|
HC CATH THROMBECTOMY PENUMBRA
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909020025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,258.88
|
| Rate for Payer: Blue Shield of California Commercial |
$2,878.20
|
| Rate for Payer: Blue Shield of California EPN |
$1,895.40
|
| 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: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| 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: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| 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: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| 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
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
|
HC CATH TIEMAN COUDE 5CC 16FR
|
Facility
|
IP
|
$168.98
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901698390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.80 |
| Max. Negotiated Rate |
$143.63 |
| Rate for Payer: Adventist Health Commercial |
$33.80
|
| Rate for Payer: Cash Price |
$76.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.59
|
| Rate for Payer: EPIC Health Plan Senior |
$67.59
|
| Rate for Payer: Galaxy Health WC |
$143.63
|
| Rate for Payer: Global Benefits Group Commercial |
$101.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$112.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$104.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.56
|
| Rate for Payer: Multiplan Commercial |
$135.18
|
| Rate for Payer: Networks By Design Commercial |
$109.84
|
| Rate for Payer: Prime Health Services Commercial |
$143.63
|
|
|
HC CATH TIEMAN COUDE 5CC 16FR
|
Facility
|
OP
|
$168.98
|
|
|
Service Code
|
CPT A4352
|
| Hospital Charge Code |
901698390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$33.80 |
| Max. Negotiated Rate |
$143.63 |
| Rate for Payer: Adventist Health Commercial |
$33.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$110.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$143.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$92.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$126.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$103.77
|
| Rate for Payer: Cash Price |
$76.04
|
| Rate for Payer: Cigna of CA HMO |
$108.15
|
| Rate for Payer: Cigna of CA PPO |
$125.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$143.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$143.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$143.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.59
|
| Rate for Payer: EPIC Health Plan Senior |
$67.59
|
| Rate for Payer: Galaxy Health WC |
$143.63
|
| Rate for Payer: Global Benefits Group Commercial |
$101.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$112.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$64.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$104.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$118.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$118.29
|
| Rate for Payer: Multiplan Commercial |
$135.18
|
| Rate for Payer: Networks By Design Commercial |
$109.84
|
| Rate for Payer: Prime Health Services Commercial |
$143.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$101.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$101.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$84.49
|
| Rate for Payer: United Healthcare All Other HMO |
$84.49
|
| Rate for Payer: United Healthcare HMO Rider |
$84.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$84.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$143.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$143.63
|
| Rate for Payer: Vantage Medical Group Senior |
$143.63
|
|
|
HC CATH TPN PEDS 5FR BRAUN
|
Facility
|
IP
|
$860.20
|
|
| Hospital Charge Code |
901603656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$172.04 |
| Max. Negotiated Rate |
$731.17 |
| Rate for Payer: Adventist Health Commercial |
$172.04
|
| Rate for Payer: Cash Price |
$387.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.08
|
| Rate for Payer: EPIC Health Plan Senior |
$344.08
|
| Rate for Payer: Galaxy Health WC |
$731.17
|
| Rate for Payer: Global Benefits Group Commercial |
$516.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$573.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$327.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$532.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.45
|
| Rate for Payer: Multiplan Commercial |
$688.16
|
| Rate for Payer: Networks By Design Commercial |
$559.13
|
| Rate for Payer: Prime Health Services Commercial |
$731.17
|
|
|
HC CATH TPN PEDS 5FR BRAUN
|
Facility
|
OP
|
$860.20
|
|
| Hospital Charge Code |
901603656
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$172.04 |
| Max. Negotiated Rate |
$731.17 |
| Rate for Payer: Adventist Health Commercial |
$172.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$564.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$731.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$473.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$645.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$528.25
|
| Rate for Payer: Cash Price |
$387.09
|
| Rate for Payer: Cigna of CA HMO |
$550.53
|
| Rate for Payer: Cigna of CA PPO |
