|
HC CATH RECTAL FMS FLEXISEAL
|
Facility
|
OP
|
$666.45
|
|
| Hospital Charge Code |
901605921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.29 |
| Max. Negotiated Rate |
$566.48 |
| Rate for Payer: Adventist Health Commercial |
$133.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$437.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$566.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$366.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$499.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$409.27
|
| Rate for Payer: Cash Price |
$299.90
|
| Rate for Payer: Cigna of CA HMO |
$426.53
|
| Rate for Payer: Cigna of CA PPO |
$493.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$566.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$566.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$566.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.58
|
| Rate for Payer: EPIC Health Plan Senior |
$266.58
|
| Rate for Payer: Galaxy Health WC |
$566.48
|
| Rate for Payer: Global Benefits Group Commercial |
$399.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$444.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$253.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$412.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$466.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$466.51
|
| Rate for Payer: Multiplan Commercial |
$533.16
|
| Rate for Payer: Networks By Design Commercial |
$433.19
|
| Rate for Payer: Prime Health Services Commercial |
$566.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$399.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$399.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$333.23
|
| Rate for Payer: United Healthcare All Other HMO |
$333.23
|
| Rate for Payer: United Healthcare HMO Rider |
$333.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$333.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$566.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$566.48
|
| Rate for Payer: Vantage Medical Group Senior |
$566.48
|
|
|
HC CATH RECTAL FMS FLEXISEAL
|
Facility
|
IP
|
$666.45
|
|
| Hospital Charge Code |
901605921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$133.29 |
| Max. Negotiated Rate |
$566.48 |
| Rate for Payer: Adventist Health Commercial |
$133.29
|
| Rate for Payer: Cash Price |
$299.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.58
|
| Rate for Payer: EPIC Health Plan Senior |
$266.58
|
| Rate for Payer: Galaxy Health WC |
$566.48
|
| Rate for Payer: Global Benefits Group Commercial |
$399.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$444.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$253.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$412.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$159.95
|
| Rate for Payer: Multiplan Commercial |
$533.16
|
| Rate for Payer: Networks By Design Commercial |
$433.19
|
| Rate for Payer: Prime Health Services Commercial |
$566.48
|
|
|
HC CATH RESCUE
|
Facility
|
OP
|
$580.00
|
|
| Hospital Charge Code |
900800869
|
|
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 |
$261.00
|
| 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 RESCUE
|
Facility
|
IP
|
$580.00
|
|
| Hospital Charge Code |
900800869
|
|
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 |
$261.00
|
| 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 RESCUE SUCTION OMNEOTECH
|
Facility
|
IP
|
$374.10
|
|
| Hospital Charge Code |
900800713
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.82 |
| Max. Negotiated Rate |
$317.99 |
| Rate for Payer: Adventist Health Commercial |
$74.82
|
| Rate for Payer: Cash Price |
$168.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.64
|
| Rate for Payer: EPIC Health Plan Senior |
$149.64
|
| Rate for Payer: Galaxy Health WC |
$317.99
|
| Rate for Payer: Global Benefits Group Commercial |
$224.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$249.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$231.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.78
|
| Rate for Payer: Multiplan Commercial |
$299.28
|
| Rate for Payer: Networks By Design Commercial |
$243.16
|
| Rate for Payer: Prime Health Services Commercial |
$317.99
|
|
|
HC CATH RESCUE SUCTION OMNEOTECH
|
Facility
|
OP
|
$374.10
|
|
| Hospital Charge Code |
900800713
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.82 |
| Max. Negotiated Rate |
$317.99 |
| Rate for Payer: Adventist Health Commercial |
