|
HC CATH SUCTION 8FR
|
Facility
|
OP
|
$4.02
|
|
| Hospital Charge Code |
901698256
|
|
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 8FR
|
Facility
|
IP
|
$4.02
|
|
| Hospital Charge Code |
901698256
|
|
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 8FR 14"
|
Facility
|
IP
|
$5.33
|
|
| Hospital Charge Code |
901602136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$4.53 |
| Rate for Payer: Adventist Health Commercial |
$1.07
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2.13
|
| Rate for Payer: Galaxy Health WC |
$4.53
|
| Rate for Payer: Global Benefits Group Commercial |
$3.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.28
|
| Rate for Payer: Multiplan Commercial |
$4.26
|
| Rate for Payer: Networks By Design Commercial |
$3.46
|
| Rate for Payer: Prime Health Services Commercial |
$4.53
|
|
|
HC CATH SUCTION 8FR 14"
|
Facility
|
OP
|
$5.33
|
|
| Hospital Charge Code |
901602136
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$4.53 |
| Rate for Payer: Adventist Health Commercial |
$1.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.27
|
| Rate for Payer: Cash Price |
$2.40
|
| Rate for Payer: Cigna of CA HMO |
$3.41
|
| Rate for Payer: Cigna of CA PPO |
$3.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.13
|
| Rate for Payer: EPIC Health Plan Senior |
$2.13
|
| Rate for Payer: Galaxy Health WC |
$4.53
|
| Rate for Payer: Global Benefits Group Commercial |
$3.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.73
|
| Rate for Payer: Multiplan Commercial |
$4.26
|
| Rate for Payer: Networks By Design Commercial |
$3.46
|
| Rate for Payer: Prime Health Services Commercial |
$4.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.67
|
| Rate for Payer: United Healthcare All Other HMO |
$2.67
|
| Rate for Payer: United Healthcare HMO Rider |
$2.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.53
|
| Rate for Payer: Vantage Medical Group Senior |
$4.53
|
|
|
HC CATH SUCTION 8FR SAFE-T-VAC
|
Facility
|
OP
|
$3.28
|
|
| Hospital Charge Code |
901698443
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.66 |
| Max. Negotiated Rate |
$2.79 |
| Rate for Payer: Adventist Health Commercial |
$0.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.01
|
| Rate for Payer: Cash Price |
$1.48
|
| Rate for Payer: Cigna of CA HMO |
$2.10
|
| Rate for Payer: Cigna of CA PPO |
$2.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.31
|
| Rate for Payer: EPIC Health Plan Senior |
$1.31
|
| Rate for Payer: Galaxy Health WC |
$2.79
|
| Rate for Payer: Global Benefits Group Commercial |
$1.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.30
|
| Rate for Payer: Multiplan Commercial |
$2.62
|
| Rate for Payer: Networks By Design Commercial |
$2.13
|
| Rate for Payer: Prime Health Services Commercial |
$2.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.64
|
| Rate for Payer: United Healthcare All Other HMO |
$1.64
|
| Rate for Payer: United Healthcare HMO Rider |
$1.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.79
|
| Rate for Payer: Vantage Medical Group Senior |
$2.79
|
|
|
HC CATH SUCTION 8FR SAFE-T-VAC
|
Facility
|
IP
|
$3.28
|
|
| Hospital Charge Code |
901698443
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.66 |
| Max. Negotiated Rate |
$2.79 |
| Rate for Payer: Adventist Health Commercial |
$0.66
|
| Rate for Payer: Cash Price |
$1.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.31
|
| Rate for Payer: EPIC Health Plan Senior |
$1.31
|
| Rate for Payer: Galaxy Health WC |
$2.79
|
| Rate for Payer: Global Benefits Group Commercial |
$1.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.79
|
| Rate for Payer: Multiplan Commercial |
$2.62
|
| Rate for Payer: Networks By Design Commercial |
$2.13
|
| Rate for Payer: Prime Health Services Commercial |
$2.79
|
|
|
HC CATH SUCTION KIT 12FR
|
Facility
|
IP
|
$3.03
|
|
| Hospital Charge Code |
901698862
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.61 |
| Max. Negotiated Rate |
$2.58 |
| Rate for Payer: Adventist Health Commercial |
$0.61
|
| Rate for Payer: Cash Price |
$1.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.21
|
| Rate for Payer: EPIC Health Plan Senior |
$1.21
|
| Rate for Payer: Galaxy Health WC |
$2.58
|
