|
HC CATH THORACIC 24FR CHEST TUBE
|
Facility
|
OP
|
$53.14
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601399
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$45.17 |
| Rate for Payer: Adventist Health Commercial |
$10.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$45.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.78
|
| Rate for Payer: Blue Shield of California Commercial |
$39.22
|
| Rate for Payer: Blue Shield of California EPN |
$25.83
|
| Rate for Payer: Cash Price |
$23.91
|
| Rate for Payer: Cigna of CA HMO |
$37.20
|
| Rate for Payer: Cigna of CA PPO |
$37.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$45.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$45.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.26
|
| Rate for Payer: EPIC Health Plan Senior |
$21.26
|
| Rate for Payer: Galaxy Health WC |
$45.17
|
| Rate for Payer: Global Benefits Group Commercial |
$31.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37.20
|
| Rate for Payer: Multiplan Commercial |
$42.51
|
| Rate for Payer: Networks By Design Commercial |
$26.57
|
| Rate for Payer: Prime Health Services Commercial |
$45.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.94
|
| Rate for Payer: United Healthcare All Other HMO |
$19.41
|
| Rate for Payer: United Healthcare HMO Rider |
$18.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$45.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.17
|
| Rate for Payer: Vantage Medical Group Senior |
$45.17
|
|
|
HC CATH THORACIC 24FR CHEST TUBE
|
Facility
|
IP
|
$53.14
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601399
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.63 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$10.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$23.91
|
| Rate for Payer: Cash Price |
$23.91
|
| Rate for Payer: Cigna of CA HMO |
$37.20
|
| Rate for Payer: Cigna of CA PPO |
$37.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.26
|
| Rate for Payer: EPIC Health Plan Senior |
$21.26
|
| Rate for Payer: Galaxy Health WC |
$45.17
|
| Rate for Payer: Global Benefits Group Commercial |
$31.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.75
|
| Rate for Payer: Multiplan Commercial |
$42.51
|
| Rate for Payer: Networks By Design Commercial |
$26.57
|
| Rate for Payer: Prime Health Services Commercial |
$45.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.94
|
| Rate for Payer: United Healthcare All Other HMO |
$19.41
|
| Rate for Payer: United Healthcare HMO Rider |
$18.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.40
|
|
|
HC CATH THORACIC 28FR CHEST TUBE
|
Facility
|
IP
|
$52.48
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$10.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$23.62
|
| Rate for Payer: Cash Price |
$23.62
|
| Rate for Payer: Cigna of CA HMO |
$36.74
|
| Rate for Payer: Cigna of CA PPO |
$36.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.99
|
| Rate for Payer: EPIC Health Plan Senior |
$20.99
|
| Rate for Payer: Galaxy Health WC |
$44.61
|
| Rate for Payer: Global Benefits Group Commercial |
$31.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.60
|
| Rate for Payer: Multiplan Commercial |
$41.98
|
| Rate for Payer: Networks By Design Commercial |
$26.24
|
| Rate for Payer: Prime Health Services Commercial |
$44.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.70
|
| Rate for Payer: United Healthcare All Other HMO |
$19.17
|
| Rate for Payer: United Healthcare HMO Rider |
$18.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.19
|
|
|
HC CATH THORACIC 28FR CHEST TUBE
|
Facility
|
OP
|
$52.48
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601400
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$44.61 |
| Rate for Payer: Adventist Health Commercial |
$10.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.40
|
| Rate for Payer: Blue Shield of California Commercial |
$38.73
|
| Rate for Payer: Blue Shield of California EPN |
$25.51
|
| Rate for Payer: Cash Price |
$23.62
|
| Rate for Payer: Cigna of CA HMO |
$36.74
|
| Rate for Payer: Cigna of CA PPO |
$36.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$44.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$44.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.99
|
| Rate for Payer: EPIC Health Plan Senior |
$20.99
|
| Rate for Payer: Galaxy Health WC |
$44.61
|
| Rate for Payer: Global Benefits Group Commercial |
$31.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.74
|
| Rate for Payer: Multiplan Commercial |
$41.98
|
| Rate for Payer: Networks By Design Commercial |
$26.24
|
| Rate for Payer: Prime Health Services Commercial |
$44.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.70
|
| Rate for Payer: United Healthcare All Other HMO |
$19.17
|
| Rate for Payer: United Healthcare HMO Rider |
$18.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.61
|
| Rate for Payer: Vantage Medical Group Senior |
$44.61
|
|
|
HC CATH THORACIC 32FR CHEST TUBE
|
Facility
|
OP
|
$80.44
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.09 |
| Max. Negotiated Rate |
$68.37 |
| Rate for Payer: Adventist Health Commercial |