$74.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$245.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$317.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$205.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$280.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$229.73
|
| Rate for Payer: Cash Price |
$168.35
|
| Rate for Payer: Cigna of CA HMO |
$239.42
|
| Rate for Payer: Cigna of CA PPO |
$276.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$317.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$317.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.64
|
| Rate for Payer: EPIC Health Plan Senior |
$149.64
|
| Rate for Payer: Galaxy Health WC |
$317.99
|
| Rate for Payer: Global Benefits Group Commercial |
$224.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$249.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$231.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$89.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$261.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$261.87
|
| Rate for Payer: Multiplan Commercial |
$299.28
|
| Rate for Payer: Networks By Design Commercial |
$243.16
|
| Rate for Payer: Prime Health Services Commercial |
$317.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$224.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$224.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$187.05
|
| Rate for Payer: United Healthcare All Other HMO |
$187.05
|
| Rate for Payer: United Healthcare HMO Rider |
$187.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$187.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$317.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$317.99
|
| Rate for Payer: Vantage Medical Group Senior |
$317.99
|
|
|
HC CATH ROBINSON 22FR STERILE
|
Facility
|
IP
|
$48.95
|
|
| Hospital Charge Code |
901601739
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$41.61 |
| Rate for Payer: Adventist Health Commercial |
$9.79
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.58
|
| Rate for Payer: Galaxy Health WC |
$41.61
|
| Rate for Payer: Global Benefits Group Commercial |
$29.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.75
|
| Rate for Payer: Multiplan Commercial |
$39.16
|
| Rate for Payer: Networks By Design Commercial |
$31.82
|
| Rate for Payer: Prime Health Services Commercial |
$41.61
|
|
|
HC CATH ROBINSON 22FR STERILE
|
Facility
|
OP
|
$48.95
|
|
| Hospital Charge Code |
901601739
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$41.61 |
| Rate for Payer: Adventist Health Commercial |
$9.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.06
|
| Rate for Payer: Cash Price |
$22.03
|
| Rate for Payer: Cigna of CA HMO |
$31.33
|
| Rate for Payer: Cigna of CA PPO |
$36.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.58
|
| Rate for Payer: EPIC Health Plan Senior |
$19.58
|
| Rate for Payer: Galaxy Health WC |
$41.61
|
| Rate for Payer: Global Benefits Group Commercial |
$29.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.27
|
| Rate for Payer: Multiplan Commercial |
$39.16
|
| Rate for Payer: Networks By Design Commercial |
$31.82
|
| Rate for Payer: Prime Health Services Commercial |
$41.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.48
|
| Rate for Payer: United Healthcare All Other HMO |
$24.48
|
| Rate for Payer: United Healthcare HMO Rider |
$24.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$41.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.61
|
| Rate for Payer: Vantage Medical Group Senior |
$41.61
|
|
|
HC CATH ROTALINK PLUS
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1724
|
| Hospital Charge Code |
906812396
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC CATH ROTALINK PLUS
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1724
|
| Hospital Charge Code |
906812396
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,558.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,394.99
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC CATH SELF-CATH 10FR ADOLESCEN
|
Facility
|
OP
|
$4.67
|
|
| Hospital Charge Code |
901603664
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$3.97 |
| Rate for Payer: Adventist Health Commercial |
$0.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.87
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: Cigna of CA HMO |
$2.99
|
| Rate for Payer: Cigna of CA PPO |
$3.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1.87
|
| Rate for Payer: Galaxy Health WC |
$3.97
|
| Rate for Payer: Global Benefits Group Commercial |
$2.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.27
