|
HC CATH ARROW T/D BAL 6FR 110CM
|
Facility
|
IP
|
$563.00
|
|
| Hospital Charge Code |
906812367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$112.60 |
| Max. Negotiated Rate |
$478.55 |
| Rate for Payer: Adventist Health Commercial |
$112.60
|
| Rate for Payer: Cash Price |
$253.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$394.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$225.20
|
| Rate for Payer: EPIC Health Plan Senior |
$225.20
|
| Rate for Payer: Galaxy Health WC |
$478.55
|
| Rate for Payer: Global Benefits Group Commercial |
$337.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$357.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$332.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.12
|
| Rate for Payer: Multiplan Commercial |
$450.40
|
| Rate for Payer: Networks By Design Commercial |
$365.95
|
| Rate for Payer: Prime Health Services Commercial |
$478.55
|
|
|
HC CATH ARROW T/D BAL 6FR 110CM
|
Facility
|
OP
|
$563.00
|
|
| Hospital Charge Code |
906812367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$112.60 |
| Max. Negotiated Rate |
$478.55 |
| Rate for Payer: Adventist Health Commercial |
$112.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$369.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$478.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$309.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$422.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$361.28
|
| Rate for Payer: Cash Price |
$253.35
|
| Rate for Payer: Cigna of CA HMO |
$360.32
|
| Rate for Payer: Cigna of CA PPO |
$416.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$478.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$478.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$478.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$394.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$225.20
|
| Rate for Payer: EPIC Health Plan Senior |
$225.20
|
| Rate for Payer: Galaxy Health WC |
$478.55
|
| Rate for Payer: Global Benefits Group Commercial |
$337.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$357.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$204.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$332.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$394.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$394.10
|
| Rate for Payer: Multiplan Commercial |
$450.40
|
| Rate for Payer: Networks By Design Commercial |
$365.95
|
| Rate for Payer: Prime Health Services Commercial |
$478.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$337.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$337.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$281.50
|
| Rate for Payer: United Healthcare All Other HMO |
$281.50
|
| Rate for Payer: United Healthcare HMO Rider |
$281.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$281.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$478.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$478.55
|
| Rate for Payer: Vantage Medical Group Senior |
$478.55
|
|
|
HC CATH, ARROW-TRETOTOLA THROMBOL
|
Facility
|
OP
|
$1,440.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909081697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.00 |
| Max. Negotiated Rate |
$1,224.00 |
| Rate for Payer: Adventist Health Commercial |
$288.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,224.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$792.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,080.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$871.63
|
| Rate for Payer: Blue Shield of California Commercial |
$1,107.36
|
| Rate for Payer: Blue Shield of California Commercial |
$730.08
|
| Rate for Payer: Cash Price |
$648.00
|
| Rate for Payer: Cigna of CA HMO |
$1,008.00
|
| Rate for Payer: Cigna of CA PPO |
$1,008.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,224.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,224.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,224.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,008.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$576.00
|
| Rate for Payer: EPIC Health Plan Senior |
$576.00
|
| Rate for Payer: Galaxy Health WC |
$1,224.00
|
| Rate for Payer: Global Benefits Group Commercial |
$864.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$914.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$522.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$849.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$345.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,008.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,008.00
|
| Rate for Payer: Multiplan Commercial |
$1,152.00
|
| Rate for Payer: Networks By Design Commercial |
$720.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,224.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$864.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$864.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$540.43
|
| Rate for Payer: United Healthcare All Other HMO |
$526.03
|
| Rate for Payer: United Healthcare HMO Rider |
$514.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$471.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,224.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,224.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,224.00
|
|
|
HC CATH, ARROW-TRETOTOLA THROMBOL
|
Facility
|
IP
|
$1,440.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909081697
