|
HC CATH CONDOM EXTND SM 25MM SLCN
|
Facility
|
OP
|
$6.97
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698729
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$5.92 |
| Rate for Payer: Adventist Health Commercial |
$1.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.47
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Cigna of CA HMO |
$4.46
|
| Rate for Payer: Cigna of CA PPO |
$5.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.79
|
| Rate for Payer: EPIC Health Plan Senior |
$2.79
|
| Rate for Payer: Galaxy Health WC |
$5.92
|
| Rate for Payer: Global Benefits Group Commercial |
$4.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.88
|
| Rate for Payer: Multiplan Commercial |
$5.58
|
| Rate for Payer: Networks By Design Commercial |
$4.53
|
| Rate for Payer: Prime Health Services Commercial |
$5.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.48
|
| Rate for Payer: United Healthcare All Other HMO |
$3.48
|
| Rate for Payer: United Healthcare HMO Rider |
$3.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.92
|
| Rate for Payer: Vantage Medical Group Senior |
$5.92
|
|
|
HC CATH CONDOM EXTND SM 25MM SLCN
|
Facility
|
IP
|
$6.97
|
|
|
Service Code
|
CPT A4349
|
| Hospital Charge Code |
901698729
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$5.92 |
| Rate for Payer: Adventist Health Commercial |
$1.39
|
| Rate for Payer: Cash Price |
$3.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.79
|
| Rate for Payer: EPIC Health Plan Senior |
$2.79
|
| Rate for Payer: Galaxy Health WC |
$5.92
|
| Rate for Payer: Global Benefits Group Commercial |
$4.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.67
|
| Rate for Payer: Multiplan Commercial |
$5.58
|
| Rate for Payer: Networks By Design Commercial |
$4.53
|
| Rate for Payer: Prime Health Services Commercial |
$5.92
|
|
|
HC CATH COOK CORONARY
|
Facility
|
OP
|
$252.00
|
|
| Hospital Charge Code |
906812005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Adventist Health Commercial |
$50.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$165.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$214.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$138.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$189.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$161.71
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Cigna of CA HMO |
$161.28
|
| Rate for Payer: Cigna of CA PPO |
$186.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$214.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$214.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$214.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$176.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.80
|
| Rate for Payer: EPIC Health Plan Senior |
$100.80
|
| Rate for Payer: Galaxy Health WC |
$214.20
|
| Rate for Payer: Global Benefits Group Commercial |
$151.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$160.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$91.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$148.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$176.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$176.40
|
| Rate for Payer: Multiplan Commercial |
$201.60
|
| Rate for Payer: Networks By Design Commercial |
$163.80
|
| Rate for Payer: Prime Health Services Commercial |
$214.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$151.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$151.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$126.00
|
| Rate for Payer: United Healthcare All Other HMO |
$126.00
|
| Rate for Payer: United Healthcare HMO Rider |
$126.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$126.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$214.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$214.20
|
| Rate for Payer: Vantage Medical Group Senior |
$214.20
|
|
|
HC CATH COOK CORONARY
|
Facility
|
IP
|
$252.00
|
|
| Hospital Charge Code |
906812005
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$50.40 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Adventist Health Commercial |
$50.40
|
| Rate for Payer: Cash Price |
$113.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$176.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$100.80
|
| Rate for Payer: EPIC Health Plan Senior |
$100.80
|
| Rate for Payer: Galaxy Health WC |
$214.20
|
| Rate for Payer: Global Benefits Group Commercial |
$151.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$160.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$148.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$60.48
|
| Rate for Payer: Multiplan Commercial |
$201.60
|
| Rate for Payer: Networks By Design Commercial |
$163.80
|
| Rate for Payer: Prime Health Services Commercial |
$214.20
|
|
|
HC CATH COOK PIGTAIL
|
Facility
|
OP
|
$148.96
|
|
| Hospital Charge Code |
906811757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$126.62 |
| Rate for Payer: Adventist Health Commercial |