$16.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$68.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$44.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$60.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.59
|
| Rate for Payer: Blue Shield of California Commercial |
$59.36
|
| Rate for Payer: Blue Shield of California EPN |
$39.09
|
| Rate for Payer: Cash Price |
$36.20
|
| Rate for Payer: Cigna of CA HMO |
$56.31
|
| Rate for Payer: Cigna of CA PPO |
$56.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$68.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$68.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$68.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.18
|
| Rate for Payer: EPIC Health Plan Senior |
$32.18
|
| Rate for Payer: Galaxy Health WC |
$68.37
|
| Rate for Payer: Global Benefits Group Commercial |
$48.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$56.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56.31
|
| Rate for Payer: Multiplan Commercial |
$64.35
|
| Rate for Payer: Networks By Design Commercial |
$40.22
|
| Rate for Payer: Prime Health Services Commercial |
$68.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$48.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$48.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.19
|
| Rate for Payer: United Healthcare All Other HMO |
$29.38
|
| Rate for Payer: United Healthcare HMO Rider |
$28.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$68.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$68.37
|
| Rate for Payer: Vantage Medical Group Senior |
$68.37
|
|
|
HC CATH THORACIC 32FR CHEST TUBE
|
Facility
|
OP
|
$51.74
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601401
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$43.98 |
| Rate for Payer: Adventist Health Commercial |
$10.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$43.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$38.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.97
|
| Rate for Payer: Blue Shield of California Commercial |
$38.18
|
| Rate for Payer: Blue Shield of California EPN |
$25.15
|
| Rate for Payer: Cash Price |
$23.28
|
| Rate for Payer: Cigna of CA HMO |
$36.22
|
| Rate for Payer: Cigna of CA PPO |
$36.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$43.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$43.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.70
|
| Rate for Payer: EPIC Health Plan Senior |
$20.70
|
| Rate for Payer: Galaxy Health WC |
$43.98
|
| Rate for Payer: Global Benefits Group Commercial |
$31.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.22
|
| Rate for Payer: Multiplan Commercial |
$41.39
|
| Rate for Payer: Networks By Design Commercial |
$25.87
|
| Rate for Payer: Prime Health Services Commercial |
$43.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.42
|
| Rate for Payer: United Healthcare All Other HMO |
$18.90
|
| Rate for Payer: United Healthcare HMO Rider |
$18.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$43.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.98
|
| Rate for Payer: Vantage Medical Group Senior |
$43.98
|
|
|
HC CATH THORACIC 32FR CHEST TUBE
|
Facility
|
IP
|
$51.74
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601401
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$10.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$23.28
|
| Rate for Payer: Cash Price |
$23.28
|
| Rate for Payer: Cigna of CA HMO |
$36.22
|
| Rate for Payer: Cigna of CA PPO |
$36.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.70
|
| Rate for Payer: EPIC Health Plan Senior |
$20.70
|
| Rate for Payer: Galaxy Health WC |
$43.98
|
| Rate for Payer: Global Benefits Group Commercial |
$31.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.42
|
| Rate for Payer: Multiplan Commercial |
$41.39
|
| Rate for Payer: Networks By Design Commercial |
$25.87
|
| Rate for Payer: Prime Health Services Commercial |
$43.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.42
|
| Rate for Payer: United Healthcare All Other HMO |
$18.90
|
| Rate for Payer: United Healthcare HMO Rider |
$18.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.94
|
|
|
HC CATH THORACIC 32FR CHEST TUBE
|
Facility
|
IP
|
$80.44
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698883
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.09 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$16.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$36.20
|
| Rate for Payer: Cash Price |
$36.20
|
| Rate for Payer: Cigna of CA HMO |
$56.31
|
| Rate for Payer: Cigna of CA PPO |
$56.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.18
|
| Rate for Payer: EPIC Health Plan Senior |
$32.18
|
| Rate for Payer: Galaxy Health WC |
$68.37
|
| Rate for Payer: Global Benefits Group Commercial |
$48.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$53.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$49.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.31
|
| Rate for Payer: Multiplan Commercial |
$64.35
|
| Rate for Payer: Networks By Design Commercial |
