|
HC CATH SELF-CATH 8FR PEDS
|
Facility
|
OP
|
$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: Aetna of CA HMO/PPO |
$2.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.42
|
| Rate for Payer: Cash Price |
$1.77
|
| Rate for Payer: Cigna of CA HMO |
$2.52
|
| Rate for Payer: Cigna of CA PPO |
$2.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.35
|
| 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: Molina Healthcare of CA Medi-Cal |
$2.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.76
|
| 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
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.97
|
| Rate for Payer: United Healthcare All Other HMO |
$1.97
|
| Rate for Payer: United Healthcare HMO Rider |
$1.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.35
|
| Rate for Payer: Vantage Medical Group Senior |
$3.35
|
|
|
HC CATH SET ARTERIAL 2.5FR 1LUMEN
|
Facility
|
IP
|
$280.63
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698809
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$56.13 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$56.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$126.28
|
| Rate for Payer: Cash Price |
$126.28
|
| Rate for Payer: Cigna of CA HMO |
$196.44
|
| Rate for Payer: Cigna of CA PPO |
$196.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.25
|
| Rate for Payer: EPIC Health Plan Senior |
$112.25
|
| Rate for Payer: Galaxy Health WC |
$238.54
|
| Rate for Payer: Global Benefits Group Commercial |
$168.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$187.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$173.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.35
|
| Rate for Payer: Multiplan Commercial |
$224.50
|
| Rate for Payer: Networks By Design Commercial |
$140.31
|
| Rate for Payer: Prime Health Services Commercial |
$238.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$105.32
|
| Rate for Payer: United Healthcare All Other HMO |
$102.51
|
| Rate for Payer: United Healthcare HMO Rider |
$100.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.91
|
|
|
HC CATH SET ARTERIAL 2.5FR 1LUMEN
|
Facility
|
OP
|
$280.63
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698809
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$56.13 |
| Max. Negotiated Rate |
$238.54 |
| Rate for Payer: Adventist Health Commercial |
$56.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$238.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$154.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$210.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$162.54
|
| Rate for Payer: Blue Shield of California Commercial |
$207.10
|
| Rate for Payer: Blue Shield of California EPN |
$136.39
|
| Rate for Payer: Cash Price |
$126.28
|
| Rate for Payer: Cigna of CA HMO |
$196.44
|
| Rate for Payer: Cigna of CA PPO |
$196.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$238.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$238.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$238.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.25
|
| Rate for Payer: EPIC Health Plan Senior |
$112.25
|
| Rate for Payer: Galaxy Health WC |
$238.54
|
| Rate for Payer: Global Benefits Group Commercial |
$168.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$187.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$173.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$196.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$196.44
|
| Rate for Payer: Multiplan Commercial |
$224.50
|
| Rate for Payer: Networks By Design Commercial |
$140.31
|
| Rate for Payer: Prime Health Services Commercial |
$238.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$168.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$168.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$105.32
|
| Rate for Payer: United Healthcare All Other HMO |
$102.51
|
| Rate for Payer: United Healthcare HMO Rider |
$100.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$238.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$238.54
|
| Rate for Payer: Vantage Medical Group Senior |
$238.54
|
|
|
HC CATH STERASSIST KIT W/20GA
|
Facility
|
IP
|
$4.92
|
|
| Hospital Charge Code |
901698286
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$4.18 |
| Rate for Payer: Adventist Health Commercial |
$0.98
|
| Rate for Payer: Cash Price |
$2.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.97
|
| Rate for Payer: EPIC Health Plan Senior |
$1.97
|
| Rate for Payer: Galaxy Health WC |
$4.18
|
| Rate for Payer: Global Benefits Group Commercial |
$2.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.18
|
| Rate for Payer: Multiplan Commercial |
$3.94
|
| Rate for Payer: Networks By Design Commercial |
$3.20
|
| Rate for Payer: Prime Health Services Commercial |
$4.18
|
|
|
HC CATH STERASSIST KIT W/20GA
|
Facility
|
OP
|
$4.92
|
|
| Hospital Charge Code |
901698286
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$4.18 |
| Rate for Payer: Adventist Health Commercial |
$0.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.02
|
| Rate for Payer: Cash Price |
$2.21
|
| Rate for Payer: Cigna of CA HMO |
$3.15
|
| Rate for Payer: Cigna of CA PPO |
$3.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.97