$29.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$97.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$126.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$81.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$111.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$95.59
|
| Rate for Payer: Cash Price |
$67.03
|
| Rate for Payer: Cigna of CA HMO |
$95.33
|
| Rate for Payer: Cigna of CA PPO |
$110.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$126.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$126.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$126.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$104.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.58
|
| Rate for Payer: EPIC Health Plan Senior |
$59.58
|
| Rate for Payer: Galaxy Health WC |
$126.62
|
| Rate for Payer: Global Benefits Group Commercial |
$89.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$94.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$54.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$87.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$104.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$104.27
|
| Rate for Payer: Multiplan Commercial |
$119.17
|
| Rate for Payer: Networks By Design Commercial |
$96.82
|
| Rate for Payer: Prime Health Services Commercial |
$126.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$89.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$89.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$74.48
|
| Rate for Payer: United Healthcare All Other HMO |
$74.48
|
| Rate for Payer: United Healthcare HMO Rider |
$74.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$74.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$126.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$126.62
|
| Rate for Payer: Vantage Medical Group Senior |
$126.62
|
|
|
HC CATH COOK PIGTAIL
|
Facility
|
IP
|
$148.96
|
|
| Hospital Charge Code |
906811757
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$126.62 |
| Rate for Payer: Adventist Health Commercial |
$29.79
|
| Rate for Payer: Cash Price |
$67.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$104.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$59.58
|
| Rate for Payer: EPIC Health Plan Senior |
$59.58
|
| Rate for Payer: Galaxy Health WC |
$126.62
|
| Rate for Payer: Global Benefits Group Commercial |
$89.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$94.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$87.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.75
|
| Rate for Payer: Multiplan Commercial |
$119.17
|
| Rate for Payer: Networks By Design Commercial |
$96.82
|
| Rate for Payer: Prime Health Services Commercial |
$126.62
|
|
|
HC CATH CORDIS BERENSTEIN
|
Facility
|
IP
|
$136.80
|
|
| Hospital Charge Code |
906812400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.36 |
| Max. Negotiated Rate |
$116.28 |
| Rate for Payer: Adventist Health Commercial |
$27.36
|
| Rate for Payer: Cash Price |
$61.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$95.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.72
|
| Rate for Payer: EPIC Health Plan Senior |
$54.72
|
| Rate for Payer: Galaxy Health WC |
$116.28
|
| Rate for Payer: Global Benefits Group Commercial |
$82.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$86.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$80.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.83
|
| Rate for Payer: Multiplan Commercial |
$109.44
|
| Rate for Payer: Networks By Design Commercial |
$88.92
|
| Rate for Payer: Prime Health Services Commercial |
$116.28
|
|
|
HC CATH CORDIS BERENSTEIN
|
Facility
|
OP
|
$136.80
|
|
| Hospital Charge Code |
906812400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.36 |
| Max. Negotiated Rate |
$116.28 |
| Rate for Payer: Adventist Health Commercial |
$27.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$89.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$116.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$102.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.78
|
| Rate for Payer: Cash Price |
$61.56
|
| Rate for Payer: Cigna of CA HMO |
$87.55
|
| Rate for Payer: Cigna of CA PPO |
$101.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$116.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$116.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$116.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$95.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.72
|
| Rate for Payer: EPIC Health Plan Senior |
$54.72
|
| Rate for Payer: Galaxy Health WC |
$116.28
|
| Rate for Payer: Global Benefits Group Commercial |
$82.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$86.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$49.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$80.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$95.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95.76
|
| Rate for Payer: Multiplan Commercial |
$109.44
|
| Rate for Payer: Networks By Design Commercial |
$88.92
|
| Rate for Payer: Prime Health Services Commercial |
$116.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$68.40
|
| Rate for Payer: United Healthcare All Other HMO |