| Rate for Payer: Global Benefits Group Commercial |
$1.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.73
|
| Rate for Payer: Multiplan Commercial |
$2.42
|
| Rate for Payer: Networks By Design Commercial |
$1.97
|
| Rate for Payer: Prime Health Services Commercial |
$2.58
|
|
|
HC CATH SUCTION KIT 12FR
|
Facility
|
OP
|
$3.03
|
|
| Hospital Charge Code |
901698862
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.61 |
| Max. Negotiated Rate |
$2.58 |
| Rate for Payer: Adventist Health Commercial |
$0.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.86
|
| Rate for Payer: Cash Price |
$1.36
|
| Rate for Payer: Cigna of CA HMO |
$1.94
|
| Rate for Payer: Cigna of CA PPO |
$2.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.21
|
| Rate for Payer: EPIC Health Plan Senior |
$1.21
|
| Rate for Payer: Galaxy Health WC |
$2.58
|
| Rate for Payer: Global Benefits Group Commercial |
$1.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.12
|
| Rate for Payer: Multiplan Commercial |
$2.42
|
| Rate for Payer: Networks By Design Commercial |
$1.97
|
| Rate for Payer: Prime Health Services Commercial |
$2.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.51
|
| Rate for Payer: United Healthcare All Other HMO |
$1.51
|
| Rate for Payer: United Healthcare HMO Rider |
$1.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.58
|
| Rate for Payer: Vantage Medical Group Senior |
$2.58
|
|
|
HC CATH SUCTION KIT 5FR 21IN
|
Facility
|
IP
|
$49.28
|
|
| Hospital Charge Code |
901698546
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$41.89 |
| Rate for Payer: Adventist Health Commercial |
$9.86
|
| Rate for Payer: Cash Price |
$22.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.71
|
| Rate for Payer: EPIC Health Plan Senior |
$19.71
|
| Rate for Payer: Galaxy Health WC |
$41.89
|
| Rate for Payer: Global Benefits Group Commercial |
$29.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.83
|
| Rate for Payer: Multiplan Commercial |
$39.42
|
| Rate for Payer: Networks By Design Commercial |
$32.03
|
| Rate for Payer: Prime Health Services Commercial |
$41.89
|
|
|
HC CATH SUCTION KIT 5FR 21IN
|
Facility
|
OP
|
$49.28
|
|
| Hospital Charge Code |
901698546
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$41.89 |
| Rate for Payer: Adventist Health Commercial |
$9.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$32.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.26
|
| Rate for Payer: Cash Price |
$22.18
|
| Rate for Payer: Cigna of CA HMO |
$31.54
|
| Rate for Payer: Cigna of CA PPO |
$36.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.71
|
| Rate for Payer: EPIC Health Plan Senior |
$19.71
|
| Rate for Payer: Galaxy Health WC |
$41.89
|
| Rate for Payer: Global Benefits Group Commercial |
$29.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$34.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34.50
|
| Rate for Payer: Multiplan Commercial |
$39.42
|
| Rate for Payer: Networks By Design Commercial |
$32.03
|
| Rate for Payer: Prime Health Services Commercial |
$41.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.64
|
| Rate for Payer: United Healthcare All Other HMO |
$24.64
|
| Rate for Payer: United Healthcare HMO Rider |
$24.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$41.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.89
|
| Rate for Payer: Vantage Medical Group Senior |
$41.89
|
|
|
HC CATH SUCTION ORAL 8FR
|
Facility
|
IP
|
$2.71
|
|
| Hospital Charge Code |
901604576
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.54 |
| Max. Negotiated Rate |
$2.30 |
| Rate for Payer: Adventist Health Commercial |
$0.54
|
| Rate for Payer: Cash Price |
$1.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.08
|
| Rate for Payer: EPIC Health Plan Senior |
$1.08
|
| Rate for Payer: Galaxy Health WC |
$2.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.65
|
| Rate for Payer: Multiplan Commercial |
$2.17
|
| Rate for Payer: Networks By Design Commercial |
$1.76
|
| Rate for Payer: Prime Health Services Commercial |
$2.30
|
|
|
HC CATH SUCTION ORAL 8FR
|
Facility
|
OP
|
$2.71
|
|
| Hospital Charge Code |
901604576
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.54 |
| Max. Negotiated Rate |
$2.30 |
| Rate for Payer: Adventist Health Commercial |