|
| Rate for Payer: EPIC Health Plan Senior |
$1.97
|
| Rate for Payer: Galaxy Health WC |
$4.18
|
| Rate for Payer: Global Benefits Group Commercial |
$2.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.44
|
| Rate for Payer: Multiplan Commercial |
$3.94
|
| Rate for Payer: Networks By Design Commercial |
$3.20
|
| Rate for Payer: Prime Health Services Commercial |
$4.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.46
|
| Rate for Payer: United Healthcare All Other HMO |
$2.46
|
| Rate for Payer: United Healthcare HMO Rider |
$2.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.18
|
| Rate for Payer: Vantage Medical Group Senior |
$4.18
|
|
|
HC CATH STERASSIST KIT W/22GA
|
Facility
|
OP
|
$4.92
|
|
| Hospital Charge Code |
901698285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$4.18 |
| Rate for Payer: Adventist Health Commercial |
$0.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.02
|
| Rate for Payer: Cash Price |
$2.21
|
| Rate for Payer: Cigna of CA HMO |
$3.15
|
| Rate for Payer: Cigna of CA PPO |
$3.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.97
|
| Rate for Payer: EPIC Health Plan Senior |
$1.97
|
| Rate for Payer: Galaxy Health WC |
$4.18
|
| Rate for Payer: Global Benefits Group Commercial |
$2.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.44
|
| Rate for Payer: Multiplan Commercial |
$3.94
|
| Rate for Payer: Networks By Design Commercial |
$3.20
|
| Rate for Payer: Prime Health Services Commercial |
$4.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.46
|
| Rate for Payer: United Healthcare All Other HMO |
$2.46
|
| Rate for Payer: United Healthcare HMO Rider |
$2.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.18
|
| Rate for Payer: Vantage Medical Group Senior |
$4.18
|
|
|
HC CATH STERASSIST KIT W/22GA
|
Facility
|
IP
|
$4.92
|
|
| Hospital Charge Code |
901698285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$4.18 |
| Rate for Payer: Adventist Health Commercial |
$0.98
|
| Rate for Payer: Cash Price |
$2.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.97
|
| Rate for Payer: EPIC Health Plan Senior |
$1.97
|
| Rate for Payer: Galaxy Health WC |
$4.18
|
| Rate for Payer: Global Benefits Group Commercial |
$2.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.18
|
| Rate for Payer: Multiplan Commercial |
$3.94
|
| Rate for Payer: Networks By Design Commercial |
$3.20
|
| Rate for Payer: Prime Health Services Commercial |
$4.18
|
|
|
HC CATH ST J TACTICATH QUARTZ
|
Facility
|
OP
|
$6,250.00
|
|
|
Service Code
|
CPT C2630
|
| Hospital Charge Code |
906812725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,250.00 |
| Max. Negotiated Rate |
$5,312.50 |
| Rate for Payer: Adventist Health Commercial |
$1,250.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4,099.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,312.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,437.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,687.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,838.12
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Cigna of CA HMO |
$4,000.00
|
| Rate for Payer: Cigna of CA PPO |
$4,625.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,312.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$5,312.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5,312.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,500.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,500.00
|
| Rate for Payer: Galaxy Health WC |
$5,312.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,750.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,168.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,381.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,868.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,500.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,375.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4,375.00
|
| Rate for Payer: Multiplan Commercial |
$5,000.00
|
| Rate for Payer: Networks By Design Commercial |
$4,062.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,312.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,750.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,750.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,125.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,125.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,125.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,125.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,312.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,312.50
|
| Rate for Payer: Vantage Medical Group Senior |
$5,312.50
|
|
|
HC CATH ST J TACTICATH QUARTZ
|
Facility
|
IP
|
$6,250.00
|
|
|
Service Code
|
CPT C2630
|
| Hospital Charge Code |
906812725
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,250.00 |
| Max. Negotiated Rate |
$5,312.50 |
| Rate for Payer: Adventist Health Commercial |
$1,250.00
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,500.00
|
| Rate for Payer: EPIC Health Plan Senior |
$2,500.00
|
| Rate for Payer: Galaxy Health WC |
$5,312.50
|
| Rate for Payer: Global Benefits Group Commercial |
$3,750.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,168.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,381.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,868.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,500.00