$68.40
|
| Rate for Payer: United Healthcare HMO Rider |
$68.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$116.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$116.28
|
| Rate for Payer: Vantage Medical Group Senior |
$116.28
|
|
|
HC CATH CORDIS PTCA GUIDE PEDS
|
Facility
|
IP
|
$695.52
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.10 |
| Max. Negotiated Rate |
$591.19 |
| Rate for Payer: Adventist Health Commercial |
$139.10
|
| Rate for Payer: Cash Price |
$312.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$486.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$278.21
|
| Rate for Payer: EPIC Health Plan Senior |
$278.21
|
| Rate for Payer: Galaxy Health WC |
$591.19
|
| Rate for Payer: Global Benefits Group Commercial |
$417.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$441.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$410.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.92
|
| Rate for Payer: Multiplan Commercial |
$556.42
|
| Rate for Payer: Networks By Design Commercial |
$452.09
|
| Rate for Payer: Prime Health Services Commercial |
$591.19
|
|
|
HC CATH CORDIS PTCA GUIDE PEDS
|
Facility
|
OP
|
$695.52
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812308
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$139.10 |
| Max. Negotiated Rate |
$591.19 |
| Rate for Payer: Adventist Health Commercial |
$139.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$213.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$591.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$382.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$521.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$446.32
|
| Rate for Payer: Cash Price |
$312.98
|
| Rate for Payer: Cash Price |
$312.98
|
| Rate for Payer: Cigna of CA HMO |
$445.13
|
| Rate for Payer: Cigna of CA PPO |
$514.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$591.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$591.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$591.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$486.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$278.21
|
| Rate for Payer: EPIC Health Plan Senior |
$278.21
|
| Rate for Payer: Galaxy Health WC |
$591.19
|
| Rate for Payer: Global Benefits Group Commercial |
$417.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$441.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$252.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$410.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$166.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$486.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$486.86
|
| Rate for Payer: Multiplan Commercial |
$556.42
|
| Rate for Payer: Networks By Design Commercial |
$452.09
|
| Rate for Payer: Prime Health Services Commercial |
$591.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$417.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$417.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$347.76
|
| Rate for Payer: United Healthcare All Other HMO |
$347.76
|
| Rate for Payer: United Healthcare HMO Rider |
$347.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$347.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$591.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$591.19
|
| Rate for Payer: Vantage Medical Group Senior |
$591.19
|
|
|
HC CATH COUDE 12FR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$30.95 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Multiplan Commercial |
$29.13
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
|
|
HC CATH COUDE 12FR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601804
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$388.84 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.36
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Cigna of CA HMO |
$23.30
|
| Rate for Payer: Cigna of CA PPO |
$26.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.49
|
| Rate for Payer: Multiplan Commercial |
$29.13
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.20
|
| Rate for Payer: United Healthcare All Other HMO |
$18.20
|
| Rate for Payer: United Healthcare HMO Rider |
$18.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.95
|
| Rate for Payer: Vantage Medical Group Senior |
$30.95
|
|
|
HC CATH COUDE 14FR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$30.95 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Multiplan Commercial |
$29.13
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
|
|
HC CATH COUDE 14FR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601805
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$388.84 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.36
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Cigna of CA HMO |
$23.30
|
| Rate for Payer: Cigna of CA PPO |
$26.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.49
|
| Rate for Payer: Multiplan Commercial |
$29.13
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.20
|
| Rate for Payer: United Healthcare All Other HMO |
$18.20
|