$40.22
|
| Rate for Payer: Prime Health Services Commercial |
$68.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.19
|
| Rate for Payer: United Healthcare All Other HMO |
$29.38
|
| Rate for Payer: United Healthcare HMO Rider |
$28.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.34
|
|
|
HC CATH THORACIC 36FR CHEST TUBE
|
Facility
|
IP
|
$52.97
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601402
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.59 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$10.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$23.84
|
| Rate for Payer: Cash Price |
$23.84
|
| Rate for Payer: Cigna of CA HMO |
$37.08
|
| Rate for Payer: Cigna of CA PPO |
$37.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.19
|
| Rate for Payer: EPIC Health Plan Senior |
$21.19
|
| Rate for Payer: Galaxy Health WC |
$45.02
|
| Rate for Payer: Global Benefits Group Commercial |
$31.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.71
|
| Rate for Payer: Multiplan Commercial |
$42.38
|
| Rate for Payer: Networks By Design Commercial |
$26.48
|
| Rate for Payer: Prime Health Services Commercial |
$45.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.88
|
| Rate for Payer: United Healthcare All Other HMO |
$19.35
|
| Rate for Payer: United Healthcare HMO Rider |
$18.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.35
|
|
|
HC CATH THORACIC 36FR CHEST TUBE
|
Facility
|
OP
|
$52.97
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601402
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.59 |
| Max. Negotiated Rate |
$45.02 |
| Rate for Payer: Adventist Health Commercial |
$10.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$45.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.68
|
| Rate for Payer: Blue Shield of California Commercial |
$39.09
|
| Rate for Payer: Blue Shield of California EPN |
$25.74
|
| Rate for Payer: Cash Price |
$23.84
|
| Rate for Payer: Cigna of CA HMO |
$37.08
|
| Rate for Payer: Cigna of CA PPO |
$37.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$45.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$45.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.19
|
| Rate for Payer: EPIC Health Plan Senior |
$21.19
|
| Rate for Payer: Galaxy Health WC |
$45.02
|
| Rate for Payer: Global Benefits Group Commercial |
$31.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37.08
|
| Rate for Payer: Multiplan Commercial |
$42.38
|
| Rate for Payer: Networks By Design Commercial |
$26.48
|
| Rate for Payer: Prime Health Services Commercial |
$45.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.88
|
| Rate for Payer: United Healthcare All Other HMO |
$19.35
|
| Rate for Payer: United Healthcare HMO Rider |
$18.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$45.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.02
|
| Rate for Payer: Vantage Medical Group Senior |
$45.02
|
|
|
HC CATH THORACIC 40FR CHEST TUBE
|
Facility
|
OP
|
$51.25
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601403
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$43.56 |
| Rate for Payer: Adventist Health Commercial |
$10.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$43.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$38.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.68
|
| Rate for Payer: Blue Shield of California Commercial |
$37.82
|
| Rate for Payer: Blue Shield of California EPN |
$24.91
|
| Rate for Payer: Cash Price |
$23.06
|
| Rate for Payer: Cigna of CA HMO |
$35.88
|
| Rate for Payer: Cigna of CA PPO |
$35.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$43.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$43.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.50
|
| Rate for Payer: EPIC Health Plan Senior |
$20.50
|
| Rate for Payer: Galaxy Health WC |
$43.56
|
| Rate for Payer: Global Benefits Group Commercial |
$30.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35.88
|
| Rate for Payer: Multiplan Commercial |
$41.00
|
| Rate for Payer: Networks By Design Commercial |
$25.62
|
| Rate for Payer: Prime Health Services Commercial |
$43.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.23
|
| Rate for Payer: United Healthcare All Other HMO |
$18.72
|
| Rate for Payer: United Healthcare HMO Rider |
$18.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$43.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.56
|
| Rate for Payer: Vantage Medical Group Senior |
$43.56
|
|
|
HC CATH THORACIC 40FR CHEST TUBE
|
Facility
|
IP
|
$51.25
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601403
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$10.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$23.06
|
| Rate for Payer: Cash Price |
$23.06
|
| Rate for Payer: Cigna of CA HMO |
$35.88
|
| Rate for Payer: Cigna of CA PPO |
$35.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.50
|
| Rate for Payer: EPIC Health Plan Senior |
$20.50
|
| Rate for Payer: Galaxy Health WC |
$43.56
|
| Rate for Payer: Global Benefits Group Commercial |
$30.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.30
|
| Rate for Payer: Multiplan Commercial |
