|
HC CATH UMBILICAL ARTERY 3.5FR
|
Facility
|
IP
|
$117.88
|
|
| Hospital Charge Code |
901601458
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.58 |
| Max. Negotiated Rate |
$100.20 |
| Rate for Payer: Adventist Health Commercial |
$23.58
|
| Rate for Payer: Cash Price |
$53.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.15
|
| Rate for Payer: EPIC Health Plan Senior |
$47.15
|
| Rate for Payer: Galaxy Health WC |
$100.20
|
| Rate for Payer: Global Benefits Group Commercial |
$70.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.29
|
| Rate for Payer: Multiplan Commercial |
$94.30
|
| Rate for Payer: Networks By Design Commercial |
$76.62
|
| Rate for Payer: Prime Health Services Commercial |
$100.20
|
|
|
HC CATH UMBILICAL ARTERY 3.5FR
|
Facility
|
OP
|
$117.88
|
|
| Hospital Charge Code |
901601458
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.58 |
| Max. Negotiated Rate |
$100.20 |
| Rate for Payer: Adventist Health Commercial |
$23.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$77.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$88.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.39
|
| Rate for Payer: Cash Price |
$53.05
|
| Rate for Payer: Cigna of CA HMO |
$75.44
|
| Rate for Payer: Cigna of CA PPO |
$87.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$100.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$100.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.15
|
| Rate for Payer: EPIC Health Plan Senior |
$47.15
|
| Rate for Payer: Galaxy Health WC |
$100.20
|
| Rate for Payer: Global Benefits Group Commercial |
$70.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82.52
|
| Rate for Payer: Multiplan Commercial |
$94.30
|
| Rate for Payer: Networks By Design Commercial |
$76.62
|
| Rate for Payer: Prime Health Services Commercial |
$100.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.94
|
| Rate for Payer: United Healthcare All Other HMO |
$58.94
|
| Rate for Payer: United Healthcare HMO Rider |
$58.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$58.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$100.20
|
| Rate for Payer: Vantage Medical Group Senior |
$100.20
|
|
|
HC CATH UMBILICAL ARTERY 5FR 15"
|
Facility
|
OP
|
$117.88
|
|
| Hospital Charge Code |
901601459
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.58 |
| Max. Negotiated Rate |
$100.20 |
| Rate for Payer: Adventist Health Commercial |
$23.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$77.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$88.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.39
|
| Rate for Payer: Cash Price |
$53.05
|
| Rate for Payer: Cigna of CA HMO |
$75.44
|
| Rate for Payer: Cigna of CA PPO |
$87.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$100.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$100.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.15
|
| Rate for Payer: EPIC Health Plan Senior |
$47.15
|
| Rate for Payer: Galaxy Health WC |
$100.20
|
| Rate for Payer: Global Benefits Group Commercial |
$70.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82.52
|
| Rate for Payer: Multiplan Commercial |
$94.30
|
| Rate for Payer: Networks By Design Commercial |
$76.62
|
| Rate for Payer: Prime Health Services Commercial |
$100.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.94
|
| Rate for Payer: United Healthcare All Other HMO |
$58.94
|
| Rate for Payer: United Healthcare HMO Rider |
$58.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$58.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$100.20
|
| Rate for Payer: Vantage Medical Group Senior |
$100.20
|
|
|
HC CATH UMBILICAL ARTERY 5FR 15"
|
Facility
|
IP
|
$117.88
|
|
| Hospital Charge Code |
901601459
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.58 |
| Max. Negotiated Rate |
$100.20 |
| Rate for Payer: Adventist Health Commercial |
$23.58
|
| Rate for Payer: Cash Price |
$53.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.15
|
| Rate for Payer: EPIC Health Plan Senior |
$47.15
|
| Rate for Payer: Galaxy Health WC |
$100.20
|
| Rate for Payer: Global Benefits Group Commercial |
$70.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$44.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$72.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.29
|
| Rate for Payer: Multiplan Commercial |
$94.30
|
| Rate for Payer: Networks By Design Commercial |
$76.62
|
| Rate for Payer: Prime Health Services Commercial |
$100.20
|
|
|
HC CATH UMBILICAL HOLDER MICRO
|
Facility
|
OP
|
$51.50
|
|
| Hospital Charge Code |
901698784
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.30 |
| Max. Negotiated Rate |
$43.77 |
| Rate for Payer: Adventist Health Commercial |