$636.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$731.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$731.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$731.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.08
|
| Rate for Payer: EPIC Health Plan Senior |
$344.08
|
| Rate for Payer: Galaxy Health WC |
$731.17
|
| Rate for Payer: Global Benefits Group Commercial |
$516.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$573.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$327.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$532.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$206.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$602.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$602.14
|
| Rate for Payer: Multiplan Commercial |
$688.16
|
| Rate for Payer: Networks By Design Commercial |
$559.13
|
| Rate for Payer: Prime Health Services Commercial |
$731.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$430.10
|
| Rate for Payer: United Healthcare All Other HMO |
$430.10
|
| Rate for Payer: United Healthcare HMO Rider |
$430.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$430.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$731.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$731.17
|
| Rate for Payer: Vantage Medical Group Senior |
$731.17
|
|
|
HC CATH TRANSVENOUS 5FR PACING
|
Facility
|
IP
|
$791.20
|
|
| Hospital Charge Code |
901605813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$672.52 |
| Rate for Payer: Adventist Health Commercial |
$158.24
|
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.48
|
| Rate for Payer: EPIC Health Plan Senior |
$316.48
|
| Rate for Payer: Galaxy Health WC |
$672.52
|
| Rate for Payer: Global Benefits Group Commercial |
$474.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$527.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$301.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$489.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.89
|
| Rate for Payer: Multiplan Commercial |
$632.96
|
| Rate for Payer: Networks By Design Commercial |
$514.28
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
|
|
HC CATH TRANSVENOUS 5FR PACING
|
Facility
|
OP
|
$791.20
|
|
| Hospital Charge Code |
901605813
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$158.24 |
| Max. Negotiated Rate |
$672.52 |
| Rate for Payer: Adventist Health Commercial |
$158.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$518.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$672.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$435.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$593.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$485.88
|
| Rate for Payer: Cash Price |
$356.04
|
| Rate for Payer: Cigna of CA HMO |
$506.37
|
| Rate for Payer: Cigna of CA PPO |
$585.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$672.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$672.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$672.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$316.48
|
| Rate for Payer: EPIC Health Plan Senior |
$316.48
|
| Rate for Payer: Galaxy Health WC |
$672.52
|
| Rate for Payer: Global Benefits Group Commercial |
$474.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$527.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$301.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$489.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$189.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$553.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$553.84
|
| Rate for Payer: Multiplan Commercial |
$632.96
|
| Rate for Payer: Networks By Design Commercial |
$514.28
|
| Rate for Payer: Prime Health Services Commercial |
$672.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$474.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$474.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$395.60
|
| Rate for Payer: United Healthcare All Other HMO |
$395.60
|
| Rate for Payer: United Healthcare HMO Rider |
$395.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$395.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$672.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$672.52
|
| Rate for Payer: Vantage Medical Group Senior |
$672.52
|
|
|
HC CATH TRAY CNTRL VNS 5FR X 15CM
|
Facility
|
OP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698532
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$493.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| 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 |
$335.94
|
| Rate for Payer: Blue Shield of California Commercial |
$428.04
|
| Rate for Payer: Blue Shield of California EPN |
$281.88
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| 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 |
$290.00
|
| 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 |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
| 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 TRAY CNTRL VNS 5FR X 15CM
|
Facility
|
IP
|
$580.00
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698532
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$116.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cigna of CA HMO |
$406.00
|