$41.00
|
| Rate for Payer: Networks By Design Commercial |
$25.62
|
| Rate for Payer: Prime Health Services Commercial |
$43.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.23
|
| Rate for Payer: United Healthcare All Other HMO |
$18.72
|
| Rate for Payer: United Healthcare HMO Rider |
$18.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.78
|
|
|
HC CATH THORACIC STRGHT 28FRX20IN
|
Facility
|
OP
|
$58.22
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698180
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.64 |
| Max. Negotiated Rate |
$49.49 |
| Rate for Payer: Adventist Health Commercial |
$11.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$49.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$33.72
|
| Rate for Payer: Blue Shield of California Commercial |
$42.97
|
| Rate for Payer: Blue Shield of California EPN |
$28.29
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cigna of CA HMO |
$40.75
|
| Rate for Payer: Cigna of CA PPO |
$40.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$49.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$49.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$49.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.29
|
| Rate for Payer: EPIC Health Plan Senior |
$23.29
|
| Rate for Payer: Galaxy Health WC |
$49.49
|
| Rate for Payer: Global Benefits Group Commercial |
$34.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40.75
|
| Rate for Payer: Multiplan Commercial |
$46.58
|
| Rate for Payer: Networks By Design Commercial |
$29.11
|
| Rate for Payer: Prime Health Services Commercial |
$49.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.85
|
| Rate for Payer: United Healthcare All Other HMO |
$21.27
|
| Rate for Payer: United Healthcare HMO Rider |
$20.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$49.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$49.49
|
| Rate for Payer: Vantage Medical Group Senior |
$49.49
|
|
|
HC CATH THORACIC STRGHT 28FRX20IN
|
Facility
|
IP
|
$58.22
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698180
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.64 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$11.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cigna of CA HMO |
$40.75
|
| Rate for Payer: Cigna of CA PPO |
$40.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.29
|
| Rate for Payer: EPIC Health Plan Senior |
$23.29
|
| Rate for Payer: Galaxy Health WC |
$49.49
|
| Rate for Payer: Global Benefits Group Commercial |
$34.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.97
|
| Rate for Payer: Multiplan Commercial |
$46.58
|
| Rate for Payer: Networks By Design Commercial |
$29.11
|
| Rate for Payer: Prime Health Services Commercial |
$49.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.85
|
| Rate for Payer: United Healthcare All Other HMO |
$21.27
|
| Rate for Payer: United Healthcare HMO Rider |
$20.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.07
|
|
|
HC CATH THORACIC STRGHT 32FRX20IN
|
Facility
|
IP
|
$56.33
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698181
|
|
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 STRGHT 32FRX20IN
|
Facility
|
OP
|
$56.33
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698181
|
|
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 STRGHT 36FRX20IN
|
Facility
|
OP
|
$59.20
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.84 |
| Max. Negotiated Rate |
$50.32 |
| Rate for Payer: Adventist Health Commercial |
$11.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$44.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.29
|
| Rate for Payer: Blue Shield of California Commercial |
$43.69
|
| Rate for Payer: Blue Shield of California EPN |
$28.77
|
| Rate for Payer: Cash Price |
$26.64
|
| Rate for Payer: Cigna of CA HMO |
$41.44
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$50.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$50.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.68
|
| Rate for Payer: EPIC Health Plan Senior |
$23.68
|
| Rate for Payer: Galaxy Health WC |
$50.32
|
| Rate for Payer: Global Benefits Group Commercial |
$35.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41.44
|
| Rate for Payer: Multiplan Commercial |
$47.36
|
| Rate for Payer: Networks By Design Commercial |
$29.60
|
| Rate for Payer: Prime Health Services Commercial |
$50.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.22
|
| Rate for Payer: United Healthcare All Other HMO |
$21.63
|
| Rate for Payer: United Healthcare HMO Rider |
$21.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$50.32
|
| Rate for Payer: Vantage Medical Group Senior |
$50.32
|
|
|
HC CATH THORACIC STRGHT 36FRX20IN
|
Facility
|
IP
|
$59.20
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698182
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11.84 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$11.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$26.64
|
| Rate for Payer: Cash Price |
$26.64
|
| Rate for Payer: Cigna of CA HMO |
$41.44
|
| Rate for Payer: Cigna of CA PPO |
