|
HC CATH SWAN-GANZ VIP 8FR CCO
|
Facility
|
OP
|
$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: Aetna of CA HMO/PPO |
$696.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$902.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$583.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$795.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$651.75
|
| Rate for Payer: Cash Price |
$477.59
|
| Rate for Payer: Cigna of CA HMO |
$679.24
|
| Rate for Payer: Cigna of CA PPO |
$785.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$902.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$902.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$902.11
|
| 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: Molina Healthcare of CA Medi-Cal |
$742.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$742.92
|
| 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
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$636.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$636.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$530.65
|
| Rate for Payer: United Healthcare All Other HMO |
$530.65
|
| Rate for Payer: United Healthcare HMO Rider |
$530.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$530.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$902.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$902.11
|
| Rate for Payer: Vantage Medical Group Senior |
$902.11
|
|
|
HC CATH SWANZ GANZ TL
|
Facility
|
OP
|
$551.93
|
|
| Hospital Charge Code |
901607753
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.39 |
| Max. Negotiated Rate |
$469.14 |
| Rate for Payer: Adventist Health Commercial |
$110.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$362.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$469.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$303.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$413.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$338.94
|
| Rate for Payer: Cash Price |
$248.37
|
| Rate for Payer: Cigna of CA HMO |
$353.24
|
| Rate for Payer: Cigna of CA PPO |
$408.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$469.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$469.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$469.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.77
|
| Rate for Payer: EPIC Health Plan Senior |
$220.77
|
| Rate for Payer: Galaxy Health WC |
$469.14
|
| Rate for Payer: Global Benefits Group Commercial |
$331.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$368.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$210.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$341.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$386.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$386.35
|
| Rate for Payer: Multiplan Commercial |
$441.54
|
| Rate for Payer: Networks By Design Commercial |
$358.75
|
| Rate for Payer: Prime Health Services Commercial |
$469.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$331.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$331.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$275.96
|
| Rate for Payer: United Healthcare All Other HMO |
$275.96
|
| Rate for Payer: United Healthcare HMO Rider |
$275.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$275.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$469.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$469.14
|
| Rate for Payer: Vantage Medical Group Senior |
$469.14
|
|
|
HC CATH SWANZ GANZ TL
|
Facility
|
IP
|
$551.93
|
|
| Hospital Charge Code |
901607753
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.39 |
| Max. Negotiated Rate |
$469.14 |
| Rate for Payer: Adventist Health Commercial |
$110.39
|
| Rate for Payer: Cash Price |
$248.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$220.77
|
| Rate for Payer: EPIC Health Plan Senior |
$220.77
|
| Rate for Payer: Galaxy Health WC |
$469.14
|
| Rate for Payer: Global Benefits Group Commercial |
$331.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$368.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$210.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$341.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.46
|
| Rate for Payer: Multiplan Commercial |
$441.54
|
| Rate for Payer: Networks By Design Commercial |
$358.75
|
| Rate for Payer: Prime Health Services Commercial |
$469.14
|
|
|
HC CATH TERUMO HEARTRAIL III
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812420
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CATH TERUMO HEARTRAIL III
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812420
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$380.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$435.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$356.18
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$493.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Senior |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$220.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$359.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$139.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$406.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$406.00
|
| Rate for Payer: Multiplan Commercial |
$464.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
|
HC CATH TERUMO OPTITORQUE
|
Facility
|
OP
|
$273.00
|
|
| Hospital Charge Code |
906812393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$232.05 |
| Rate for Payer: Adventist Health Commercial |
$54.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$179.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$232.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$150.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.65
|
| Rate for Payer: Cash Price |
$122.85
|
| Rate for Payer: Cigna of CA HMO |
$174.72