$10.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$33.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$43.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$38.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$31.63
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cigna of CA HMO |
$32.96
|
| Rate for Payer: Cigna of CA PPO |
$38.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$43.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$43.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.60
|
| Rate for Payer: EPIC Health Plan Senior |
$20.60
|
| Rate for Payer: Galaxy Health WC |
$43.77
|
| Rate for Payer: Global Benefits Group Commercial |
$30.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.05
|
| Rate for Payer: Multiplan Commercial |
$41.20
|
| Rate for Payer: Networks By Design Commercial |
$33.48
|
| Rate for Payer: Prime Health Services Commercial |
$43.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.75
|
| Rate for Payer: United Healthcare All Other HMO |
$25.75
|
| Rate for Payer: United Healthcare HMO Rider |
$25.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$43.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.77
|
| Rate for Payer: Vantage Medical Group Senior |
$43.77
|
|
|
HC CATH UMBILICAL HOLDER MICRO
|
Facility
|
IP
|
$51.50
|
|
| Hospital Charge Code |
901698784
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.30 |
| Max. Negotiated Rate |
$43.77 |
| Rate for Payer: Adventist Health Commercial |
$10.30
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.60
|
| Rate for Payer: EPIC Health Plan Senior |
$20.60
|
| Rate for Payer: Galaxy Health WC |
$43.77
|
| Rate for Payer: Global Benefits Group Commercial |
$30.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.36
|
| Rate for Payer: Multiplan Commercial |
$41.20
|
| Rate for Payer: Networks By Design Commercial |
$33.48
|
| Rate for Payer: Prime Health Services Commercial |
$43.77
|
|
|
HC CATH UMBILICAL POLY DUAL 3.5FR
|
Facility
|
IP
|
$234.50
|
|
| Hospital Charge Code |
901698904
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.90 |
| Max. Negotiated Rate |
$199.32 |
| Rate for Payer: Adventist Health Commercial |
$46.90
|
| Rate for Payer: Cash Price |
$105.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.80
|
| Rate for Payer: EPIC Health Plan Senior |
$93.80
|
| Rate for Payer: Galaxy Health WC |
$199.32
|
| Rate for Payer: Global Benefits Group Commercial |
$140.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$156.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$145.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.28
|
| Rate for Payer: Multiplan Commercial |
$187.60
|
| Rate for Payer: Networks By Design Commercial |
$152.43
|
| Rate for Payer: Prime Health Services Commercial |
$199.32
|
|
|
HC CATH UMBILICAL POLY DUAL 3.5FR
|
Facility
|
OP
|
$234.50
|
|
| Hospital Charge Code |
901698904
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$46.90 |
| Max. Negotiated Rate |
$199.32 |
| Rate for Payer: Adventist Health Commercial |
$46.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$153.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$199.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$128.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$175.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.01
|
| Rate for Payer: Cash Price |
$105.53
|
| Rate for Payer: Cigna of CA HMO |
$150.08
|
| Rate for Payer: Cigna of CA PPO |
$173.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$199.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$199.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$199.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$93.80
|
| Rate for Payer: EPIC Health Plan Senior |
$93.80
|
| Rate for Payer: Galaxy Health WC |
$199.32
|
| Rate for Payer: Global Benefits Group Commercial |
$140.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$156.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$89.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$145.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$56.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$164.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$164.15
|
| Rate for Payer: Multiplan Commercial |
$187.60
|
| Rate for Payer: Networks By Design Commercial |
$152.43
|
| Rate for Payer: Prime Health Services Commercial |
$199.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$140.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$140.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$117.25
|
| Rate for Payer: United Healthcare All Other HMO |
$117.25
|
| Rate for Payer: United Healthcare HMO Rider |
$117.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$117.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$199.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$199.32