$41.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.68
|
| Rate for Payer: EPIC Health Plan Senior |
$23.68
|
| Rate for Payer: Galaxy Health WC |
$50.32
|
| Rate for Payer: Global Benefits Group Commercial |
$35.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$36.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.21
|
| Rate for Payer: Multiplan Commercial |
$47.36
|
| Rate for Payer: Networks By Design Commercial |
$29.60
|
| Rate for Payer: Prime Health Services Commercial |
$50.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.22
|
| Rate for Payer: United Healthcare All Other HMO |
$21.63
|
| Rate for Payer: United Healthcare HMO Rider |
$21.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.39
|
|
|
HC CATH THORACIC VENT 11FRX13CM
|
Facility
|
IP
|
$1,209.39
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604496
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.88 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$241.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$544.23
|
| Rate for Payer: Cash Price |
$544.23
|
| Rate for Payer: Cigna of CA HMO |
$846.57
|
| Rate for Payer: Cigna of CA PPO |
$846.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$483.76
|
| Rate for Payer: EPIC Health Plan Senior |
$483.76
|
| Rate for Payer: Galaxy Health WC |
$1,027.98
|
| Rate for Payer: Global Benefits Group Commercial |
$725.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$806.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$460.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$748.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$290.25
|
| Rate for Payer: Multiplan Commercial |
$967.51
|
| Rate for Payer: Networks By Design Commercial |
$604.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,027.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$453.88
|
| Rate for Payer: United Healthcare All Other HMO |
$441.79
|
| Rate for Payer: United Healthcare HMO Rider |
$432.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$396.08
|
|
|
HC CATH THORACIC VENT 11FRX13CM
|
Facility
|
OP
|
$1,209.39
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901604496
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$241.88 |
| Max. Negotiated Rate |
$1,027.98 |
| Rate for Payer: Adventist Health Commercial |
$241.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,027.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$665.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$907.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$700.48
|
| Rate for Payer: Blue Shield of California Commercial |
$892.53
|
| Rate for Payer: Blue Shield of California EPN |
$587.76
|
| Rate for Payer: Cash Price |
$544.23
|
| Rate for Payer: Cigna of CA HMO |
$846.57
|
| Rate for Payer: Cigna of CA PPO |
$846.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,027.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,027.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,027.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$483.76
|
| Rate for Payer: EPIC Health Plan Senior |
$483.76
|
| Rate for Payer: Galaxy Health WC |
$1,027.98
|
| Rate for Payer: Global Benefits Group Commercial |
$725.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$806.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$460.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$748.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$290.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$846.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$846.57
|
| Rate for Payer: Multiplan Commercial |
$967.51
|
| Rate for Payer: Networks By Design Commercial |
$604.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,027.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$725.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$725.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$453.88
|
| Rate for Payer: United Healthcare All Other HMO |
$441.79
|
| Rate for Payer: United Healthcare HMO Rider |
$432.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$396.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,027.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,027.98
|
| Rate for Payer: Vantage Medical Group Senior |
$1,027.98
|
|
|
HC CATH THRMDLTN 5F SWAN BXTR
|
Facility
|
OP
|
$634.80
|
|
| Hospital Charge Code |
901600422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.96 |
| Max. Negotiated Rate |
$539.58 |
| Rate for Payer: Adventist Health Commercial |
$126.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$416.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$539.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$349.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$476.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$389.83
|
| Rate for Payer: Cash Price |
$285.66
|
| Rate for Payer: Cigna of CA HMO |
$406.27
|
| Rate for Payer: Cigna of CA PPO |
$469.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$539.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$539.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$539.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.92
|
| Rate for Payer: EPIC Health Plan Senior |