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$288.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$288.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$648.00
|
| Rate for Payer: Cash Price |
$648.00
|
| Rate for Payer: Cigna of CA HMO |
$1,008.00
|
| Rate for Payer: Cigna of CA PPO |
$1,008.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,008.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$576.00
|
| Rate for Payer: EPIC Health Plan Senior |
$576.00
|
| Rate for Payer: Galaxy Health WC |
$1,224.00
|
| Rate for Payer: Global Benefits Group Commercial |
$864.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$914.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$849.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$345.60
|
| Rate for Payer: Multiplan Commercial |
$1,152.00
|
| Rate for Payer: Networks By Design Commercial |
$720.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,224.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$540.43
|
| Rate for Payer: United Healthcare All Other HMO |
$526.03
|
| Rate for Payer: United Healthcare HMO Rider |
$514.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$471.60
|
|
|
HC CATH ARROW TWO-LUMEN CVP 9FR
|
Facility
|
IP
|
$566.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
906812635
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.20 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$113.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$254.70
|
| Rate for Payer: Cash Price |
$254.70
|
| Rate for Payer: Cigna of CA HMO |
$396.20
|
| Rate for Payer: Cigna of CA PPO |
$396.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$396.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$226.40
|
| Rate for Payer: EPIC Health Plan Senior |
$226.40
|
| Rate for Payer: Galaxy Health WC |
$481.10
|
| Rate for Payer: Global Benefits Group Commercial |
$339.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$359.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$333.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.84
|
| Rate for Payer: Multiplan Commercial |
$452.80
|
| Rate for Payer: Networks By Design Commercial |
$283.00
|
| Rate for Payer: Prime Health Services Commercial |
$481.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$212.42
|
| Rate for Payer: United Healthcare All Other HMO |
$206.76
|
| Rate for Payer: United Healthcare HMO Rider |
$202.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$185.37
|
|
|
HC CATH ARROW TWO-LUMEN CVP 9FR
|
Facility
|
OP
|
$566.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
906812635
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$113.20 |
| Max. Negotiated Rate |
$481.10 |
| Rate for Payer: Adventist Health Commercial |
$113.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$481.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$311.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$424.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$342.60
|
| Rate for Payer: Blue Shield of California Commercial |
$286.96
|
| Rate for Payer: Blue Shield of California Commercial |
$435.25
|
| Rate for Payer: Cash Price |
$254.70
|
| Rate for Payer: Cigna of CA HMO |
$396.20
|
| Rate for Payer: Cigna of CA PPO |
$396.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$481.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$481.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$481.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$396.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$226.40
|
| Rate for Payer: EPIC Health Plan Senior |
$226.40
|
| Rate for Payer: Galaxy Health WC |
$481.10
|
| Rate for Payer: Global Benefits Group Commercial |
$339.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$359.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$205.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$333.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$396.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$396.20
|
| Rate for Payer: Multiplan Commercial |
$452.80
|
| Rate for Payer: Networks By Design Commercial |
$283.00
|
| Rate for Payer: Prime Health Services Commercial |
$481.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$339.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$339.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$212.42
|
| Rate for Payer: United Healthcare All Other HMO |
$206.76
|
| Rate for Payer: United Healthcare HMO Rider |
$202.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$185.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$481.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$481.10
|
| Rate for Payer: Vantage Medical Group Senior |
$481.10
|
|
|
HC CATH ARTERIAL 20GA X1-3/4" KIT
|
Facility
|
OP
|
$214.90
|
|
| Hospital Charge Code |
901698169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.98 |
| Max. Negotiated Rate |
$182.66 |
| Rate for Payer: Adventist Health Commercial |
$42.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$140.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$182.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$118.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$161.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$137.90
|
| Rate for Payer: Cash Price |
$96.70
|
| Rate for Payer: Cigna of CA HMO |
$137.54
|
| Rate for Payer: Cigna of CA PPO |
$159.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$182.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$182.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$150.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.96