|
| Rate for Payer: Multiplan Commercial |
$3.74
|
| Rate for Payer: Networks By Design Commercial |
$3.04
|
| Rate for Payer: Prime Health Services Commercial |
$3.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.33
|
| Rate for Payer: United Healthcare All Other HMO |
$2.33
|
| Rate for Payer: United Healthcare HMO Rider |
$2.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.97
|
| Rate for Payer: Vantage Medical Group Senior |
$3.97
|
|
|
HC CATH SELF-CATH 10FR ADOLESCEN
|
Facility
|
IP
|
$4.67
|
|
| Hospital Charge Code |
901603664
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.93 |
| Max. Negotiated Rate |
$3.97 |
| Rate for Payer: Adventist Health Commercial |
$0.93
|
| Rate for Payer: Cash Price |
$2.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.87
|
| Rate for Payer: EPIC Health Plan Senior |
$1.87
|
| Rate for Payer: Galaxy Health WC |
$3.97
|
| Rate for Payer: Global Benefits Group Commercial |
$2.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.12
|
| Rate for Payer: Multiplan Commercial |
$3.74
|
| Rate for Payer: Networks By Design Commercial |
$3.04
|
| Rate for Payer: Prime Health Services Commercial |
$3.97
|
|
|
HC CATH SELF-CATH 12FR LONG CRVD
|
Facility
|
OP
|
$869.40
|
|
| Hospital Charge Code |
901603665
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$738.99 |
| Rate for Payer: Adventist Health Commercial |
$173.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$570.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$478.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$652.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$533.90
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: Cigna of CA HMO |
$556.42
|
| Rate for Payer: Cigna of CA PPO |
$643.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$738.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$738.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$738.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Senior |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$538.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$208.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$608.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$608.58
|
| Rate for Payer: Multiplan Commercial |
$695.52
|
| Rate for Payer: Networks By Design Commercial |
$565.11
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$521.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$521.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$434.70
|
| Rate for Payer: United Healthcare All Other HMO |
$434.70
|
| Rate for Payer: United Healthcare HMO Rider |
$434.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$434.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$738.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$738.99
|
| Rate for Payer: Vantage Medical Group Senior |
$738.99
|
|
|
HC CATH SELF-CATH 12FR LONG CRVD
|
Facility
|
IP
|
$869.40
|
|
| Hospital Charge Code |
901603665
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$173.88 |
| Max. Negotiated Rate |
$738.99 |
| Rate for Payer: Adventist Health Commercial |
$173.88
|
| Rate for Payer: Cash Price |
$391.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$347.76
|
| Rate for Payer: EPIC Health Plan Senior |
$347.76
|
| Rate for Payer: Galaxy Health WC |
$738.99
|
| Rate for Payer: Global Benefits Group Commercial |
$521.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$579.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$331.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$538.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$208.66
|
| Rate for Payer: Multiplan Commercial |
$695.52
|
| Rate for Payer: Networks By Design Commercial |
$565.11
|
| Rate for Payer: Prime Health Services Commercial |
$738.99
|
|
|
HC CATH SELF-CATH 14FR COUDE
|
Facility
|
OP
|
$12.05
|
|
| Hospital Charge Code |
901603842
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$10.24 |
| Rate for Payer: Adventist Health Commercial |
$2.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.40
|
| Rate for Payer: Cash Price |
$5.42
|
| Rate for Payer: Cigna of CA HMO |
$7.71
|
| Rate for Payer: Cigna of CA PPO |
$8.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.82
|
| Rate for Payer: EPIC Health Plan Senior |
$4.82
|
| Rate for Payer: Galaxy Health WC |
$10.24
|
| Rate for Payer: Global Benefits Group Commercial |
$7.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.44
|
| Rate for Payer: Multiplan Commercial |
$9.64
|