$0.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.66
|
| Rate for Payer: Cash Price |
$1.22
|
| Rate for Payer: Cigna of CA HMO |
$1.73
|
| Rate for Payer: Cigna of CA PPO |
$2.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.08
|
| Rate for Payer: EPIC Health Plan Senior |
$1.08
|
| Rate for Payer: Galaxy Health WC |
$2.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.90
|
| Rate for Payer: Multiplan Commercial |
$2.17
|
| Rate for Payer: Networks By Design Commercial |
$1.76
|
| Rate for Payer: Prime Health Services Commercial |
$2.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.35
|
| Rate for Payer: United Healthcare All Other HMO |
$1.35
|
| Rate for Payer: United Healthcare HMO Rider |
$1.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.30
|
| Rate for Payer: Vantage Medical Group Senior |
$2.30
|
|
|
HC CATH SUCTION RED POLY 10FR
|
Facility
|
OP
|
$8.69
|
|
| Hospital Charge Code |
901698415
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$7.39 |
| Rate for Payer: Adventist Health Commercial |
$1.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.34
|
| Rate for Payer: Cash Price |
$3.91
|
| Rate for Payer: Cigna of CA HMO |
$5.56
|
| Rate for Payer: Cigna of CA PPO |
$6.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.48
|
| Rate for Payer: EPIC Health Plan Senior |
$3.48
|
| Rate for Payer: Galaxy Health WC |
$7.39
|
| Rate for Payer: Global Benefits Group Commercial |
$5.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.08
|
| Rate for Payer: Multiplan Commercial |
$6.95
|
| Rate for Payer: Networks By Design Commercial |
$5.65
|
| Rate for Payer: Prime Health Services Commercial |
$7.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.34
|
| Rate for Payer: United Healthcare All Other HMO |
$4.34
|
| Rate for Payer: United Healthcare HMO Rider |
$4.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.39
|
| Rate for Payer: Vantage Medical Group Senior |
$7.39
|
|
|
HC CATH SUCTION RED POLY 10FR
|
Facility
|
IP
|
$8.69
|
|
| Hospital Charge Code |
901698415
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$7.39 |
| Rate for Payer: Adventist Health Commercial |
$1.74
|
| Rate for Payer: Cash Price |
$3.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.48
|
| Rate for Payer: EPIC Health Plan Senior |
$3.48
|
| Rate for Payer: Galaxy Health WC |
$7.39
|
| Rate for Payer: Global Benefits Group Commercial |
$5.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.09
|
| Rate for Payer: Multiplan Commercial |
$6.95
|
| Rate for Payer: Networks By Design Commercial |
$5.65
|
| Rate for Payer: Prime Health Services Commercial |
$7.39
|
|
|
HC CATH SUCTION RED POLY 14FR
|
Facility
|
OP
|
$6.56
|
|
| Hospital Charge Code |
901698416
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.31 |
| Max. Negotiated Rate |
$5.58 |
| Rate for Payer: Adventist Health Commercial |
$1.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.03
|
| Rate for Payer: Cash Price |
$2.95
|
| Rate for Payer: Cigna of CA HMO |
$4.20
|
| Rate for Payer: Cigna of CA PPO |
$4.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.62
|
| Rate for Payer: EPIC Health Plan Senior |
$2.62
|
| Rate for Payer: Galaxy Health WC |
$5.58
|
| Rate for Payer: Global Benefits Group Commercial |
$3.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.59
|
| Rate for Payer: Multiplan Commercial |
$5.25
|
| Rate for Payer: Networks By Design Commercial |
$4.26
|
| Rate for Payer: Prime Health Services Commercial |
$5.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.28
|
| Rate for Payer: United Healthcare All Other HMO |
$3.28
|
| Rate for Payer: United Healthcare HMO Rider |
$3.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.58
|
| Rate for Payer: Vantage Medical Group Senior |
$5.58
|
|
|
HC CATH SUCTION RED POLY 14FR
|
Facility
|
IP
|
$6.56
|
|
| Hospital Charge Code |
901698416
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.31 |
| Max. Negotiated Rate |
$5.58 |
| Rate for Payer: Adventist Health Commercial |
$1.31
|
| Rate for Payer: Cash Price |
$2.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.62
|
| Rate for Payer: EPIC Health Plan Senior |
$2.62
|
| Rate for Payer: Galaxy Health WC |
$5.58
|
| Rate for Payer: Global Benefits Group Commercial |