|
| Rate for Payer: EPIC Health Plan Senior |
$85.96
|
| Rate for Payer: Galaxy Health WC |
$182.66
|
| Rate for Payer: Global Benefits Group Commercial |
$128.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$136.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$78.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$126.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$150.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$150.43
|
| Rate for Payer: Multiplan Commercial |
$171.92
|
| Rate for Payer: Networks By Design Commercial |
$139.69
|
| Rate for Payer: Prime Health Services Commercial |
$182.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$128.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$128.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$107.45
|
| Rate for Payer: United Healthcare All Other HMO |
$107.45
|
| Rate for Payer: United Healthcare HMO Rider |
$107.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$107.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$182.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.66
|
| Rate for Payer: Vantage Medical Group Senior |
$182.66
|
|
|
HC CATH ARTERIAL 20GA X1-3/4" KIT
|
Facility
|
IP
|
$214.90
|
|
| Hospital Charge Code |
901698169
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.98 |
| Max. Negotiated Rate |
$182.66 |
| Rate for Payer: Adventist Health Commercial |
$42.98
|
| Rate for Payer: Cash Price |
$96.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$150.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.96
|
| Rate for Payer: EPIC Health Plan Senior |
$85.96
|
| Rate for Payer: Galaxy Health WC |
$182.66
|
| Rate for Payer: Global Benefits Group Commercial |
$128.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$136.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$126.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.58
|
| Rate for Payer: Multiplan Commercial |
$171.92
|
| Rate for Payer: Networks By Design Commercial |
$139.69
|
| Rate for Payer: Prime Health Services Commercial |
$182.66
|
|
|
HC CATH ARTERIAL KIT 20GA
|
Facility
|
OP
|
$203.00
|
|
| Hospital Charge Code |
901698701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$172.55 |
| Rate for Payer: EPIC Health Plan Commercial |
$81.20
|
| Rate for Payer: EPIC Health Plan Senior |
$81.20
|
| Rate for Payer: Galaxy Health WC |
$172.55
|
| Rate for Payer: Adventist Health Commercial |
$40.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$133.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$172.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$111.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$152.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$130.27
|
| Rate for Payer: Cash Price |
$91.35
|
| Rate for Payer: Cigna of CA HMO |
$129.92
|
| Rate for Payer: Cigna of CA PPO |
$150.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$172.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$172.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$172.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$142.10
|
| Rate for Payer: Global Benefits Group Commercial |
$121.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$128.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$73.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$119.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$142.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$142.10
|
| Rate for Payer: Multiplan Commercial |
$162.40
|
| Rate for Payer: Networks By Design Commercial |
$131.95
|
| Rate for Payer: Prime Health Services Commercial |
$172.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$121.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$121.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$101.50
|
| Rate for Payer: United Healthcare All Other HMO |
$101.50
|
| Rate for Payer: United Healthcare HMO Rider |
$101.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$172.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$172.55
|
| Rate for Payer: Vantage Medical Group Senior |
$172.55
|
|
|
HC CATH ARTERIAL KIT 20GA
|
Facility
|
OP
|
$318.29
|
|
| Hospital Charge Code |
901607626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$270.55 |
| Rate for Payer: Adventist Health Commercial |
$63.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$208.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$270.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$175.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$238.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$204.25
|
| Rate for Payer: Cash Price |
$143.23
|
| Rate for Payer: Cigna of CA HMO |
$203.71
|
| Rate for Payer: Cigna of CA PPO |
$235.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$270.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$270.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$270.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$222.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$127.32
|
| Rate for Payer: EPIC Health Plan Senior |
$127.32
|
| Rate for Payer: Galaxy Health WC |
$270.55
|
| Rate for Payer: Global Benefits Group Commercial |
$190.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$202.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$115.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$187.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$222.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$222.80
|
| Rate for Payer: Multiplan Commercial |
$254.63
|