| Rate for Payer: United Healthcare HMO Rider |
$18.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.95
|
| Rate for Payer: Vantage Medical Group Senior |
$30.95
|
|
|
HC CATH COUDE 18FR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$388.84 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.36
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Cigna of CA HMO |
$23.30
|
| Rate for Payer: Cigna of CA PPO |
$26.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.49
|
| Rate for Payer: Multiplan Commercial |
$29.13
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.20
|
| Rate for Payer: United Healthcare All Other HMO |
$18.20
|
| Rate for Payer: United Healthcare HMO Rider |
$18.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.95
|
| Rate for Payer: Vantage Medical Group Senior |
$30.95
|
|
|
HC CATH COUDE 18FR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601807
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$30.95 |
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Multiplan Commercial |
$29.13
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
|
|
HC CATH COUDE 20FR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$388.84 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.36
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Cigna of CA HMO |
$23.30
|
| Rate for Payer: Cigna of CA PPO |
$26.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.49
|
| Rate for Payer: Multiplan Commercial |
$29.13
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.20
|
| Rate for Payer: United Healthcare All Other HMO |
$18.20
|
| Rate for Payer: United Healthcare HMO Rider |
$18.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.95
|
| Rate for Payer: Vantage Medical Group Senior |
$30.95
|
|
|
HC CATH COUDE 20FR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601808
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$30.95 |
| Rate for Payer: Adventist Health Commercial |
$7.28
|
| Rate for Payer: Cash Price |
$16.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.56
|
| Rate for Payer: EPIC Health Plan Senior |
$14.56
|
| Rate for Payer: Galaxy Health WC |
$30.95
|
| Rate for Payer: Global Benefits Group Commercial |
$21.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Multiplan Commercial |
$29.13
|
| Rate for Payer: Networks By Design Commercial |
$23.67
|
| Rate for Payer: Prime Health Services Commercial |
$30.95
|
|
|
HC CATH COUDE TIEMAN 16FR
|
Facility
|
OP
|
$38.54
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601806
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$388.84 |
| Rate for Payer: Adventist Health Commercial |
$7.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.73
|
| Rate for Payer: Cash Price |
$17.34
|
| Rate for Payer: Cash Price |
$17.34
|
| Rate for Payer: Cigna of CA HMO |
$24.67
|
| Rate for Payer: Cigna of CA PPO |
$28.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.42
|
| Rate for Payer: EPIC Health Plan Senior |
$15.42
|
| Rate for Payer: Galaxy Health WC |
$32.76
|
| Rate for Payer: Global Benefits Group Commercial |
$23.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.98
|
| Rate for Payer: Multiplan Commercial |
$30.83
|
| Rate for Payer: Networks By Design Commercial |
$25.05
|
| Rate for Payer: Prime Health Services Commercial |
$32.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.27
|
| Rate for Payer: United Healthcare All Other HMO |
$19.27
|
| Rate for Payer: United Healthcare HMO Rider |
$19.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.76
|
| Rate for Payer: Vantage Medical Group Senior |
$32.76
|
|
|
HC CATH COUDE TIEMAN 16FR
|
Facility
|
IP
|
$38.54
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901601806
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$32.76 |
| Rate for Payer: Adventist Health Commercial |
$7.71
|
| Rate for Payer: Cash Price |
$17.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.42
|
| Rate for Payer: EPIC Health Plan Senior |
$15.42
|
| Rate for Payer: Galaxy Health WC |
$32.76
|
| Rate for Payer: Global Benefits Group Commercial |
$23.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.25
|
| Rate for Payer: Multiplan Commercial |
$30.83
|
| Rate for Payer: Networks By Design Commercial |
$25.05
|
| Rate for Payer: Prime Health Services Commercial |
$32.76
|
|
|
HC CATH COUDE TIP W G STRIP 12FR
|
Facility
|
IP
|
$47.89
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$40.71 |
| Rate for Payer: Adventist Health Commercial |
$9.58
|
| Rate for Payer: Cash Price |
$21.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.16
|
| Rate for Payer: EPIC Health Plan Senior |
$19.16
|
| Rate for Payer: Galaxy Health WC |
$40.71
|
| Rate for Payer: Global Benefits Group Commercial |
$28.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.49
|
| Rate for Payer: Multiplan Commercial |
$38.31
|
| Rate for Payer: Networks By Design Commercial |
$31.13
|
| Rate for Payer: Prime Health Services Commercial |
$40.71
|
|
|
HC CATH COUDE TIP W G STRIP 12FR
|
Facility
|
OP
|
$47.89
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901607690