$3.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.57
|
| Rate for Payer: Multiplan Commercial |
$5.25
|
| Rate for Payer: Networks By Design Commercial |
$4.26
|
| Rate for Payer: Prime Health Services Commercial |
$5.58
|
|
|
HC CATH SUCTION REPLOGLE 10FR
|
Facility
|
OP
|
$66.09
|
|
| Hospital Charge Code |
901698411
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.22 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Adventist Health Commercial |
$13.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.59
|
| Rate for Payer: Cash Price |
$29.74
|
| Rate for Payer: Cigna of CA HMO |
$42.30
|
| Rate for Payer: Cigna of CA PPO |
$48.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.44
|
| Rate for Payer: EPIC Health Plan Senior |
$26.44
|
| Rate for Payer: Galaxy Health WC |
$56.18
|
| Rate for Payer: Global Benefits Group Commercial |
$39.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.26
|
| Rate for Payer: Multiplan Commercial |
$52.87
|
| Rate for Payer: Networks By Design Commercial |
$42.96
|
| Rate for Payer: Prime Health Services Commercial |
$56.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.05
|
| Rate for Payer: United Healthcare All Other HMO |
$33.05
|
| Rate for Payer: United Healthcare HMO Rider |
$33.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.18
|
| Rate for Payer: Vantage Medical Group Senior |
$56.18
|
|
|
HC CATH SUCTION REPLOGLE 10FR
|
Facility
|
IP
|
$66.09
|
|
| Hospital Charge Code |
901698411
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.22 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Adventist Health Commercial |
$13.22
|
| Rate for Payer: Cash Price |
$29.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.44
|
| Rate for Payer: EPIC Health Plan Senior |
$26.44
|
| Rate for Payer: Galaxy Health WC |
$56.18
|
| Rate for Payer: Global Benefits Group Commercial |
$39.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.86
|
| Rate for Payer: Multiplan Commercial |
$52.87
|
| Rate for Payer: Networks By Design Commercial |
$42.96
|
| Rate for Payer: Prime Health Services Commercial |
$56.18
|
|
|
HC CATH SUREFIRE MICROCATH
|
Facility
|
IP
|
$9,574.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909001887
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,914.80 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$1,914.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$4,308.30
|
| Rate for Payer: Cash Price |
$4,308.30
|
| Rate for Payer: Cigna of CA HMO |
$6,701.80
|
| Rate for Payer: Cigna of CA PPO |
$6,701.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,829.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,829.60
|
| Rate for Payer: Galaxy Health WC |
$8,137.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,744.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,385.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,647.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,926.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,297.76
|
| Rate for Payer: Multiplan Commercial |
$7,659.20
|
| Rate for Payer: Networks By Design Commercial |
$4,787.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,137.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,593.12
|
| Rate for Payer: United Healthcare All Other HMO |
$3,497.38
|
| Rate for Payer: United Healthcare HMO Rider |
$3,421.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,135.49
|
|
|
HC CATH SUREFIRE MICROCATH
|
Facility
|
OP
|
$9,574.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
909001887
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,914.80 |
| Max. Negotiated Rate |
$8,137.90 |
| Rate for Payer: Adventist Health Commercial |
$1,914.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,137.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,265.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,180.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,545.26
|
| Rate for Payer: Blue Shield of California Commercial |
$7,065.61
|
| Rate for Payer: Blue Shield of California EPN |
$4,652.96
|
| Rate for Payer: Cash Price |
$4,308.30
|
| Rate for Payer: Cigna of CA HMO |
$6,701.80
|
| Rate for Payer: Cigna of CA PPO |