|
| Rate for Payer: Vantage Medical Group Senior |
$199.32
|
|
|
HC CATH UMBILICAL VESL DL 3.5FR
|
Facility
|
IP
|
$422.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.45 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$84.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$190.01
|
| Rate for Payer: Cash Price |
$190.01
|
| Rate for Payer: Cigna of CA HMO |
$295.57
|
| Rate for Payer: Cigna of CA PPO |
$295.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.90
|
| Rate for Payer: EPIC Health Plan Senior |
$168.90
|
| Rate for Payer: Galaxy Health WC |
$358.90
|
| Rate for Payer: Global Benefits Group Commercial |
$253.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$281.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$261.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.34
|
| Rate for Payer: Multiplan Commercial |
$337.79
|
| Rate for Payer: Networks By Design Commercial |
$211.12
|
| Rate for Payer: Prime Health Services Commercial |
$358.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$158.47
|
| Rate for Payer: United Healthcare All Other HMO |
$154.24
|
| Rate for Payer: United Healthcare HMO Rider |
$150.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$138.28
|
|
|
HC CATH UMBILICAL VESL DL 3.5FR
|
Facility
|
OP
|
$422.24
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901698611
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$84.45 |
| Max. Negotiated Rate |
$358.90 |
| Rate for Payer: Adventist Health Commercial |
$84.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$358.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$232.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$316.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$244.56
|
| Rate for Payer: Blue Shield of California Commercial |
$311.61
|
| Rate for Payer: Blue Shield of California EPN |
$205.21
|
| Rate for Payer: Cash Price |
$190.01
|
| Rate for Payer: Cigna of CA HMO |
$295.57
|
| Rate for Payer: Cigna of CA PPO |
$295.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$358.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$358.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$358.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$168.90
|
| Rate for Payer: EPIC Health Plan Senior |
$168.90
|
| Rate for Payer: Galaxy Health WC |
$358.90
|
| Rate for Payer: Global Benefits Group Commercial |
$253.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$281.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$160.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$261.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$101.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$295.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$295.57
|
| Rate for Payer: Multiplan Commercial |
$337.79
|
| Rate for Payer: Networks By Design Commercial |
$211.12
|
| Rate for Payer: Prime Health Services Commercial |
$358.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$253.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$253.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$158.47
|
| Rate for Payer: United Healthcare All Other HMO |
$154.24
|
| Rate for Payer: United Healthcare HMO Rider |
$150.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$138.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$358.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$358.90
|
| Rate for Payer: Vantage Medical Group Senior |
$358.90
|
|
|
HC CATH UMBILICAL VESSEL 3.5FR
|
Facility
|
IP
|
$272.93
|
|
| Hospital Charge Code |
901698903
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.59 |
| Max. Negotiated Rate |
$231.99 |
| Rate for Payer: Adventist Health Commercial |
$54.59
|
| Rate for Payer: Cash Price |
$122.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.17
|
| Rate for Payer: EPIC Health Plan Senior |
$109.17
|
| Rate for Payer: Galaxy Health WC |
$231.99
|
| Rate for Payer: Global Benefits Group Commercial |
$163.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$182.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$168.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.50
|
| Rate for Payer: Multiplan Commercial |
$218.34
|
| Rate for Payer: Networks By Design Commercial |
$177.40
|
| Rate for Payer: Prime Health Services Commercial |
$231.99
|
|
|
HC CATH UMBILICAL VESSEL 3.5FR
|
Facility
|
OP
|
$272.93
|
|
| Hospital Charge Code |
901698903
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.59 |
| Max. Negotiated Rate |
$231.99 |
| Rate for Payer: Cigna of CA PPO |
$201.97
|
| Rate for Payer: Adventist Health Commercial |
$54.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$179.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$231.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$150.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.61