|
| Rate for Payer: Cigna of CA PPO |
$202.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$232.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$232.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$232.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.20
|
| Rate for Payer: EPIC Health Plan Senior |
$109.20
|
| Rate for Payer: Galaxy Health WC |
$232.05
|
| Rate for Payer: Global Benefits Group Commercial |
$163.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$182.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$168.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$191.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$191.10
|
| Rate for Payer: Multiplan Commercial |
$218.40
|
| Rate for Payer: Networks By Design Commercial |
$177.45
|
| Rate for Payer: Prime Health Services Commercial |
$232.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$163.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$163.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$136.50
|
| Rate for Payer: United Healthcare All Other HMO |
$136.50
|
| Rate for Payer: United Healthcare HMO Rider |
$136.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$136.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$232.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$232.05
|
| Rate for Payer: Vantage Medical Group Senior |
$232.05
|
|
|
HC CATH TERUMO OPTITORQUE
|
Facility
|
IP
|
$273.00
|
|
| Hospital Charge Code |
906812393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$232.05 |
| Rate for Payer: Adventist Health Commercial |
$54.60
|
| Rate for Payer: Cash Price |
$122.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.20
|
| Rate for Payer: EPIC Health Plan Senior |
$109.20
|
| Rate for Payer: Galaxy Health WC |
$232.05
|
| Rate for Payer: Global Benefits Group Commercial |
$163.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$182.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$168.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.52
|
| Rate for Payer: Multiplan Commercial |
$218.40
|
| Rate for Payer: Networks By Design Commercial |
$177.45
|
| Rate for Payer: Prime Health Services Commercial |
$232.05
|
|
|
HC CATH TERUMO PRIORITYONE
|
Facility
|
IP
|
$1,380.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
906812558
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$276.00 |
| Max. Negotiated Rate |
$1,173.00 |
| Rate for Payer: Adventist Health Commercial |
$276.00
|
| Rate for Payer: Cash Price |
$621.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$552.00
|
| Rate for Payer: EPIC Health Plan Senior |
$552.00
|
| Rate for Payer: Galaxy Health WC |
$1,173.00
|
| Rate for Payer: Global Benefits Group Commercial |
$828.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$920.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$525.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$854.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.20
|
| Rate for Payer: Multiplan Commercial |
$1,104.00
|
| Rate for Payer: Networks By Design Commercial |
$897.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,173.00
|
|
|
HC CATH TERUMO PRIORITYONE
|
Facility
|
OP
|
$1,380.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
906812558
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$276.00 |
| Max. Negotiated Rate |
$1,173.00 |
| Rate for Payer: Adventist Health Commercial |
$276.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$905.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,173.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$759.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,035.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$847.46
|
| Rate for Payer: Cash Price |
$621.00
|
| Rate for Payer: Cigna of CA HMO |
$883.20
|
| Rate for Payer: Cigna of CA PPO |
$1,021.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,173.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,173.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,173.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$552.00
|
| Rate for Payer: EPIC Health Plan Senior |
$552.00
|
| Rate for Payer: Galaxy Health WC |
$1,173.00
|
| Rate for Payer: Global Benefits Group Commercial |
$828.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$920.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$525.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$854.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$966.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$966.00
|
| Rate for Payer: Multiplan Commercial |
$1,104.00
|
| Rate for Payer: Networks By Design Commercial |
$897.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,173.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$828.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$828.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$690.00
|
| Rate for Payer: United Healthcare All Other HMO |
$690.00
|
| Rate for Payer: United Healthcare HMO Rider |
$690.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$690.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,173.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,173.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,173.00
|
|
|
HC CATH TERUMO PROGREAT
|
Facility
|
OP
|
$1,380.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$276.00 |
| Max. Negotiated Rate |
$1,173.00 |
| Rate for Payer: Adventist Health Commercial |
$276.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$905.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,173.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$759.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,035.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$847.46
|
| Rate for Payer: Cash Price |
$621.00
|
| Rate for Payer: Cigna of CA HMO |
$883.20
|
| Rate for Payer: Cigna of CA PPO |