| Rate for Payer: Networks By Design Commercial |
$206.89
|
| Rate for Payer: Prime Health Services Commercial |
$270.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$190.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$190.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$159.15
|
| Rate for Payer: United Healthcare All Other HMO |
$159.15
|
| Rate for Payer: United Healthcare HMO Rider |
$159.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$159.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$270.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$270.55
|
| Rate for Payer: Vantage Medical Group Senior |
$270.55
|
|
|
HC CATH ARTERIAL KIT 20GA
|
Facility
|
IP
|
$318.29
|
|
| Hospital Charge Code |
901607626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.66 |
| Max. Negotiated Rate |
$270.55 |
| Rate for Payer: Adventist Health Commercial |
$63.66
|
| Rate for Payer: Cash Price |
$143.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$222.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$127.32
|
| Rate for Payer: EPIC Health Plan Senior |
$127.32
|
| Rate for Payer: Galaxy Health WC |
$270.55
|
| Rate for Payer: Global Benefits Group Commercial |
$190.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$202.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$187.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$76.39
|
| Rate for Payer: Multiplan Commercial |
$254.63
|
| Rate for Payer: Networks By Design Commercial |
$206.89
|
| Rate for Payer: Prime Health Services Commercial |
$270.55
|
|
|
HC CATH ARTERIAL KIT 20GA
|
Facility
|
IP
|
$203.00
|
|
| Hospital Charge Code |
901698701
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$172.55 |
| Rate for Payer: Adventist Health Commercial |
$40.60
|
| Rate for Payer: Cash Price |
$91.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$142.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.20
|
| Rate for Payer: EPIC Health Plan Senior |
$81.20
|
| Rate for Payer: Galaxy Health WC |
$172.55
|
| Rate for Payer: Global Benefits Group Commercial |
$121.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$128.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$119.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.72
|
| Rate for Payer: Multiplan Commercial |
$162.40
|
| Rate for Payer: Networks By Design Commercial |
$131.95
|
| Rate for Payer: Prime Health Services Commercial |
$172.55
|
|
|
HC CATH ARTERIAL SET 18GA X 12CM
|
Facility
|
IP
|
$152.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$129.20 |
| Rate for Payer: Adventist Health Commercial |
$30.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$106.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Senior |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$96.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$89.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.48
|
| Rate for Payer: Multiplan Commercial |
$121.60
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
|
|
HC CATH ARTERIAL SET 18GA X 12CM
|
Facility
|
OP
|
$152.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$1,155.59 |
| Rate for Payer: Adventist Health Commercial |
$30.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,155.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$129.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$83.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$114.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$97.54
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cash Price |
$68.40
|
| Rate for Payer: Cigna of CA HMO |
$97.28
|
| Rate for Payer: Cigna of CA PPO |
$112.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$129.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$129.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$129.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$106.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Senior |
$60.80
|
| Rate for Payer: Galaxy Health WC |
$129.20
|
| Rate for Payer: Global Benefits Group Commercial |
$91.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$96.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$55.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$89.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$106.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$106.40
|
| Rate for Payer: Multiplan Commercial |
$121.60
|
| Rate for Payer: Networks By Design Commercial |
$98.80
|
| Rate for Payer: Prime Health Services Commercial |
$129.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$91.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$91.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$76.00
|
| Rate for Payer: United Healthcare All Other HMO |
$76.00
|
| Rate for Payer: United Healthcare HMO Rider |
$76.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$76.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$129.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$129.20
|
| Rate for Payer: Vantage Medical Group Senior |
$129.20
|
|
|
HC CATH ARTERIAL SET 20GA X 5CM
|
Facility
|
OP
|
$129.20
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.84 |
| Max. Negotiated Rate |
$1,155.59 |
| Rate for Payer: Adventist Health Commercial |
$25.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,155.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$109.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$71.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$96.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.91
|