| Rate for Payer: Cigna of CA PPO |
$406.00
|
| 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 |
$290.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$217.67
|
| Rate for Payer: United Healthcare All Other HMO |
$211.87
|
| Rate for Payer: United Healthcare HMO Rider |
$207.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$189.95
|
|
|
HC CATH TROCAR 10FR CHEST TUBE
|
Facility
|
IP
|
$137.48
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601391
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$27.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$61.87
|
| Rate for Payer: Cash Price |
$61.87
|
| Rate for Payer: Cigna of CA HMO |
$96.24
|
| Rate for Payer: Cigna of CA PPO |
$96.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.99
|
| Rate for Payer: EPIC Health Plan Senior |
$54.99
|
| Rate for Payer: Galaxy Health WC |
$116.86
|
| Rate for Payer: Global Benefits Group Commercial |
$82.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.00
|
| Rate for Payer: Multiplan Commercial |
$109.98
|
| Rate for Payer: Networks By Design Commercial |
$68.74
|
| Rate for Payer: Prime Health Services Commercial |
$116.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.60
|
| Rate for Payer: United Healthcare All Other HMO |
$50.22
|
| Rate for Payer: United Healthcare HMO Rider |
$49.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$45.02
|
|
|
HC CATH TROCAR 10FR CHEST TUBE
|
Facility
|
OP
|
$137.48
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601391
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$116.86 |
| Rate for Payer: Adventist Health Commercial |
$27.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$116.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$75.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$103.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.63
|
| Rate for Payer: Blue Shield of California Commercial |
$101.46
|
| Rate for Payer: Blue Shield of California EPN |
$66.82
|
| Rate for Payer: Cash Price |
$61.87
|
| Rate for Payer: Cigna of CA HMO |
$96.24
|
| Rate for Payer: Cigna of CA PPO |
$96.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$116.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$116.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$116.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.99
|
| Rate for Payer: EPIC Health Plan Senior |
$54.99
|
| Rate for Payer: Galaxy Health WC |
$116.86
|
| Rate for Payer: Global Benefits Group Commercial |
$82.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$91.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$96.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$96.24
|
| Rate for Payer: Multiplan Commercial |
$109.98
|
| Rate for Payer: Networks By Design Commercial |
$68.74
|
| Rate for Payer: Prime Health Services Commercial |
$116.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$82.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$82.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.60
|
| Rate for Payer: United Healthcare All Other HMO |
$50.22
|
| Rate for Payer: United Healthcare HMO Rider |
$49.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$45.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$116.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$116.86
|
| Rate for Payer: Vantage Medical Group Senior |
$116.86
|
|
|
HC CATH TROCAR 20FR CHEST TUBE
|
Facility
|
OP
|
$131.10
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.22 |
| Max. Negotiated Rate |
$111.44 |
| Rate for Payer: Adventist Health Commercial |
$26.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$111.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$72.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$98.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.93
|
| Rate for Payer: Blue Shield of California Commercial |
$96.75
|
| Rate for Payer: Blue Shield of California EPN |
$63.71
|
| Rate for Payer: Cash Price |
$58.99
|
| Rate for Payer: Cigna of CA HMO |
$91.77
|
| Rate for Payer: Cigna of CA PPO |
$91.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$111.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$111.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.44
|
| Rate for Payer: EPIC Health Plan Senior |
$52.44
|
| Rate for Payer: Galaxy Health WC |
$111.44
|
| Rate for Payer: Global Benefits Group Commercial |
$78.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$87.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$91.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$91.77
|
| Rate for Payer: Multiplan Commercial |
$104.88
|
| Rate for Payer: Networks By Design Commercial |
$65.55
|
| Rate for Payer: Prime Health Services Commercial |
$111.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$78.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$78.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.20
|
| Rate for Payer: United Healthcare All Other HMO |
$47.89
|
| Rate for Payer: United Healthcare HMO Rider |
$46.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$111.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$111.44
|
| Rate for Payer: Vantage Medical Group Senior |
$111.44
|
|
|
HC CATH TROCAR 20FR CHEST TUBE
|
Facility
|
IP
|
$131.10
