$233.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$133.62
|
| Rate for Payer: EPIC Health Plan Senior |
$133.62
|
| Rate for Payer: Galaxy Health WC |
$283.93
|
| Rate for Payer: Global Benefits Group Commercial |
$200.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$212.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$121.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$197.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$233.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$233.83
|
| Rate for Payer: Multiplan Commercial |
$267.23
|
| Rate for Payer: Networks By Design Commercial |
$217.13
|
| Rate for Payer: Prime Health Services Commercial |
$283.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$200.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$200.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$167.02
|
| Rate for Payer: United Healthcare All Other HMO |
$167.02
|
| Rate for Payer: United Healthcare HMO Rider |
$167.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$167.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$283.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.93
|
| Rate for Payer: Vantage Medical Group Senior |
$283.93
|
|
|
HC CATH ARROW T/D BAL
|
Facility
|
IP
|
$334.04
|
|
| Hospital Charge Code |
906812009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$66.81 |
| Max. Negotiated Rate |
$283.93 |
| Rate for Payer: Adventist Health Commercial |
$66.81
|
| Rate for Payer: Cash Price |
$150.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$233.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$133.62
|
| Rate for Payer: EPIC Health Plan Senior |
$133.62
|
| Rate for Payer: Galaxy Health WC |
$283.93
|
| Rate for Payer: Global Benefits Group Commercial |
$200.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$212.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$197.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.17
|
| Rate for Payer: Multiplan Commercial |
$267.23
|
| Rate for Payer: Networks By Design Commercial |
$217.13
|
| Rate for Payer: Prime Health Services Commercial |
$283.93
|
|