| Rate for Payer: Cash Price |
$58.14
|
| Rate for Payer: Cash Price |
$58.14
|
| Rate for Payer: Cigna of CA HMO |
$82.69
|
| Rate for Payer: Cigna of CA PPO |
$95.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$109.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$109.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$109.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$90.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.68
|
| Rate for Payer: EPIC Health Plan Senior |
$51.68
|
| Rate for Payer: Galaxy Health WC |
$109.82
|
| Rate for Payer: Global Benefits Group Commercial |
$77.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$46.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$76.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$90.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$90.44
|
| Rate for Payer: Multiplan Commercial |
$103.36
|
| Rate for Payer: Networks By Design Commercial |
$83.98
|
| Rate for Payer: Prime Health Services Commercial |
$109.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$77.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$77.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$64.60
|
| Rate for Payer: United Healthcare All Other HMO |
$64.60
|
| Rate for Payer: United Healthcare HMO Rider |
$64.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$64.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$109.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$109.82
|
| Rate for Payer: Vantage Medical Group Senior |
$109.82
|
|
|
HC CATH ARTERIAL SET 20GA X 5CM
|
Facility
|
IP
|
$129.20
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.84 |
| Max. Negotiated Rate |
$109.82 |
| Rate for Payer: Adventist Health Commercial |
$25.84
|
| Rate for Payer: Cash Price |
$58.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$90.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.68
|
| Rate for Payer: EPIC Health Plan Senior |
$51.68
|
| Rate for Payer: Galaxy Health WC |
$109.82
|
| Rate for Payer: Global Benefits Group Commercial |
$77.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$76.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.01
|
| Rate for Payer: Multiplan Commercial |
$103.36
|
| Rate for Payer: Networks By Design Commercial |
$83.98
|
| Rate for Payer: Prime Health Services Commercial |
$109.82
|
|
|
HC CATH ATHERECTOMY CROSSER
|
Facility
|
IP
|
$4,737.50
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909020040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$947.50 |
| Max. Negotiated Rate |
$4,026.88 |
| Rate for Payer: Multiplan Commercial |
$3,790.00
|
| Rate for Payer: Adventist Health Commercial |
$947.50
|
| Rate for Payer: Cash Price |
$2,131.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,316.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,895.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,895.00
|
| Rate for Payer: Galaxy Health WC |
$4,026.88
|
| Rate for Payer: Global Benefits Group Commercial |
$2,842.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,008.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,795.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,137.00
|
| Rate for Payer: Networks By Design Commercial |
$3,079.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,026.88
|
|
|
HC CATH ATHERECTOMY CROSSER
|
Facility
|
OP
|
$4,737.50
|
|
|
Service Code
|
CPT C1714
|
| Hospital Charge Code |
909020040
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$947.50 |
| Max. Negotiated Rate |
$26,837.02 |
| Rate for Payer: Adventist Health Commercial |
$947.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26,837.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,026.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,605.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,553.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,040.05
|
| Rate for Payer: Cash Price |
$2,131.88
|
| Rate for Payer: Cash Price |
$2,131.88
|
| Rate for Payer: Cigna of CA HMO |
$3,032.00
|
| Rate for Payer: Cigna of CA PPO |
$3,505.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,026.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,026.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,026.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,316.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,895.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,895.00
|
| Rate for Payer: Galaxy Health WC |
$4,026.88
|
| Rate for Payer: Global Benefits Group Commercial |
$2,842.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,008.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,719.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,795.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,137.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,316.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,316.25
|
| Rate for Payer: Multiplan Commercial |
$3,790.00
|
| Rate for Payer: Networks By Design Commercial |
$3,079.38
|
| Rate for Payer: Prime Health Services Commercial |
$4,026.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,842.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,842.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,368.75
|
| Rate for Payer: United Healthcare All Other HMO |
$2,368.75
|
| Rate for Payer: United Healthcare HMO Rider |
$2,368.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,368.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,026.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,026.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4,026.88