|
| Rate for Payer: Cash Price |
$122.82
|
| Rate for Payer: Cigna of CA HMO |
$174.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$231.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$231.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$231.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.17
|
| Rate for Payer: EPIC Health Plan Senior |
$109.17
|
| Rate for Payer: Galaxy Health WC |
$231.99
|
| Rate for Payer: Global Benefits Group Commercial |
$163.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$182.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$103.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$168.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$191.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$191.05
|
| Rate for Payer: Multiplan Commercial |
$218.34
|
| Rate for Payer: Networks By Design Commercial |
$177.40
|
| Rate for Payer: Prime Health Services Commercial |
$231.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$163.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$163.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$136.47
|
| Rate for Payer: United Healthcare All Other HMO |
$136.47
|
| Rate for Payer: United Healthcare HMO Rider |
$136.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$136.47
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$231.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$231.99
|
| Rate for Payer: Vantage Medical Group Senior |
$231.99
|
|
|
HC CATH UMBILICAL VESSEL 5.0FR
|
Facility
|
IP
|
$273.49
|
|
| Hospital Charge Code |
901603823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.70 |
| Max. Negotiated Rate |
$232.47 |
| Rate for Payer: Adventist Health Commercial |
$54.70
|
| Rate for Payer: Cash Price |
$123.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.40
|
| Rate for Payer: EPIC Health Plan Senior |
$109.40
|
| Rate for Payer: Galaxy Health WC |
$232.47
|
| Rate for Payer: Global Benefits Group Commercial |
$164.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$182.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$169.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.64
|
| Rate for Payer: Multiplan Commercial |
$218.79
|
| Rate for Payer: Networks By Design Commercial |
$177.77
|
| Rate for Payer: Prime Health Services Commercial |
$232.47
|
|
|
HC CATH UMBILICAL VESSEL 5.0FR
|
Facility
|
OP
|
$273.49
|
|
| Hospital Charge Code |
901603823
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.70 |
| Max. Negotiated Rate |
$232.47 |
| Rate for Payer: Adventist Health Commercial |
$54.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$179.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$232.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$150.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$205.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$167.95
|
| Rate for Payer: Cash Price |
$123.07
|
| Rate for Payer: Cigna of CA HMO |
$175.03
|
| Rate for Payer: Cigna of CA PPO |
$202.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$232.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$232.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$232.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$109.40
|
| Rate for Payer: EPIC Health Plan Senior |
$109.40
|
| Rate for Payer: Galaxy Health WC |
$232.47
|
| Rate for Payer: Global Benefits Group Commercial |
$164.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$182.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$104.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$169.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$191.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$191.44
|
| Rate for Payer: Multiplan Commercial |
$218.79
|
| Rate for Payer: Networks By Design Commercial |
$177.77
|
| Rate for Payer: Prime Health Services Commercial |
$232.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$164.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$164.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$136.75
|
| Rate for Payer: United Healthcare All Other HMO |
$136.75
|
| Rate for Payer: United Healthcare HMO Rider |
$136.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$136.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$232.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$232.47
|
| Rate for Payer: Vantage Medical Group Senior |
$232.47
|
|
|
HC CATH URETHRAL 14FR PVC
|
Facility
|
OP
|
$3.69
|
|
| Hospital Charge Code |
901698527
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$3.14 |
| Rate for Payer: Adventist Health Commercial |
$0.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.27
|
| Rate for Payer: Cash Price |
$1.66
|