| Rate for Payer: Networks By Design Commercial |
$7.83
|
| Rate for Payer: Prime Health Services Commercial |
$10.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.03
|
| Rate for Payer: United Healthcare All Other HMO |
$6.03
|
| Rate for Payer: United Healthcare HMO Rider |
$6.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.24
|
| Rate for Payer: Vantage Medical Group Senior |
$10.24
|
|
|
HC CATH SELF-CATH 14FR COUDE
|
Facility
|
IP
|
$12.05
|
|
| Hospital Charge Code |
901603842
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$10.24 |
| Rate for Payer: Adventist Health Commercial |
$2.41
|
| Rate for Payer: Cash Price |
$5.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.82
|
| Rate for Payer: EPIC Health Plan Senior |
$4.82
|
| Rate for Payer: Galaxy Health WC |
$10.24
|
| Rate for Payer: Global Benefits Group Commercial |
$7.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.89
|
| Rate for Payer: Multiplan Commercial |
$9.64
|
| Rate for Payer: Networks By Design Commercial |
$7.83
|
| Rate for Payer: Prime Health Services Commercial |
$10.24
|
|
|
HC CATH SELF-CATH 14FR FEMALE
|
Facility
|
IP
|
$35.67
|
|
| Hospital Charge Code |
901603662
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.13 |
| Max. Negotiated Rate |
$30.32 |
| Rate for Payer: Adventist Health Commercial |
$7.13
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.27
|
| Rate for Payer: EPIC Health Plan Senior |
$14.27
|
| Rate for Payer: Galaxy Health WC |
$30.32
|
| Rate for Payer: Global Benefits Group Commercial |
$21.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.56
|
| Rate for Payer: Multiplan Commercial |
$28.54
|
| Rate for Payer: Networks By Design Commercial |
$23.19
|
| Rate for Payer: Prime Health Services Commercial |
$30.32
|
|
|
HC CATH SELF-CATH 14FR FEMALE
|
Facility
|
OP
|
$35.67
|
|
| Hospital Charge Code |
901603662
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.13 |
| Max. Negotiated Rate |
$30.32 |
| Rate for Payer: Adventist Health Commercial |
$7.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.90
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Cigna of CA HMO |
$22.83
|
| Rate for Payer: Cigna of CA PPO |
$26.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.27
|
| Rate for Payer: EPIC Health Plan Senior |
$14.27
|
| Rate for Payer: Galaxy Health WC |
$30.32
|
| Rate for Payer: Global Benefits Group Commercial |
$21.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.97
|
| Rate for Payer: Multiplan Commercial |
$28.54
|
| Rate for Payer: Networks By Design Commercial |
$23.19
|
| Rate for Payer: Prime Health Services Commercial |
$30.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.84
|
| Rate for Payer: United Healthcare All Other HMO |
$17.84
|
| Rate for Payer: United Healthcare HMO Rider |
$17.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.32
|
| Rate for Payer: Vantage Medical Group Senior |
$30.32
|
|
|
HC CATH SELF-CATH 14FR LONG
|
Facility
|
IP
|
$5.25
|
|
| Hospital Charge Code |
901603666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$4.46 |
| Rate for Payer: Adventist Health Commercial |
$1.05
|
| Rate for Payer: Cash Price |
$2.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.10
|
| Rate for Payer: EPIC Health Plan Senior |
$2.10
|
| Rate for Payer: Galaxy Health WC |
$4.46
|
| Rate for Payer: Global Benefits Group Commercial |
$3.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.26
|
| Rate for Payer: Multiplan Commercial |
$4.20
|
| Rate for Payer: Networks By Design Commercial |
$3.41
|
| Rate for Payer: Prime Health Services Commercial |
$4.46
|
|
|
HC CATH SELF-CATH 14FR LONG
|
Facility
|
OP
|
$5.25
|
|
| Hospital Charge Code |
901603666
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$4.46 |
| Rate for Payer: Adventist Health Commercial |
$1.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.22
|
| Rate for Payer: Cash Price |
$2.36
|
| Rate for Payer: Cigna of CA HMO |
$3.36
|
| Rate for Payer: Cigna of CA PPO |
$3.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.10
|
| Rate for Payer: EPIC Health Plan Senior |
$2.10
|
| Rate for Payer: Galaxy Health WC |
$4.46
|
| Rate for Payer: Global Benefits Group Commercial |
$3.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.67
|
| Rate for Payer: Multiplan Commercial |
$4.20
|
| Rate for Payer: Networks By Design Commercial |
$3.41
|
| Rate for Payer: Prime Health Services Commercial |
$4.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.15
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.62
|