|
|
|
HC CATH BALLOON PURSUIT
|
Facility
|
IP
|
$630.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$126.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$283.50
|
| Rate for Payer: Cash Price |
$283.50
|
| Rate for Payer: Cigna of CA HMO |
$441.00
|
| Rate for Payer: Cigna of CA PPO |
$441.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$441.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.00
|
| Rate for Payer: EPIC Health Plan Senior |
$252.00
|
| Rate for Payer: Galaxy Health WC |
$535.50
|
| Rate for Payer: Global Benefits Group Commercial |
$378.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$400.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$371.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.20
|
| Rate for Payer: Multiplan Commercial |
$504.00
|
| Rate for Payer: Networks By Design Commercial |
$315.00
|
| Rate for Payer: Prime Health Services Commercial |
$535.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$236.44
|
| Rate for Payer: United Healthcare All Other HMO |
$230.14
|
| Rate for Payer: United Healthcare HMO Rider |
$225.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.32
|
|
|
HC CATH BALLOON PURSUIT
|
Facility
|
OP
|
$630.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081415
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$126.00 |
| Max. Negotiated Rate |
$535.50 |
| Rate for Payer: Adventist Health Commercial |
$126.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$535.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$346.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$472.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$381.34
|
| Rate for Payer: Blue Shield of California Commercial |
$319.41
|
| Rate for Payer: Blue Shield of California Commercial |
$484.47
|
| Rate for Payer: Cash Price |
$283.50
|
| Rate for Payer: Cigna of CA HMO |
$441.00
|
| Rate for Payer: Cigna of CA PPO |
$441.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$535.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$535.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$535.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$441.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$252.00
|
| Rate for Payer: EPIC Health Plan Senior |
$252.00
|
| Rate for Payer: Galaxy Health WC |
$535.50
|
| Rate for Payer: Global Benefits Group Commercial |
$378.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$400.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$228.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$371.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$151.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$441.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$441.00
|
| Rate for Payer: Multiplan Commercial |
$504.00
|
| Rate for Payer: Networks By Design Commercial |
$315.00
|
| Rate for Payer: Prime Health Services Commercial |
$535.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$378.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$378.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$236.44
|
| Rate for Payer: United Healthcare All Other HMO |
$230.14
|
| Rate for Payer: United Healthcare HMO Rider |
$225.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$535.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$535.50
|
| Rate for Payer: Vantage Medical Group Senior |
$535.50
|
|
|
HC CATH BAYLIS BMC
|
Facility
|
OP
|
$851.00
|
|
| Hospital Charge Code |
906812324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$170.20 |
| Max. Negotiated Rate |
$723.35 |
| Rate for Payer: Adventist Health Commercial |
$170.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$558.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$723.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$468.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$638.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$546.09
|
| Rate for Payer: Cash Price |
$382.95
|
| Rate for Payer: Cigna of CA HMO |
$544.64
|
| Rate for Payer: Cigna of CA PPO |
$629.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$723.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$723.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$723.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$595.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.40
|
| Rate for Payer: EPIC Health Plan Senior |
$340.40
|
| Rate for Payer: Galaxy Health WC |
$723.35
|
| Rate for Payer: Global Benefits Group Commercial |
$510.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$540.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$308.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$502.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$595.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$595.70
|
| Rate for Payer: Multiplan Commercial |
$680.80
|
| Rate for Payer: Networks By Design Commercial |
$553.15
|
| Rate for Payer: Prime Health Services Commercial |
$723.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$510.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$510.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$425.50
|
| Rate for Payer: United Healthcare All Other HMO |
$425.50
|
| Rate for Payer: United Healthcare HMO Rider |
$425.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$425.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$723.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$723.35
|
| Rate for Payer: Vantage Medical Group Senior |