| Rate for Payer: Cigna of CA HMO |
$2.36
|
| Rate for Payer: Cigna of CA PPO |
$2.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1.48
|
| Rate for Payer: Galaxy Health WC |
$3.14
|
| Rate for Payer: Global Benefits Group Commercial |
$2.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.58
|
| Rate for Payer: Multiplan Commercial |
$2.95
|
| Rate for Payer: Networks By Design Commercial |
$2.40
|
| Rate for Payer: Prime Health Services Commercial |
$3.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.84
|
| Rate for Payer: United Healthcare All Other HMO |
$1.84
|
| Rate for Payer: United Healthcare HMO Rider |
$1.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.14
|
| Rate for Payer: Vantage Medical Group Senior |
$3.14
|
|
|
HC CATH URETHRAL 14FR PVC
|
Facility
|
IP
|
$3.69
|
|
| Hospital Charge Code |
901698527
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$3.14 |
| Rate for Payer: Adventist Health Commercial |
$0.74
|
| Rate for Payer: Cash Price |
$1.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1.48
|
| Rate for Payer: Galaxy Health WC |
$3.14
|
| Rate for Payer: Global Benefits Group Commercial |
$2.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.89
|
| Rate for Payer: Multiplan Commercial |
$2.95
|
| Rate for Payer: Networks By Design Commercial |
$2.40
|
| Rate for Payer: Prime Health Services Commercial |
$3.14
|
|
|
HC CATH URETHRAL PVP KIT 14FR
|
Facility
|
IP
|
$20.66
|
|
| Hospital Charge Code |
901698633
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$17.56 |
| Rate for Payer: Adventist Health Commercial |
$4.13
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.26
|
| Rate for Payer: EPIC Health Plan Senior |
$8.26
|
| Rate for Payer: Galaxy Health WC |
$17.56
|
| Rate for Payer: Global Benefits Group Commercial |
$12.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.96
|
| Rate for Payer: Multiplan Commercial |
$16.53
|
| Rate for Payer: Networks By Design Commercial |
$13.43
|
| Rate for Payer: Prime Health Services Commercial |
$17.56
|
|
|
HC CATH URETHRAL PVP KIT 14FR
|
Facility
|
OP
|
$20.66
|
|
| Hospital Charge Code |
901698633
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$17.56 |
| Rate for Payer: Adventist Health Commercial |
$4.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.69
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cigna of CA HMO |
$13.22
|
| Rate for Payer: Cigna of CA PPO |
$15.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.26
|
| Rate for Payer: EPIC Health Plan Senior |
$8.26
|
| Rate for Payer: Galaxy Health WC |
$17.56
|
| Rate for Payer: Global Benefits Group Commercial |
$12.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.46
|
| Rate for Payer: Multiplan Commercial |
$16.53
|
| Rate for Payer: Networks By Design Commercial |
$13.43
|
| Rate for Payer: Prime Health Services Commercial |
$17.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.33
|
| Rate for Payer: United Healthcare All Other HMO |
$10.33
|
| Rate for Payer: United Healthcare HMO Rider |
$10.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.56
|
| Rate for Payer: Vantage Medical Group Senior |
$17.56
|
|
|
HC CATH URETHRAL REDRUBBER 10FR
|
Facility
|
IP
|
$5.66
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607555
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$4.81 |
| Rate for Payer: Adventist Health Commercial |
$1.13
|
| Rate for Payer: Cash Price |
$2.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2.26
|
| Rate for Payer: Galaxy Health WC |
$4.81
|
| Rate for Payer: Global Benefits Group Commercial |
$3.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.36
|
| Rate for Payer: Multiplan Commercial |
$4.53
|
| Rate for Payer: Networks By Design Commercial |
$3.68
|
| Rate for Payer: Prime Health Services Commercial |
$4.81
|
|
|
HC CATH URETHRAL REDRUBBER 10FR
|
Facility
|
OP
|
$5.66
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607555
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$4.81 |
| Rate for Payer: Adventist Health Commercial |
$1.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.48
|
| Rate for Payer: Cash Price |
$2.55
|
| Rate for Payer: Cigna of CA HMO |
$3.62
|
| Rate for Payer: Cigna of CA PPO |
$4.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2.26
|
| Rate for Payer: Galaxy Health WC |
$4.81
|
| Rate for Payer: Global Benefits Group Commercial |
$3.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.96
|
| Rate for Payer: Multiplan Commercial |
$4.53
|
| Rate for Payer: Networks By Design Commercial |
$3.68
|
| Rate for Payer: Prime Health Services Commercial |
$4.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.83
|
| Rate for Payer: United Healthcare All Other HMO |
$2.83
|
| Rate for Payer: United Healthcare HMO Rider |