| Rate for Payer: United Healthcare All Other HMO |
$2.62
|
| Rate for Payer: United Healthcare HMO Rider |
$2.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.46
|
| Rate for Payer: Vantage Medical Group Senior |
$4.46
|
|
|
HC CATH SELF-CATH 14FR SOFT
|
Facility
|
IP
|
$4.02
|
|
| Hospital Charge Code |
901603849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$3.42 |
| Rate for Payer: Adventist Health Commercial |
$0.80
|
| Rate for Payer: Cash Price |
$1.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.61
|
| Rate for Payer: EPIC Health Plan Senior |
$1.61
|
| Rate for Payer: Galaxy Health WC |
$3.42
|
| Rate for Payer: Global Benefits Group Commercial |
$2.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.96
|
| Rate for Payer: Multiplan Commercial |
$3.22
|
| Rate for Payer: Networks By Design Commercial |
$2.61
|
| Rate for Payer: Prime Health Services Commercial |
$3.42
|
|
|
HC CATH SELF-CATH 14FR SOFT
|
Facility
|
OP
|
$4.02
|
|
| Hospital Charge Code |
901603849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$3.42 |
| Rate for Payer: Adventist Health Commercial |
$0.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.47
|
| Rate for Payer: Cash Price |
$1.81
|
| Rate for Payer: Cigna of CA HMO |
$2.57
|
| Rate for Payer: Cigna of CA PPO |
$2.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.61
|
| Rate for Payer: EPIC Health Plan Senior |
$1.61
|
| Rate for Payer: Galaxy Health WC |
$3.42
|
| Rate for Payer: Global Benefits Group Commercial |
$2.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.81
|
| Rate for Payer: Multiplan Commercial |
$3.22
|
| Rate for Payer: Networks By Design Commercial |
$2.61
|
| Rate for Payer: Prime Health Services Commercial |
$3.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.01
|
| Rate for Payer: United Healthcare All Other HMO |
$2.01
|
| Rate for Payer: United Healthcare HMO Rider |
$2.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.42
|
| Rate for Payer: Vantage Medical Group Senior |
$3.42
|
|
|
HC CATH SELF-CATH 16FR MENTOR
|
Facility
|
IP
|
$10.58
|
|
| Hospital Charge Code |
901603727
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$8.99 |
| Rate for Payer: Adventist Health Commercial |
$2.12
|
| Rate for Payer: Cash Price |
$4.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.23
|
| Rate for Payer: EPIC Health Plan Senior |
$4.23
|
| Rate for Payer: Galaxy Health WC |
$8.99
|
| Rate for Payer: Global Benefits Group Commercial |
$6.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.54
|
| Rate for Payer: Multiplan Commercial |
$8.46
|
| Rate for Payer: Networks By Design Commercial |
$6.88
|
| Rate for Payer: Prime Health Services Commercial |
$8.99
|
|
|
HC CATH SELF-CATH 16FR MENTOR
|
Facility
|
OP
|
$10.58
|
|
| Hospital Charge Code |
901603727
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$8.99 |
| Rate for Payer: Adventist Health Commercial |
$2.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.50
|
| Rate for Payer: Cash Price |
$4.76
|
| Rate for Payer: Cigna of CA HMO |
$6.77
|
| Rate for Payer: Cigna of CA PPO |
$7.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.23
|
| Rate for Payer: EPIC Health Plan Senior |
$4.23
|
| Rate for Payer: Galaxy Health WC |
$8.99
|
| Rate for Payer: Global Benefits Group Commercial |
$6.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.41
|
| Rate for Payer: Multiplan Commercial |
$8.46
|
| Rate for Payer: Networks By Design Commercial |
$6.88
|
| Rate for Payer: Prime Health Services Commercial |
$8.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.29
|
| Rate for Payer: United Healthcare All Other HMO |
$5.29
|
| Rate for Payer: United Healthcare HMO Rider |
$5.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.99
|
| Rate for Payer: Vantage Medical Group Senior |
$8.99
|
|
|
HC CATH SELF-CATH 8FR PEDS
|
Facility
|
IP
|
$3.94
|
|
| Hospital Charge Code |
901603663
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.79 |
| Max. Negotiated Rate |
$3.35 |
| Rate for Payer: Adventist Health Commercial |
$0.79
|
| Rate for Payer: Cash Price |
$1.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.58
|
| Rate for Payer: EPIC Health Plan Senior |
$1.58
|
| Rate for Payer: Galaxy Health WC |
$3.35
|
| Rate for Payer: Global Benefits Group Commercial |
$2.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.95
|
| Rate for Payer: Multiplan Commercial |
$3.15
|
| Rate for Payer: Networks By Design Commercial |
$2.56
|
| Rate for Payer: Prime Health Services Commercial |
$3.35
|
|