$253.92
|
| Rate for Payer: Galaxy Health WC |
$539.58
|
| Rate for Payer: Global Benefits Group Commercial |
$380.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$423.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$444.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$444.36
|
| Rate for Payer: Multiplan Commercial |
$507.84
|
| Rate for Payer: Networks By Design Commercial |
$412.62
|
| Rate for Payer: Prime Health Services Commercial |
$539.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$380.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$380.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$317.40
|
| Rate for Payer: United Healthcare All Other HMO |
$317.40
|
| Rate for Payer: United Healthcare HMO Rider |
$317.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$317.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$539.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$539.58
|
| Rate for Payer: Vantage Medical Group Senior |
$539.58
|
|
|
HC CATH THRMDLTN 5F SWAN BXTR
|
Facility
|
IP
|
$634.80
|
|
| Hospital Charge Code |
901600422
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.96 |
| Max. Negotiated Rate |
$539.58 |
| Rate for Payer: Adventist Health Commercial |
$126.96
|
| Rate for Payer: Cash Price |
$285.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.92
|
| Rate for Payer: EPIC Health Plan Senior |
$253.92
|
| Rate for Payer: Galaxy Health WC |
$539.58
|
| Rate for Payer: Global Benefits Group Commercial |
$380.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$423.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$241.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$392.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$152.35
|
| Rate for Payer: Multiplan Commercial |
$507.84
|
| Rate for Payer: Networks By Design Commercial |
$412.62
|
| Rate for Payer: Prime Health Services Commercial |
$539.58
|
|
|
HC CATH THROMBEC BALLOON
|
Facility
|
IP
|
$744.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$148.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cigna of CA HMO |
$520.80
|
| Rate for Payer: Cigna of CA PPO |
$520.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$297.60
|
| Rate for Payer: EPIC Health Plan Senior |
$297.60
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$496.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$283.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$460.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.56
|
| Rate for Payer: Multiplan Commercial |
$595.20
|
| Rate for Payer: Networks By Design Commercial |
$372.00
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$279.22
|
| Rate for Payer: United Healthcare All Other HMO |
$271.78
|
| Rate for Payer: United Healthcare HMO Rider |
$265.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$243.66
|
|
|
HC CATH THROMBEC BALLOON
|
Facility
|
OP
|
$744.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000259
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$632.40 |
| Rate for Payer: Adventist Health Commercial |
$148.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$632.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$409.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$558.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$430.92
|
| Rate for Payer: Blue Shield of California Commercial |
$549.07
|
| Rate for Payer: Blue Shield of California EPN |
$361.58
|
| Rate for Payer: Cash Price |
$334.80
|
| Rate for Payer: Cigna of CA HMO |
$520.80
|
| Rate for Payer: Cigna of CA PPO |
$520.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$632.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$632.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$632.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$297.60
|
| Rate for Payer: EPIC Health Plan Senior |
$297.60
|
| Rate for Payer: Galaxy Health WC |
$632.40
|
| Rate for Payer: Global Benefits Group Commercial |
$446.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$496.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$283.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$460.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$178.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$520.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$520.80
|
| Rate for Payer: Multiplan Commercial |
$595.20
|
| Rate for Payer: Networks By Design Commercial |
$372.00
|
| Rate for Payer: Prime Health Services Commercial |
$632.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$446.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$446.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$279.22
|
| Rate for Payer: United Healthcare All Other HMO |
$271.78
|
| Rate for Payer: United Healthcare HMO Rider |
$265.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$243.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$632.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$632.40
|
| Rate for Payer: Vantage Medical Group Senior |
$632.40
|
|
|
HC CATH THROMBECTOMY PENUMBRA
|
Facility
|
IP
|
$3,900.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
|