$2.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.81
|
| Rate for Payer: Vantage Medical Group Senior |
$4.81
|
|
|
HC CATH URETHRAL REDRUBBER 12FR
|
Facility
|
OP
|
$5.66
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607554
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$4.81 |
| Rate for Payer: Adventist Health Commercial |
$1.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.48
|
| Rate for Payer: Cash Price |
$2.55
|
| Rate for Payer: Cigna of CA HMO |
$3.62
|
| Rate for Payer: Cigna of CA PPO |
$4.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2.26
|
| Rate for Payer: Galaxy Health WC |
$4.81
|
| Rate for Payer: Global Benefits Group Commercial |
$3.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.96
|
| Rate for Payer: Multiplan Commercial |
$4.53
|
| Rate for Payer: Networks By Design Commercial |
$3.68
|
| Rate for Payer: Prime Health Services Commercial |
$4.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.83
|
| Rate for Payer: United Healthcare All Other HMO |
$2.83
|
| Rate for Payer: United Healthcare HMO Rider |
$2.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.81
|
| Rate for Payer: Vantage Medical Group Senior |
$4.81
|
|
|
HC CATH URETHRAL REDRUBBER 12FR
|
Facility
|
IP
|
$5.66
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607554
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$4.81 |
| Rate for Payer: Adventist Health Commercial |
$1.13
|
| Rate for Payer: Cash Price |
$2.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2.26
|
| Rate for Payer: Galaxy Health WC |
$4.81
|
| Rate for Payer: Global Benefits Group Commercial |
$3.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.36
|
| Rate for Payer: Multiplan Commercial |
$4.53
|
| Rate for Payer: Networks By Design Commercial |
$3.68
|
| Rate for Payer: Prime Health Services Commercial |
$4.81
|
|
|
HC CATH URETHRAL REDRUBBER 14FR
|
Facility
|
OP
|
$4.92
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607553
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$4.18 |
| Rate for Payer: Adventist Health Commercial |
$0.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.02
|
| Rate for Payer: Cash Price |
$2.21
|
| Rate for Payer: Cigna of CA HMO |
$3.15
|
| Rate for Payer: Cigna of CA PPO |
$3.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.97
|
| Rate for Payer: EPIC Health Plan Senior |
$1.97
|
| Rate for Payer: Galaxy Health WC |
$4.18
|
| Rate for Payer: Global Benefits Group Commercial |
$2.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.44
|
| Rate for Payer: Multiplan Commercial |
$3.94
|
| Rate for Payer: Networks By Design Commercial |
$3.20
|
| Rate for Payer: Prime Health Services Commercial |
$4.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.46
|
| Rate for Payer: United Healthcare All Other HMO |
$2.46
|
| Rate for Payer: United Healthcare HMO Rider |
$2.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.18
|
| Rate for Payer: Vantage Medical Group Senior |
$4.18
|
|
|
HC CATH URETHRAL REDRUBBER 14FR
|
Facility
|
IP
|
$4.92
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607553
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$4.18 |
| Rate for Payer: Adventist Health Commercial |
$0.98
|
| Rate for Payer: Cash Price |
$2.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.97
|
| Rate for Payer: EPIC Health Plan Senior |
$1.97
|
| Rate for Payer: Galaxy Health WC |
$4.18
|
| Rate for Payer: Global Benefits Group Commercial |
$2.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.18
|
| Rate for Payer: Multiplan Commercial |
$3.94
|
| Rate for Payer: Networks By Design Commercial |
$3.20
|
| Rate for Payer: Prime Health Services Commercial |
$4.18
|
|
|
HC CATH URETHRAL REDRUBBER 16FR
|
Facility
|
OP
|
$5.66
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607552
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$4.81 |
| Rate for Payer: Adventist Health Commercial |
$1.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.48
|
| Rate for Payer: Cash Price |
$2.55
|
| Rate for Payer: Cigna of CA HMO |
$3.62
|
| Rate for Payer: Cigna of CA PPO |
$4.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2.26
|
| Rate for Payer: Galaxy Health WC |
$4.81
|
| Rate for Payer: Global Benefits Group Commercial |
$3.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.96
|
| Rate for Payer: Multiplan Commercial |
$4.53
|
| Rate for Payer: Networks By Design Commercial |
$3.68
|
| Rate for Payer: Prime Health Services Commercial |
$4.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.83
|
| Rate for Payer: United Healthcare All Other HMO |
$2.83
|
| Rate for Payer: United Healthcare HMO Rider |
$2.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.81
|
| Rate for Payer: Vantage Medical Group Senior |
$4.81
|
|