$1,021.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,173.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,173.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,173.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$552.00
|
| Rate for Payer: EPIC Health Plan Senior |
$552.00
|
| Rate for Payer: Galaxy Health WC |
$1,173.00
|
| Rate for Payer: Global Benefits Group Commercial |
$828.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$920.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$525.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$854.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$966.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$966.00
|
| Rate for Payer: Multiplan Commercial |
$1,104.00
|
| Rate for Payer: Networks By Design Commercial |
$897.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,173.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$828.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$828.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$690.00
|
| Rate for Payer: United Healthcare All Other HMO |
$690.00
|
| Rate for Payer: United Healthcare HMO Rider |
$690.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$690.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,173.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,173.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,173.00
|
|
|
HC CATH TERUMO PROGREAT
|
Facility
|
IP
|
$1,380.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$276.00 |
| Max. Negotiated Rate |
$1,173.00 |
| Rate for Payer: Adventist Health Commercial |
$276.00
|
| Rate for Payer: Cash Price |
$621.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$552.00
|
| Rate for Payer: EPIC Health Plan Senior |
$552.00
|
| Rate for Payer: Galaxy Health WC |
$1,173.00
|
| Rate for Payer: Global Benefits Group Commercial |
$828.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$920.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$525.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$854.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$331.20
|
| Rate for Payer: Multiplan Commercial |
$1,104.00
|
| Rate for Payer: Networks By Design Commercial |
$897.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,173.00
|
|
|
HC CATH THAL-QUICK 12FR CHEST
|
Facility
|
OP
|
$668.38
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602840
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$133.68 |
| Max. Negotiated Rate |
$568.12 |
| Rate for Payer: Adventist Health Commercial |
$133.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$568.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$367.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$501.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$387.13
|
| Rate for Payer: Blue Shield of California Commercial |
$493.26
|
| Rate for Payer: Blue Shield of California EPN |
$324.83
|
| Rate for Payer: Cash Price |
$300.77
|
| Rate for Payer: Cigna of CA HMO |
$467.87
|
| Rate for Payer: Cigna of CA PPO |
$467.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$568.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$568.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$568.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$267.35
|
| Rate for Payer: EPIC Health Plan Senior |
$267.35
|
| Rate for Payer: Galaxy Health WC |
$568.12
|
| Rate for Payer: Global Benefits Group Commercial |
$401.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$445.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$254.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$413.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$467.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$467.87
|
| Rate for Payer: Multiplan Commercial |
$534.70
|
| Rate for Payer: Networks By Design Commercial |
$334.19
|
| Rate for Payer: Prime Health Services Commercial |
$568.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$401.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$401.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$250.84
|
| Rate for Payer: United Healthcare All Other HMO |
$244.16
|
| Rate for Payer: United Healthcare HMO Rider |
$238.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$218.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$568.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$568.12
|
| Rate for Payer: Vantage Medical Group Senior |
$568.12
|
|
|
HC CATH THAL-QUICK 12FR CHEST
|
Facility
|
IP
|
$668.38
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602840
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$133.68 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$133.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$300.77
|
| Rate for Payer: Cash Price |
$300.77
|
| Rate for Payer: Cigna of CA HMO |
$467.87
|
| Rate for Payer: Cigna of CA PPO |
$467.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$267.35
|
| Rate for Payer: EPIC Health Plan Senior |
$267.35
|
| Rate for Payer: Galaxy Health WC |
$568.12
|
| Rate for Payer: Global Benefits Group Commercial |
$401.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$445.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$254.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$413.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.41
|
| Rate for Payer: Multiplan Commercial |
$534.70
|
| Rate for Payer: Networks By Design Commercial |
$334.19
|
| Rate for Payer: Prime Health Services Commercial |
$568.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$250.84
|
| Rate for Payer: United Healthcare All Other HMO |
$244.16
|
| Rate for Payer: United Healthcare HMO Rider |
$238.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$218.89
|
|
|
HC CATH THAL-QUICK 16FR CHEST
|
Facility
|
IP
|
$682.18
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602841