|
| Rate for Payer: Multiplan Commercial |
$5,000.00
|
| Rate for Payer: Networks By Design Commercial |
$4,062.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,312.50
|
|
|
HC CATH STJ UNIVERSAL CPS AIM SL
|
Facility
|
IP
|
$920.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812538
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$184.00 |
| Max. Negotiated Rate |
$782.00 |
| Rate for Payer: Adventist Health Commercial |
$184.00
|
| Rate for Payer: Cash Price |
$414.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$368.00
|
| Rate for Payer: EPIC Health Plan Senior |
$368.00
|
| Rate for Payer: Galaxy Health WC |
$782.00
|
| Rate for Payer: Global Benefits Group Commercial |
$552.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$613.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$350.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$569.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.80
|
| Rate for Payer: Multiplan Commercial |
$736.00
|
| Rate for Payer: Networks By Design Commercial |
$598.00
|
| Rate for Payer: Prime Health Services Commercial |
$782.00
|
|
|
HC CATH STJ UNIVERSAL CPS AIM SL
|
Facility
|
OP
|
$920.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812538
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$184.00 |
| Max. Negotiated Rate |
$782.00 |
| Rate for Payer: Adventist Health Commercial |
$184.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$603.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$782.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$506.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$690.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$564.97
|
| Rate for Payer: Cash Price |
$414.00
|
| Rate for Payer: Cigna of CA HMO |
$588.80
|
| Rate for Payer: Cigna of CA PPO |
$680.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$782.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$782.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$782.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$368.00
|
| Rate for Payer: EPIC Health Plan Senior |
$368.00
|
| Rate for Payer: Galaxy Health WC |
$782.00
|
| Rate for Payer: Global Benefits Group Commercial |
$552.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$613.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$350.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$569.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$644.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$644.00
|
| Rate for Payer: Multiplan Commercial |
$736.00
|
| Rate for Payer: Networks By Design Commercial |
$598.00
|
| Rate for Payer: Prime Health Services Commercial |
$782.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$552.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$552.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$460.00
|
| Rate for Payer: United Healthcare All Other HMO |
$460.00
|
| Rate for Payer: United Healthcare HMO Rider |
$460.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$460.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$782.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$782.00
|
| Rate for Payer: Vantage Medical Group Senior |
$782.00
|
|
|
HC CATH ST J VIEWFLEX XTRA IVUS
|
Facility
|
IP
|
$4,725.00
|
|
|
Service Code
|
CPT C1759
|
| Hospital Charge Code |
906812647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$945.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$945.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$2,126.25
|
| Rate for Payer: Cash Price |
$2,126.25
|
| Rate for Payer: Cigna of CA HMO |
$3,307.50
|
| Rate for Payer: Cigna of CA PPO |
$3,307.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,890.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,890.00
|
| Rate for Payer: Galaxy Health WC |
$4,016.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,835.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,151.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,800.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,924.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,134.00
|
| Rate for Payer: Multiplan Commercial |
$3,780.00
|
| Rate for Payer: Networks By Design Commercial |
$2,362.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,016.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,773.29
|
| Rate for Payer: United Healthcare All Other HMO |
$1,726.04
|
| Rate for Payer: United Healthcare HMO Rider |
$1,688.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,547.44
|
|
|
HC CATH ST J VIEWFLEX XTRA IVUS
|
Facility
|
OP
|
$4,725.00
|
|
|
Service Code
|
CPT C1759
|
| Hospital Charge Code |
906812647
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$945.00 |
| Max. Negotiated Rate |
$4,016.25 |
| Rate for Payer: Adventist Health Commercial |
$945.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,016.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,598.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,543.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,736.72
|
| Rate for Payer: Blue Shield of California Commercial |
$3,487.05
|
| Rate for Payer: Blue Shield of California EPN |
$2,296.35