$6,701.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,137.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,137.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,137.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,829.60
|
| Rate for Payer: EPIC Health Plan Senior |
$3,829.60
|
| Rate for Payer: Galaxy Health WC |
$8,137.90
|
| Rate for Payer: Global Benefits Group Commercial |
$5,744.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6,385.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,647.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5,926.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,297.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6,701.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6,701.80
|
| Rate for Payer: Multiplan Commercial |
$7,659.20
|
| Rate for Payer: Networks By Design Commercial |
$4,787.00
|
| Rate for Payer: Prime Health Services Commercial |
$8,137.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5,744.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5,744.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,593.12
|
| Rate for Payer: United Healthcare All Other HMO |
$3,497.38
|
| Rate for Payer: United Healthcare HMO Rider |
$3,421.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,135.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,137.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,137.90
|
| Rate for Payer: Vantage Medical Group Senior |
$8,137.90
|
|
|
HC CATH SWAN CONT.8FR NON HEPARIN
|
Facility
|
IP
|
$1,858.40
|
|
| Hospital Charge Code |
901607286
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$371.68 |
| Max. Negotiated Rate |
$1,579.64 |
| Rate for Payer: Adventist Health Commercial |
$371.68
|
| Rate for Payer: Cash Price |
$836.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$743.36
|
| Rate for Payer: EPIC Health Plan Senior |
$743.36
|
| Rate for Payer: Galaxy Health WC |
$1,579.64
|
| Rate for Payer: Global Benefits Group Commercial |
$1,115.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,239.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$708.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,150.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$446.02
|
| Rate for Payer: Multiplan Commercial |
$1,486.72
|
| Rate for Payer: Networks By Design Commercial |
$1,207.96
|
| Rate for Payer: Prime Health Services Commercial |
$1,579.64
|
|
|
HC CATH SWAN CONT.8FR NON HEPARIN
|
Facility
|
OP
|
$1,858.40
|
|
| Hospital Charge Code |
901607286
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$371.68 |
| Max. Negotiated Rate |
$1,579.64 |
| Rate for Payer: Adventist Health Commercial |
$371.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,218.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,579.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,022.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,393.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,141.24
|
| Rate for Payer: Cash Price |
$836.28
|
| Rate for Payer: Cigna of CA HMO |
$1,189.38
|
| Rate for Payer: Cigna of CA PPO |
$1,375.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,579.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,579.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,579.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$743.36
|
| Rate for Payer: EPIC Health Plan Senior |
$743.36
|
| Rate for Payer: Galaxy Health WC |
$1,579.64
|
| Rate for Payer: Global Benefits Group Commercial |
$1,115.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,239.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$708.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,150.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$446.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,300.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,300.88
|
| Rate for Payer: Multiplan Commercial |
$1,486.72
|
| Rate for Payer: Networks By Design Commercial |
$1,207.96
|
| Rate for Payer: Prime Health Services Commercial |
$1,579.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,115.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,115.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$929.20
|
| Rate for Payer: United Healthcare All Other HMO |
$929.20
|
| Rate for Payer: United Healthcare HMO Rider |