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.44 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$136.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$306.98
|
| Rate for Payer: Cash Price |
$306.98
|
| Rate for Payer: Cigna of CA HMO |
$477.53
|
| Rate for Payer: Cigna of CA PPO |
$477.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$272.87
|
| Rate for Payer: EPIC Health Plan Senior |
$272.87
|
| Rate for Payer: Galaxy Health WC |
$579.85
|
| Rate for Payer: Global Benefits Group Commercial |
$409.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$455.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$259.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$422.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$163.72
|
| Rate for Payer: Multiplan Commercial |
$545.74
|
| Rate for Payer: Networks By Design Commercial |
$341.09
|
| Rate for Payer: Prime Health Services Commercial |
$579.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$256.02
|
| Rate for Payer: United Healthcare All Other HMO |
$249.20
|
| Rate for Payer: United Healthcare HMO Rider |
$243.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$223.41
|
|
|
HC CATH THAL-QUICK 16FR CHEST
|
Facility
|
OP
|
$682.18
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602841
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$136.44 |
| Max. Negotiated Rate |
$579.85 |
| Rate for Payer: Adventist Health Commercial |
$136.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$579.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$375.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$511.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$395.12
|
| Rate for Payer: Blue Shield of California Commercial |
$503.45
|
| Rate for Payer: Blue Shield of California EPN |
$331.54
|
| Rate for Payer: Cash Price |
$306.98
|
| Rate for Payer: Cigna of CA HMO |
$477.53
|
| Rate for Payer: Cigna of CA PPO |
$477.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$579.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$579.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$579.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$272.87
|
| Rate for Payer: EPIC Health Plan Senior |
$272.87
|
| Rate for Payer: Galaxy Health WC |
$579.85
|
| Rate for Payer: Global Benefits Group Commercial |
$409.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$455.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$259.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$422.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$163.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$477.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$477.53
|
| Rate for Payer: Multiplan Commercial |
$545.74
|
| Rate for Payer: Networks By Design Commercial |
$341.09
|
| Rate for Payer: Prime Health Services Commercial |
$579.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$409.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$409.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$256.02
|
| Rate for Payer: United Healthcare All Other HMO |
$249.20
|
| Rate for Payer: United Healthcare HMO Rider |
$243.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$223.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$579.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$579.85
|
| Rate for Payer: Vantage Medical Group Senior |
$579.85
|
|
|
HC CATH THAL-QUICK 18FR CHEST
|
Facility
|
OP
|
$747.68
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602842
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$149.54 |
| Max. Negotiated Rate |
$635.53 |
| Rate for Payer: Adventist Health Commercial |
$149.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$635.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$411.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$560.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$433.06
|
| Rate for Payer: Blue Shield of California Commercial |
$551.79
|
| Rate for Payer: Blue Shield of California EPN |
$363.37
|
| Rate for Payer: Cash Price |
$336.46
|
| Rate for Payer: Cigna of CA HMO |
$523.38
|
| Rate for Payer: Cigna of CA PPO |
$523.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$635.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$635.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$635.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$299.07
|
| Rate for Payer: EPIC Health Plan Senior |
$299.07
|
| Rate for Payer: Galaxy Health WC |
$635.53
|
| Rate for Payer: Global Benefits Group Commercial |
$448.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$498.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$284.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$462.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$523.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$523.38
|
| Rate for Payer: Multiplan Commercial |
$598.14
|
| Rate for Payer: Networks By Design Commercial |
$373.84
|
| Rate for Payer: Prime Health Services Commercial |
$635.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$448.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$448.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$280.60
|
| Rate for Payer: United Healthcare All Other HMO |
$273.13
|
| Rate for Payer: United Healthcare HMO Rider |
$267.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$244.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$635.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$635.53
|
| Rate for Payer: Vantage Medical Group Senior |
$635.53
|
|
|
HC CATH THAL-QUICK 18FR CHEST
|
Facility
|
IP
|
$747.68
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901602842
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$149.54 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$149.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$336.46