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$40.71 |
| Rate for Payer: Adventist Health Commercial |
$9.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$35.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.73
|
| Rate for Payer: Cash Price |
$21.55
|
| Rate for Payer: Cash Price |
$21.55
|
| Rate for Payer: Cigna of CA HMO |
$30.65
|
| Rate for Payer: Cigna of CA PPO |
$35.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.16
|
| Rate for Payer: EPIC Health Plan Senior |
$19.16
|
| Rate for Payer: Galaxy Health WC |
$40.71
|
| Rate for Payer: Global Benefits Group Commercial |
$28.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.52
|
| Rate for Payer: Multiplan Commercial |
$38.31
|
| Rate for Payer: Networks By Design Commercial |
$31.13
|
| Rate for Payer: Prime Health Services Commercial |
$40.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.95
|
| Rate for Payer: United Healthcare All Other HMO |
$23.95
|
| Rate for Payer: United Healthcare HMO Rider |
$23.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.71
|
| Rate for Payer: Vantage Medical Group Senior |
$40.71
|
|
|
HC CATH CRICOTHYROTOMY 3.5MM
|
Facility
|
IP
|
$874.00
|
|
| Hospital Charge Code |
901604422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.80 |
| Max. Negotiated Rate |
$742.90 |
| Rate for Payer: Adventist Health Commercial |
$174.80
|
| Rate for Payer: Cash Price |
$393.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$611.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.60
|
| Rate for Payer: EPIC Health Plan Senior |
$349.60
|
| Rate for Payer: Galaxy Health WC |
$742.90
|
| Rate for Payer: Global Benefits Group Commercial |
$524.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$554.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$515.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.76
|
| Rate for Payer: Multiplan Commercial |
$699.20
|
| Rate for Payer: Networks By Design Commercial |
$568.10
|
| Rate for Payer: Prime Health Services Commercial |
$742.90
|
|
|
HC CATH CRICOTHYROTOMY 3.5MM
|
Facility
|
OP
|
$874.00
|
|
| Hospital Charge Code |
901604422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$174.80 |
| Max. Negotiated Rate |
$742.90 |
| Rate for Payer: Adventist Health Commercial |
$174.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$573.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$742.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$480.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$655.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$560.85
|
| Rate for Payer: Cash Price |
$393.30
|
| Rate for Payer: Cigna of CA HMO |
$559.36
|
| Rate for Payer: Cigna of CA PPO |
$646.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$742.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$742.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$742.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$611.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.60
|
| Rate for Payer: EPIC Health Plan Senior |
$349.60
|
| Rate for Payer: Galaxy Health WC |
$742.90
|
| Rate for Payer: Global Benefits Group Commercial |
$524.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$554.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$317.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$515.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$209.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$611.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$611.80
|
| Rate for Payer: Multiplan Commercial |
$699.20
|
| Rate for Payer: Networks By Design Commercial |
$568.10
|
| Rate for Payer: Prime Health Services Commercial |
$742.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$524.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$524.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$437.00
|
| Rate for Payer: United Healthcare All Other HMO |
$437.00
|
| Rate for Payer: United Healthcare HMO Rider |
$437.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$437.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$742.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$742.90
|
| Rate for Payer: Vantage Medical Group Senior |
$742.90
|
|
|
HC CATH CRICOTHYROTOMY ADULT
|
Facility
|
IP
|
$963.19
|
|
| Hospital Charge Code |
901602640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$192.64 |
| Max. Negotiated Rate |
$818.71 |
| Rate for Payer: Adventist Health Commercial |
$192.64
|
| Rate for Payer: Cash Price |
$433.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$674.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$385.28
|
| Rate for Payer: EPIC Health Plan Senior |
$385.28
|
| Rate for Payer: Galaxy Health WC |
$818.71
|
| Rate for Payer: Global Benefits Group Commercial |
$577.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$611.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$568.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$231.17
|
| Rate for Payer: Multiplan Commercial |
$770.55
|
| Rate for Payer: Networks By Design Commercial |
$626.07
|
| Rate for Payer: Prime Health Services Commercial |
$818.71
|
|