|
| Rate for Payer: Cash Price |
$2,126.25
|
| Rate for Payer: Cigna of CA HMO |
$3,307.50
|
| Rate for Payer: Cigna of CA PPO |
$3,307.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,016.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,016.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,016.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,890.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,890.00
|
| Rate for Payer: Galaxy Health WC |
$4,016.25
|
| Rate for Payer: Global Benefits Group Commercial |
$2,835.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,151.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,800.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,924.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,134.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,307.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,307.50
|
| Rate for Payer: Multiplan Commercial |
$3,780.00
|
| Rate for Payer: Networks By Design Commercial |
$2,362.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,016.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,835.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,835.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,773.29
|
| Rate for Payer: United Healthcare All Other HMO |
$1,726.04
|
| Rate for Payer: United Healthcare HMO Rider |
$1,688.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,547.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,016.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,016.25
|
| Rate for Payer: Vantage Medical Group Senior |
$4,016.25
|
|
|
HC CATH SUCTION 10FR
|
Facility
|
OP
|
$6.15
|
|
| Hospital Charge Code |
901603550
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.23 |
| Max. Negotiated Rate |
$5.23 |
| Rate for Payer: Adventist Health Commercial |
$1.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.78
|
| Rate for Payer: Cash Price |
$2.77
|
| Rate for Payer: Cigna of CA HMO |
$3.94
|
| Rate for Payer: Cigna of CA PPO |
$4.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.46
|
| Rate for Payer: EPIC Health Plan Senior |
$2.46
|
| Rate for Payer: Galaxy Health WC |
$5.23
|
| Rate for Payer: Global Benefits Group Commercial |
$3.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.30
|
| Rate for Payer: Multiplan Commercial |
$4.92
|
| Rate for Payer: Networks By Design Commercial |
$4.00
|
| Rate for Payer: Prime Health Services Commercial |
$5.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.08
|
| Rate for Payer: United Healthcare All Other HMO |
$3.08
|
| Rate for Payer: United Healthcare HMO Rider |
$3.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.23
|
| Rate for Payer: Vantage Medical Group Senior |
$5.23
|
|
|
HC CATH SUCTION 10FR
|
Facility
|
IP
|
$6.15
|
|
| Hospital Charge Code |
901603550
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.23 |
| Max. Negotiated Rate |
$5.23 |
| Rate for Payer: Adventist Health Commercial |
$1.23
|
| Rate for Payer: Cash Price |
$2.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.46
|
| Rate for Payer: EPIC Health Plan Senior |
$2.46
|
| Rate for Payer: Galaxy Health WC |
$5.23
|
| Rate for Payer: Global Benefits Group Commercial |
$3.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.48
|
| Rate for Payer: Multiplan Commercial |
$4.92
|
| Rate for Payer: Networks By Design Commercial |
$4.00
|
| Rate for Payer: Prime Health Services Commercial |
$5.23
|
|
|
HC CATH SUCTION 14FR
|
Facility
|
IP
|
$6.23
|
|
| Hospital Charge Code |
901698865
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$5.30 |
| Rate for Payer: Adventist Health Commercial |
$1.25
|
| Rate for Payer: Cash Price |
$2.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.49
|
| Rate for Payer: EPIC Health Plan Senior |
$2.49
|
| Rate for Payer: Galaxy Health WC |
$5.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.50
|
| Rate for Payer: Multiplan Commercial |
$4.98
|
| Rate for Payer: Networks By Design Commercial |
$4.05
|
| Rate for Payer: Prime Health Services Commercial |
$5.30
|
|
|
HC CATH SUCTION 14FR
|
Facility
|
IP
|
$4.59
|
|
| Hospital Charge Code |
901603552
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Adventist Health Commercial |
$0.92
|
| Rate for Payer: Cash Price |
$2.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.84
|
| Rate for Payer: EPIC Health Plan Senior |
$1.84
|
| Rate for Payer: Galaxy Health WC |
$3.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.10
|
| Rate for Payer: Multiplan Commercial |
$3.67
|
| Rate for Payer: Networks By Design Commercial |
$2.98
|
| Rate for Payer: Prime Health Services Commercial |
$3.90
|
|
|
HC CATH SUCTION 14FR
|
Facility
|
OP
|
$6.23
|
|
| Hospital Charge Code |
901698865
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$5.30 |
| Rate for Payer: Multiplan Commercial |
$4.98
|
| Rate for Payer: Networks By Design Commercial |
$4.05
|
| Rate for Payer: Prime Health Services Commercial |
$5.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.12
|
| Rate for Payer: United Healthcare All Other HMO |
$3.12
|
| Rate for Payer: United Healthcare HMO Rider |
$3.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.30
|
| Rate for Payer: Vantage Medical Group Senior |
$5.30
|