$723.35
|
|
|
HC CATH BAYLIS BMC
|
Facility
|
IP
|
$851.00
|
|
| Hospital Charge Code |
906812324
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$170.20 |
| Max. Negotiated Rate |
$723.35 |
| Rate for Payer: Adventist Health Commercial |
$170.20
|
| Rate for Payer: Cash Price |
$382.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$595.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$340.40
|
| Rate for Payer: EPIC Health Plan Senior |
$340.40
|
| Rate for Payer: Galaxy Health WC |
$723.35
|
| Rate for Payer: Global Benefits Group Commercial |
$510.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$540.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$502.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.24
|
| Rate for Payer: Multiplan Commercial |
$680.80
|
| Rate for Payer: Networks By Design Commercial |
$553.15
|
| Rate for Payer: Prime Health Services Commercial |
$723.35
|
|
|
HC CATH BLLN CORDIS MAXI LD
|
Facility
|
IP
|
$1,170.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$234.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$234.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Cigna of CA HMO |
$819.00
|
| Rate for Payer: Cigna of CA PPO |
$819.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$819.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$468.00
|
| Rate for Payer: EPIC Health Plan Senior |
$468.00
|
| Rate for Payer: Galaxy Health WC |
$994.50
|
| Rate for Payer: Global Benefits Group Commercial |
$702.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$742.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$690.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.80
|
| Rate for Payer: Multiplan Commercial |
$936.00
|
| Rate for Payer: Networks By Design Commercial |
$585.00
|
| Rate for Payer: Prime Health Services Commercial |
$994.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$439.10
|
| Rate for Payer: United Healthcare All Other HMO |
$427.40
|
| Rate for Payer: United Healthcare HMO Rider |
$418.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$383.18
|
|
|
HC CATH BLLN CORDIS MAXI LD
|
Facility
|
OP
|
$1,170.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081413
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$234.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Adventist Health Commercial |
$234.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$994.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$643.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$877.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$708.20
|
| Rate for Payer: Blue Shield of California Commercial |
$593.19
|
| Rate for Payer: Blue Shield of California Commercial |
$899.73
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Cigna of CA HMO |
$819.00
|
| Rate for Payer: Cigna of CA PPO |
$819.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$994.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$994.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$994.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$819.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$468.00
|
| Rate for Payer: EPIC Health Plan Senior |
$468.00
|
| Rate for Payer: Galaxy Health WC |
$994.50
|
| Rate for Payer: Global Benefits Group Commercial |
$702.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$742.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$424.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$690.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$280.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$819.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$819.00
|
| Rate for Payer: Multiplan Commercial |
$936.00
|
| Rate for Payer: Networks By Design Commercial |
$585.00
|
| Rate for Payer: Prime Health Services Commercial |
$994.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$702.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$702.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$439.10
|
| Rate for Payer: United Healthcare All Other HMO |
$427.40
|
| Rate for Payer: United Healthcare HMO Rider |
$418.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$383.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$994.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$994.50
|
| Rate for Payer: Vantage Medical Group Senior |
$994.50
|
|
|
HC CATH BLLN CORDIS PWRFLEX EXTRM
|
Facility
|
IP
|
$900.00
|
|
|
Service Code
|
CPT C1725
|
| Hospital Charge Code |
909081213
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$180.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cigna of CA HMO |
$630.00
|
| Rate for Payer: Cigna of CA PPO |
$630.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$630.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$360.00
|
| Rate for Payer: EPIC Health Plan Senior |
$360.00
|
| Rate for Payer: Galaxy Health WC |
$765.00
|
| Rate for Payer: Global Benefits Group Commercial |
$540.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$571.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$531.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$216.00
|
| Rate for Payer: Multiplan Commercial |
$720.00
|
| Rate for Payer: Networks By Design Commercial |
$450.00
|
| Rate for Payer: Prime Health Services Commercial |
$765.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$337.77
|
| Rate for Payer: United Healthcare All Other HMO |
$328.77
|
| Rate for Payer: United Healthcare HMO Rider |
$321.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$294.75
|
|