$929.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$929.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,579.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,579.64
|
| Rate for Payer: Vantage Medical Group Senior |
$1,579.64
|
|
|
HC CATH SWAN-GANZ 7.5FR 110CM
|
Facility
|
IP
|
$1,598.22
|
|
| Hospital Charge Code |
901698772
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$319.64 |
| Max. Negotiated Rate |
$1,358.49 |
| Rate for Payer: Adventist Health Commercial |
$319.64
|
| Rate for Payer: Cash Price |
$719.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$639.29
|
| Rate for Payer: EPIC Health Plan Senior |
$639.29
|
| Rate for Payer: Galaxy Health WC |
$1,358.49
|
| Rate for Payer: Global Benefits Group Commercial |
$958.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,066.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$608.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$989.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$383.57
|
| Rate for Payer: Multiplan Commercial |
$1,278.58
|
| Rate for Payer: Networks By Design Commercial |
$1,038.84
|
| Rate for Payer: Prime Health Services Commercial |
$1,358.49
|
|
|
HC CATH SWAN-GANZ 7.5FR 110CM
|
Facility
|
OP
|
$1,598.22
|
|
| Hospital Charge Code |
901698772
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$319.64 |
| Max. Negotiated Rate |
$1,358.49 |
| Rate for Payer: Adventist Health Commercial |
$319.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,048.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,358.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$879.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,198.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$981.47
|
| Rate for Payer: Cash Price |
$719.20
|
| Rate for Payer: Cigna of CA HMO |
$1,022.86
|
| Rate for Payer: Cigna of CA PPO |
$1,182.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,358.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,358.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,358.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$639.29
|
| Rate for Payer: EPIC Health Plan Senior |
$639.29
|
| Rate for Payer: Galaxy Health WC |
$1,358.49
|
| Rate for Payer: Global Benefits Group Commercial |
$958.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,066.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$608.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$989.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$383.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,118.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,118.75
|
| Rate for Payer: Multiplan Commercial |
$1,278.58
|
| Rate for Payer: Networks By Design Commercial |
$1,038.84
|
| Rate for Payer: Prime Health Services Commercial |
$1,358.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$958.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$958.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$799.11
|
| Rate for Payer: United Healthcare All Other HMO |
$799.11
|
| Rate for Payer: United Healthcare HMO Rider |
$799.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$799.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,358.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,358.49
|
| Rate for Payer: Vantage Medical Group Senior |
$1,358.49
|
|
|
HC CATH SWAN-GANZ VIP 8FR CCO
|
Facility
|
IP
|
$1,061.31
|
|
| Hospital Charge Code |
901698451
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$212.26 |
| Max. Negotiated Rate |
$902.11 |
| Rate for Payer: Adventist Health Commercial |
$212.26
|
| Rate for Payer: Cash Price |
$477.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$424.52
|
| Rate for Payer: EPIC Health Plan Senior |
$424.52
|
| Rate for Payer: Galaxy Health WC |
$902.11
|
| Rate for Payer: Global Benefits Group Commercial |
$636.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$707.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$404.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$656.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$254.71
|
| Rate for Payer: Multiplan Commercial |
$849.05
|
| Rate for Payer: Networks By Design Commercial |
$689.85
|
| Rate for Payer: Prime Health Services Commercial |
$902.11
|
|