| Rate for Payer: Adventist Health Commercial |
$1.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.83
|
| Rate for Payer: Cash Price |
$2.80
|
| Rate for Payer: Cigna of CA HMO |
$3.99
|
| Rate for Payer: Cigna of CA PPO |
$4.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.49
|
| Rate for Payer: EPIC Health Plan Senior |
$2.49
|
| Rate for Payer: Galaxy Health WC |
$5.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.36
|
|
|
HC CATH SUCTION 14FR
|
Facility
|
OP
|
$4.59
|
|
| Hospital Charge Code |
901603552
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: Adventist Health Commercial |
$0.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.82
|
| Rate for Payer: Cash Price |
$2.07
|
| Rate for Payer: Cigna of CA HMO |
$2.94
|
| Rate for Payer: Cigna of CA PPO |
$3.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.84
|
| Rate for Payer: EPIC Health Plan Senior |
$1.84
|
| Rate for Payer: Galaxy Health WC |
$3.90
|
| Rate for Payer: Global Benefits Group Commercial |
$2.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.21
|
| Rate for Payer: Multiplan Commercial |
$3.67
|
| Rate for Payer: Networks By Design Commercial |
$2.98
|
| Rate for Payer: Prime Health Services Commercial |
$3.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.29
|
| Rate for Payer: United Healthcare All Other HMO |
$2.29
|
| Rate for Payer: United Healthcare HMO Rider |
$2.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.90
|
| Rate for Payer: Vantage Medical Group Senior |
$3.90
|
|
|
HC CATH SUCTION 5FR 14"
|
Facility
|
IP
|
$6.64
|
|
| Hospital Charge Code |
901600359
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$5.64 |
| Rate for Payer: Adventist Health Commercial |
$1.33
|
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.66
|
| Rate for Payer: EPIC Health Plan Senior |
$2.66
|
| Rate for Payer: Galaxy Health WC |
$5.64
|
| Rate for Payer: Global Benefits Group Commercial |
$3.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.59
|
| Rate for Payer: Multiplan Commercial |
$5.31
|
| Rate for Payer: Networks By Design Commercial |
$4.32
|
| Rate for Payer: Prime Health Services Commercial |
$5.64
|
|
|
HC CATH SUCTION 5FR 14"
|
Facility
|
OP
|
$6.64
|
|
| Hospital Charge Code |
901600359
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$5.64 |
| Rate for Payer: Adventist Health Commercial |
$1.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.08
|
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: Cigna of CA HMO |
$4.25
|
| Rate for Payer: Cigna of CA PPO |
$4.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.66
|
| Rate for Payer: EPIC Health Plan Senior |
$2.66
|
| Rate for Payer: Galaxy Health WC |
$5.64
|
| Rate for Payer: Global Benefits Group Commercial |
$3.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.65
|
| Rate for Payer: Multiplan Commercial |
$5.31
|
| Rate for Payer: Networks By Design Commercial |
$4.32
|
| Rate for Payer: Prime Health Services Commercial |
$5.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.32
|
| Rate for Payer: United Healthcare All Other HMO |
$3.32
|
| Rate for Payer: United Healthcare HMO Rider |
$3.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.64
|
| Rate for Payer: Vantage Medical Group Senior |
$5.64
|
|
|
HC CATH SUCTION 6FR
|
Facility
|
OP
|
$4.02
|
|
| Hospital Charge Code |
901698255
|
|
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 SUCTION 6FR
|
Facility
|
IP
|
$4.02
|
|
| Hospital Charge Code |
901698255
|
|
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 SUCTION 6FR 14"
|
Facility
|
IP
|
$6.64
|
|
| Hospital Charge Code |
901602135
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$5.64 |
| Rate for Payer: Adventist Health Commercial |
$1.33
|
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.66
|
| Rate for Payer: EPIC Health Plan Senior |
$2.66
|
| Rate for Payer: Galaxy Health WC |
$5.64
|
| Rate for Payer: Global Benefits Group Commercial |
$3.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.59
|
| Rate for Payer: Multiplan Commercial |
$5.31
|
| Rate for Payer: Networks By Design Commercial |
$4.32
|
| Rate for Payer: Prime Health Services Commercial |
$5.64
|
|
|
HC CATH SUCTION 6FR 14"
|
Facility
|
OP
|
$6.64
|
|
| Hospital Charge Code |
901602135
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$5.64 |
| Rate for Payer: Adventist Health Commercial |
$1.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.08
|
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: Cigna of CA HMO |
$4.25
|
| Rate for Payer: Cigna of CA PPO |
$4.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.66
|
| Rate for Payer: EPIC Health Plan Senior |
$2.66
|
| Rate for Payer: Galaxy Health WC |
$5.64
|
| Rate for Payer: Global Benefits Group Commercial |
$3.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.65
|
| Rate for Payer: Multiplan Commercial |
$5.31
|
| Rate for Payer: Networks By Design Commercial |
$4.32
|
| Rate for Payer: Prime Health Services Commercial |
$5.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.32
|
| Rate for Payer: United Healthcare All Other HMO |
$3.32
|
| Rate for Payer: United Healthcare HMO Rider |
$3.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.64
|
| Rate for Payer: Vantage Medical Group Senior |
$5.64
|
|