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601394
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.22 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$26.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$58.99
|
| Rate for Payer: Cash Price |
$58.99
|
| Rate for Payer: Cigna of CA HMO |
$91.77
|
| Rate for Payer: Cigna of CA PPO |
$91.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.44
|
| Rate for Payer: EPIC Health Plan Senior |
$52.44
|
| Rate for Payer: Galaxy Health WC |
$111.44
|
| Rate for Payer: Global Benefits Group Commercial |
$78.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$87.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$49.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$81.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.46
|
| Rate for Payer: Multiplan Commercial |
$104.88
|
| Rate for Payer: Networks By Design Commercial |
$65.55
|
| Rate for Payer: Prime Health Services Commercial |
$111.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.20
|
| Rate for Payer: United Healthcare All Other HMO |
$47.89
|
| Rate for Payer: United Healthcare HMO Rider |
$46.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.94
|
|
|
HC CATH TROCAR 28FR CHEST TUBE
|
Facility
|
OP
|
$134.06
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601395
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.81 |
| Max. Negotiated Rate |
$113.95 |
| Rate for Payer: Adventist Health Commercial |
$26.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$100.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$77.65
|
| Rate for Payer: Blue Shield of California Commercial |
$98.94
|
| Rate for Payer: Blue Shield of California EPN |
$65.15
|
| Rate for Payer: Cash Price |
$60.33
|
| Rate for Payer: Cigna of CA HMO |
$93.84
|
| Rate for Payer: Cigna of CA PPO |
$93.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$113.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$113.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.62
|
| Rate for Payer: EPIC Health Plan Senior |
$53.62
|
| Rate for Payer: Galaxy Health WC |
$113.95
|
| Rate for Payer: Global Benefits Group Commercial |
$80.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$93.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93.84
|
| Rate for Payer: Multiplan Commercial |
$107.25
|
| Rate for Payer: Networks By Design Commercial |
$67.03
|
| Rate for Payer: Prime Health Services Commercial |
$113.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$80.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$80.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.31
|
| Rate for Payer: United Healthcare All Other HMO |
$48.97
|
| Rate for Payer: United Healthcare HMO Rider |
$47.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$113.95
|
| Rate for Payer: Vantage Medical Group Senior |
$113.95
|
|
|
HC CATH TROCAR 28FR CHEST TUBE
|
Facility
|
IP
|
$134.06
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601395
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$26.81 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$26.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$60.33
|
| Rate for Payer: Cash Price |
$60.33
|
| Rate for Payer: Cigna of CA HMO |
$93.84
|
| Rate for Payer: Cigna of CA PPO |
$93.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.62
|
| Rate for Payer: EPIC Health Plan Senior |
$53.62
|
| Rate for Payer: Galaxy Health WC |
$113.95
|
| Rate for Payer: Global Benefits Group Commercial |
$80.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$89.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.17
|
| Rate for Payer: Multiplan Commercial |
$107.25
|
| Rate for Payer: Networks By Design Commercial |
$67.03
|
| Rate for Payer: Prime Health Services Commercial |
$113.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.31
|
| Rate for Payer: United Healthcare All Other HMO |
$48.97
|
| Rate for Payer: United Healthcare HMO Rider |
$47.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.90
|
|
|
HC CATH TROCAR 32FR CHEST TUBE
|
Facility
|
OP
|
$115.67
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601396
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.13 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Adventist Health Commercial |
$23.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$98.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$63.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$86.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.00
|
| Rate for Payer: Blue Shield of California Commercial |
$85.36
|
| Rate for Payer: Blue Shield of California EPN |
$56.22
|
| Rate for Payer: Cash Price |
$52.05
|
| Rate for Payer: Cigna of CA HMO |
$80.97
|
| Rate for Payer: Cigna of CA PPO |
$80.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$98.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$98.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$98.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.27
|
| Rate for Payer: EPIC Health Plan Senior |
$46.27
|
| Rate for Payer: Galaxy Health WC |
$98.32
|
| Rate for Payer: Global Benefits Group Commercial |
$69.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$77.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$71.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$80.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$80.97