|
| Rate for Payer: Cash Price |
$336.46
|
| Rate for Payer: Cigna of CA HMO |
$523.38
|
| Rate for Payer: Cigna of CA PPO |
$523.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$299.07
|
| Rate for Payer: EPIC Health Plan Senior |
$299.07
|
| Rate for Payer: Galaxy Health WC |
$635.53
|
| Rate for Payer: Global Benefits Group Commercial |
$448.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$498.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$284.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$462.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.44
|
| Rate for Payer: Multiplan Commercial |
$598.14
|
| Rate for Payer: Networks By Design Commercial |
$373.84
|
| Rate for Payer: Prime Health Services Commercial |
$635.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$280.60
|
| Rate for Payer: United Healthcare All Other HMO |
$273.13
|
| Rate for Payer: United Healthcare HMO Rider |
$267.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$244.87
|
|
|
HC CATH THERMODILUTN 7FR 4 LUMEN
|
Facility
|
IP
|
$377.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607617
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$320.45 |
| Rate for Payer: Adventist Health Commercial |
$75.40
|
| Rate for Payer: Cash Price |
$169.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: EPIC Health Plan Senior |
$150.80
|
| Rate for Payer: Galaxy Health WC |
$320.45
|
| Rate for Payer: Global Benefits Group Commercial |
$226.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$233.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.48
|
| Rate for Payer: Multiplan Commercial |
$301.60
|
| Rate for Payer: Networks By Design Commercial |
$245.05
|
| Rate for Payer: Prime Health Services Commercial |
$320.45
|
|
|
HC CATH THERMODILUTN 7FR 4 LUMEN
|
Facility
|
OP
|
$377.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901607617
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$320.45 |
| Rate for Payer: Adventist Health Commercial |
$75.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$247.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$320.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$207.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$282.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$231.52
|
| Rate for Payer: Cash Price |
$169.65
|
| Rate for Payer: Cigna of CA HMO |
$241.28
|
| Rate for Payer: Cigna of CA PPO |
$278.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$320.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$320.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$320.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: EPIC Health Plan Senior |
$150.80
|
| Rate for Payer: Galaxy Health WC |
$320.45
|
| Rate for Payer: Global Benefits Group Commercial |
$226.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$251.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$143.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$233.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$263.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$263.90
|
| Rate for Payer: Multiplan Commercial |
$301.60
|
| Rate for Payer: Networks By Design Commercial |
$245.05
|
| Rate for Payer: Prime Health Services Commercial |
$320.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$226.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$226.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$188.50
|
| Rate for Payer: United Healthcare All Other HMO |
$188.50
|
| Rate for Payer: United Healthcare HMO Rider |
$188.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$188.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$320.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$320.45
|
| Rate for Payer: Vantage Medical Group Senior |
$320.45
|
|
|
HC CATH THORACIC 12FR CHEST TUBE
|
Facility
|
OP
|
$54.04
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901603648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.81 |
| Max. Negotiated Rate |
$45.93 |
| Rate for Payer: Adventist Health Commercial |
$10.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$45.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.30
|
| Rate for Payer: Blue Shield of California Commercial |
$39.88
|
| Rate for Payer: Blue Shield of California EPN |
$26.26
|
| Rate for Payer: Cash Price |
$24.32
|
| Rate for Payer: Cigna of CA HMO |
$37.83
|
| Rate for Payer: Cigna of CA PPO |
$37.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$45.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$45.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.62
|
| Rate for Payer: EPIC Health Plan Senior |
$21.62
|
| Rate for Payer: Galaxy Health WC |
$45.93
|
| Rate for Payer: Global Benefits Group Commercial |
$32.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37.83
|
| Rate for Payer: Multiplan Commercial |
$43.23
|
| Rate for Payer: Networks By Design Commercial |
$27.02
|
| Rate for Payer: Prime Health Services Commercial |
$45.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.28
|
| Rate for Payer: United Healthcare All Other HMO |
$19.74
|
| Rate for Payer: United Healthcare HMO Rider |
$19.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$45.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.93
|
| Rate for Payer: Vantage Medical Group Senior |
$45.93
|
|
|
HC CATH THORACIC 12FR CHEST TUBE
|
Facility
|
IP
|
$54.04
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901603648
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.81 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$10.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$24.32
|
| Rate for Payer: Cash Price |
$24.32
|
| Rate for Payer: Cigna of CA HMO |
$37.83
|
| Rate for Payer: Cigna of CA PPO |
$37.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.62