|
| Rate for Payer: Multiplan Commercial |
$92.54
|
| Rate for Payer: Networks By Design Commercial |
$57.84
|
| Rate for Payer: Prime Health Services Commercial |
$98.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$69.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$69.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.41
|
| Rate for Payer: United Healthcare All Other HMO |
$42.25
|
| Rate for Payer: United Healthcare HMO Rider |
$41.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$37.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$98.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$98.32
|
| Rate for Payer: Vantage Medical Group Senior |
$98.32
|
|
|
HC CATH TROCAR 32FR CHEST TUBE
|
Facility
|
IP
|
$115.67
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901601396
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$23.13 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$23.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$52.05
|
| Rate for Payer: Cash Price |
$52.05
|
| Rate for Payer: Cigna of CA HMO |
$80.97
|
| Rate for Payer: Cigna of CA PPO |
$80.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.27
|
| Rate for Payer: EPIC Health Plan Senior |
$46.27
|
| Rate for Payer: Galaxy Health WC |
$98.32
|
| Rate for Payer: Global Benefits Group Commercial |
$69.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$77.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.07
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$71.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.76
|
| Rate for Payer: Multiplan Commercial |
$92.54
|
| Rate for Payer: Networks By Design Commercial |
$57.84
|
| Rate for Payer: Prime Health Services Commercial |
$98.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.41
|
| Rate for Payer: United Healthcare All Other HMO |
$42.25
|
| Rate for Payer: United Healthcare HMO Rider |
$41.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$37.88
|
|
|
HC CATH UMBILICAL 1 LUMEN 3.5FR
|
Facility
|
IP
|
$97.36
|
|
| Hospital Charge Code |
901698574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$82.76 |
| Rate for Payer: Adventist Health Commercial |
$19.47
|
| Rate for Payer: Cash Price |
$43.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.94
|
| Rate for Payer: EPIC Health Plan Senior |
$38.94
|
| Rate for Payer: Galaxy Health WC |
$82.76
|
| Rate for Payer: Global Benefits Group Commercial |
$58.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.37
|
| Rate for Payer: Multiplan Commercial |
$77.89
|
| Rate for Payer: Networks By Design Commercial |
$63.28
|
| Rate for Payer: Prime Health Services Commercial |
$82.76
|
|
|
HC CATH UMBILICAL 1 LUMEN 3.5FR
|
Facility
|
OP
|
$97.36
|
|
| Hospital Charge Code |
901698574
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$82.76 |
| Rate for Payer: Adventist Health Commercial |
$19.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$82.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$73.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.79
|
| Rate for Payer: Cash Price |
$43.81
|
| Rate for Payer: Cigna of CA HMO |
$62.31
|
| Rate for Payer: Cigna of CA PPO |
$72.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$82.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$82.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$82.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.94
|
| Rate for Payer: EPIC Health Plan Senior |
$38.94
|
| Rate for Payer: Galaxy Health WC |
$82.76
|
| Rate for Payer: Global Benefits Group Commercial |
$58.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68.15
|
| Rate for Payer: Multiplan Commercial |
$77.89
|
| Rate for Payer: Networks By Design Commercial |
$63.28
|
| Rate for Payer: Prime Health Services Commercial |
$82.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$48.68
|
| Rate for Payer: United Healthcare All Other HMO |
$48.68
|
| Rate for Payer: United Healthcare HMO Rider |
$48.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$48.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$82.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$82.76
|
| Rate for Payer: Vantage Medical Group Senior |
$82.76
|
|
|
HC CATH UMBILICAL 3.5FR SGL LUMEN
|
Facility
|
IP
|
$95.38
|
|
| Hospital Charge Code |
901698407
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$81.07 |
| Rate for Payer: Adventist Health Commercial |
$19.08
|
| Rate for Payer: Cash Price |
$42.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.15
|
| Rate for Payer: EPIC Health Plan Senior |
$38.15
|
| Rate for Payer: Galaxy Health WC |
$81.07
|
| Rate for Payer: Global Benefits Group Commercial |
$57.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.89
|
| Rate for Payer: Multiplan Commercial |
$76.30
|
| Rate for Payer: Networks By Design Commercial |
$62.00
|
| Rate for Payer: Prime Health Services Commercial |
$81.07
|
|
|
HC CATH UMBILICAL 3.5FR SGL LUMEN
|
Facility
|
OP
|
$95.38
|
|
| Hospital Charge Code |
901698407
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.08 |
| Max. Negotiated Rate |
$81.07 |
| Rate for Payer: Adventist Health Commercial |