|
| Rate for Payer: EPIC Health Plan Senior |
$21.62
|
| Rate for Payer: Galaxy Health WC |
$45.93
|
| Rate for Payer: Global Benefits Group Commercial |
$32.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.97
|
| Rate for Payer: Multiplan Commercial |
$43.23
|
| Rate for Payer: Networks By Design Commercial |
$27.02
|
| Rate for Payer: Prime Health Services Commercial |
$45.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.28
|
| Rate for Payer: United Healthcare All Other HMO |
$19.74
|
| Rate for Payer: United Healthcare HMO Rider |
$19.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.70
|
|
|
HC CATH THORACIC 16FR CHEST TUBE
|
Facility
|
IP
|
$56.33
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601397
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.27 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$11.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$25.35
|
| Rate for Payer: Cash Price |
$25.35
|
| Rate for Payer: Cigna of CA HMO |
$39.43
|
| Rate for Payer: Cigna of CA PPO |
$39.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.53
|
| Rate for Payer: EPIC Health Plan Senior |
$22.53
|
| Rate for Payer: Galaxy Health WC |
$47.88
|
| Rate for Payer: Global Benefits Group Commercial |
$33.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.52
|
| Rate for Payer: Multiplan Commercial |
$45.06
|
| Rate for Payer: Networks By Design Commercial |
$28.16
|
| Rate for Payer: Prime Health Services Commercial |
$47.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.14
|
| Rate for Payer: United Healthcare All Other HMO |
$20.58
|
| Rate for Payer: United Healthcare HMO Rider |
$20.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.45
|
|
|
HC CATH THORACIC 16FR CHEST TUBE
|
Facility
|
OP
|
$56.33
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601397
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.27 |
| Max. Negotiated Rate |
$47.88 |
| Rate for Payer: Adventist Health Commercial |
$11.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.63
|
| Rate for Payer: Blue Shield of California Commercial |
$41.57
|
| Rate for Payer: Blue Shield of California EPN |
$27.38
|
| Rate for Payer: Cash Price |
$25.35
|
| Rate for Payer: Cigna of CA HMO |
$39.43
|
| Rate for Payer: Cigna of CA PPO |
$39.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.53
|
| Rate for Payer: EPIC Health Plan Senior |
$22.53
|
| Rate for Payer: Galaxy Health WC |
$47.88
|
| Rate for Payer: Global Benefits Group Commercial |
$33.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.43
|
| Rate for Payer: Multiplan Commercial |
$45.06
|
| Rate for Payer: Networks By Design Commercial |
$28.16
|
| Rate for Payer: Prime Health Services Commercial |
$47.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.14
|
| Rate for Payer: United Healthcare All Other HMO |
$20.58
|
| Rate for Payer: United Healthcare HMO Rider |
$20.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.88
|
| Rate for Payer: Vantage Medical Group Senior |
$47.88
|
|
|
HC CATH THORACIC 20FR CHEST TUBE
|
Facility
|
OP
|
$53.79
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601398
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.76 |
| Max. Negotiated Rate |
$45.72 |
| Rate for Payer: Adventist Health Commercial |
$10.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$45.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$40.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.16
|
| Rate for Payer: Blue Shield of California Commercial |
$39.70
|
| Rate for Payer: Blue Shield of California EPN |
$26.14
|
| Rate for Payer: Cash Price |
$24.21
|
| Rate for Payer: Cigna of CA HMO |
$37.65
|
| Rate for Payer: Cigna of CA PPO |
$37.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$45.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$45.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.52
|
| Rate for Payer: EPIC Health Plan Senior |
$21.52
|
| Rate for Payer: Galaxy Health WC |
$45.72
|
| Rate for Payer: Global Benefits Group Commercial |
$32.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37.65
|
| Rate for Payer: Multiplan Commercial |
$43.03
|
| Rate for Payer: Networks By Design Commercial |
$26.89
|
| Rate for Payer: Prime Health Services Commercial |
$45.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$32.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$32.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.19
|
| Rate for Payer: United Healthcare All Other HMO |
$19.65
|
| Rate for Payer: United Healthcare HMO Rider |
$19.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$45.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.72
|
| Rate for Payer: Vantage Medical Group Senior |
$45.72
|
|
|
HC CATH THORACIC 20FR CHEST TUBE
|
Facility
|
IP
|
$53.79
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601398
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.76 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$10.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$24.21
|
| Rate for Payer: Cash Price |
$24.21
|
| Rate for Payer: Cigna of CA HMO |
$37.65
|
| Rate for Payer: Cigna of CA PPO |
$37.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.52
|
| Rate for Payer: EPIC Health Plan Senior |
$21.52
|
| Rate for Payer: Galaxy Health WC |
$45.72
|
| Rate for Payer: Global Benefits Group Commercial |
$32.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.91
|
| Rate for Payer: Multiplan Commercial |
$43.03
|
| Rate for Payer: Networks By Design Commercial |
$26.89
|
| Rate for Payer: Prime Health Services Commercial |
$45.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.19
|
| Rate for Payer: United Healthcare All Other HMO |
$19.65
|
| Rate for Payer: United Healthcare HMO Rider |
$19.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.62
|
|