$19.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$62.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$71.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.57
|
| Rate for Payer: Cash Price |
$42.92
|
| Rate for Payer: Cigna of CA HMO |
$61.04
|
| Rate for Payer: Cigna of CA PPO |
$70.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$81.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.15
|
| Rate for Payer: EPIC Health Plan Senior |
$38.15
|
| Rate for Payer: Galaxy Health WC |
$81.07
|
| Rate for Payer: Global Benefits Group Commercial |
$57.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$66.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$66.77
|
| Rate for Payer: Multiplan Commercial |
$76.30
|
| Rate for Payer: Networks By Design Commercial |
$62.00
|
| Rate for Payer: Prime Health Services Commercial |
$81.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.69
|
| Rate for Payer: United Healthcare All Other HMO |
$47.69
|
| Rate for Payer: United Healthcare HMO Rider |
$47.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$81.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.07
|
| Rate for Payer: Vantage Medical Group Senior |
$81.07
|
|
|
HC CATH UMBILICAL 5FR 1 LUMEN
|
Facility
|
IP
|
$106.40
|
|
| Hospital Charge Code |
901698631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.28 |
| Max. Negotiated Rate |
$90.44 |
| Rate for Payer: Adventist Health Commercial |
$21.28
|
| Rate for Payer: Cash Price |
$47.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.56
|
| Rate for Payer: EPIC Health Plan Senior |
$42.56
|
| Rate for Payer: Galaxy Health WC |
$90.44
|
| Rate for Payer: Global Benefits Group Commercial |
$63.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.54
|
| Rate for Payer: Multiplan Commercial |
$85.12
|
| Rate for Payer: Networks By Design Commercial |
$69.16
|
| Rate for Payer: Prime Health Services Commercial |
$90.44
|
|
|
HC CATH UMBILICAL 5FR 1 LUMEN
|
Facility
|
OP
|
$106.40
|
|
| Hospital Charge Code |
901698631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$21.28 |
| Max. Negotiated Rate |
$90.44 |
| Rate for Payer: Adventist Health Commercial |
$21.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$69.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$90.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$58.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$79.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.34
|
| Rate for Payer: Cash Price |
$47.88
|
| Rate for Payer: Cigna of CA HMO |
$68.10
|
| Rate for Payer: Cigna of CA PPO |
$78.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$90.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$90.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$90.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.56
|
| Rate for Payer: EPIC Health Plan Senior |
$42.56
|
| Rate for Payer: Galaxy Health WC |
$90.44
|
| Rate for Payer: Global Benefits Group Commercial |
$63.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$65.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$74.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$74.48
|
| Rate for Payer: Multiplan Commercial |
$85.12
|
| Rate for Payer: Networks By Design Commercial |
$69.16
|
| Rate for Payer: Prime Health Services Commercial |
$90.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$53.20
|
| Rate for Payer: United Healthcare All Other HMO |
$53.20
|
| Rate for Payer: United Healthcare HMO Rider |
$53.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$53.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$90.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$90.44
|
| Rate for Payer: Vantage Medical Group Senior |
$90.44
|
|
|
HC CATH UMBILICAL 5FR DUAL LUMEN
|
Facility
|
OP
|
$210.00
|
|
| Hospital Charge Code |
901698632
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$137.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$115.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$157.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.96
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$178.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$178.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$178.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$129.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$147.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$147.00
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$105.00
|
| Rate for Payer: United Healthcare All Other HMO |
$105.00
|
| Rate for Payer: United Healthcare HMO Rider |
$105.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$105.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$178.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$178.50
|
| Rate for Payer: Vantage Medical Group Senior |
$178.50
|
|
|
HC CATH UMBILICAL 5FR DUAL LUMEN
|
Facility
|
IP
|
$210.00
|
|
| Hospital Charge Code |
901698632
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$140.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$80.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$129.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.40
|
| Rate for Payer: Multiplan Commercial |
$168.00
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
