|
HC CATH FOLEY 16FR W/TEMP PROBE
|
Facility
|
OP
|
$104.96
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901604296
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.99 |
| Max. Negotiated Rate |
$89.22 |
| Rate for Payer: Adventist Health Commercial |
$20.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$89.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$57.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$78.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.35
|
| Rate for Payer: Cash Price |
$47.23
|
| Rate for Payer: Cash Price |
$47.23
|
| Rate for Payer: Cigna of CA HMO |
$67.17
|
| Rate for Payer: Cigna of CA PPO |
$77.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$89.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$89.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$89.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$73.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.98
|
| Rate for Payer: EPIC Health Plan Senior |
$41.98
|
| Rate for Payer: Galaxy Health WC |
$89.22
|
| Rate for Payer: Global Benefits Group Commercial |
$62.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$38.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$61.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$73.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$73.47
|
| Rate for Payer: Multiplan Commercial |
$83.97
|
| Rate for Payer: Networks By Design Commercial |
$68.22
|
| Rate for Payer: Prime Health Services Commercial |
$89.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$62.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$62.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.48
|
| Rate for Payer: United Healthcare All Other HMO |
$52.48
|
| Rate for Payer: United Healthcare HMO Rider |
$52.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$89.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$89.22
|
| Rate for Payer: Vantage Medical Group Senior |
$89.22
|
|
|
HC CATH FOLEY 16FR W/TEMP PROBE
|
Facility
|
IP
|
$104.96
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901604296
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.99 |
| Max. Negotiated Rate |
$89.22 |
| Rate for Payer: Adventist Health Commercial |
$20.99
|
| Rate for Payer: Cash Price |
$47.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$73.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.98
|
| Rate for Payer: EPIC Health Plan Senior |
$41.98
|
| Rate for Payer: Galaxy Health WC |
$89.22
|
| Rate for Payer: Global Benefits Group Commercial |
$62.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$66.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$61.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.19
|
| Rate for Payer: Multiplan Commercial |
$83.97
|
| Rate for Payer: Networks By Design Commercial |
$68.22
|
| Rate for Payer: Prime Health Services Commercial |
$89.22
|
|
|
HC CATH FOLEY 16FR W TEMP SENSING
|
Facility
|
IP
|
$185.29
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698191
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.06 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Adventist Health Commercial |
$37.06
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$129.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.12
|
| Rate for Payer: EPIC Health Plan Senior |
$74.12
|
| Rate for Payer: Galaxy Health WC |
$157.50
|
| Rate for Payer: Global Benefits Group Commercial |
$111.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$117.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$109.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.47
|
| Rate for Payer: Multiplan Commercial |
$148.23
|
| Rate for Payer: Networks By Design Commercial |
$120.44
|
| Rate for Payer: Prime Health Services Commercial |
$157.50
|
|
|
HC CATH FOLEY 16FR W TEMP SENSING
|
Facility
|
OP
|
$185.29
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698191
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.97 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Adventist Health Commercial |
$37.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$157.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$101.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$138.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$118.90
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Cash Price |
$83.38
|
| Rate for Payer: Cigna of CA HMO |
$118.59
|
| Rate for Payer: Cigna of CA PPO |
$137.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$157.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$157.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$157.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$129.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$74.12
|
| Rate for Payer: EPIC Health Plan Senior |
$74.12
|
| Rate for Payer: Galaxy Health WC |
$157.50
|
| Rate for Payer: Global Benefits Group Commercial |
$111.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$117.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$67.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$109.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$129.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$129.70
|
| Rate for Payer: Multiplan Commercial |
$148.23
|
| Rate for Payer: Networks By Design Commercial |
$120.44
|
| Rate for Payer: Prime Health Services Commercial |
$157.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$111.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$111.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$92.64
|
| Rate for Payer: United Healthcare All Other HMO |
$92.64
|
| Rate for Payer: United Healthcare HMO Rider |
$92.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$92.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$157.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$157.50
|
| Rate for Payer: Vantage Medical Group Senior |
$157.50
|
|
|
HC CATH FOLEY 16FR W/TEMP SENSING
|
Facility
|
OP
|
$207.27
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901608089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.97 |
| Max. Negotiated Rate |
$176.18 |
| Rate for Payer: Adventist Health Commercial |
$41.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$176.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$114.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$155.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$133.01
|
| Rate for Payer: Cash Price |
$93.27
|
| Rate for Payer: Cash Price |
$93.27
|
| Rate for Payer: Cigna of CA HMO |
$132.65
|
| Rate for Payer: Cigna of CA PPO |
$153.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$176.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$176.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$176.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$145.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.91
|
| Rate for Payer: EPIC Health Plan Senior |
$82.91
|
| Rate for Payer: Galaxy Health WC |
$176.18
|
| Rate for Payer: Global Benefits Group Commercial |
$124.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$131.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$75.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$122.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$145.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$145.09
|
| Rate for Payer: Multiplan Commercial |
$165.82
|
| Rate for Payer: Networks By Design Commercial |
$134.73
|
| Rate for Payer: Prime Health Services Commercial |
$176.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$124.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$124.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$103.64
|
| Rate for Payer: United Healthcare All Other HMO |
$103.64
|
| Rate for Payer: United Healthcare HMO Rider |
$103.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$103.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$176.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$176.18
|
| Rate for Payer: Vantage Medical Group Senior |
$176.18
|
|
|
HC CATH FOLEY 16FR W/TEMP SENSING
|
Facility
|
IP
|
$207.27
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901608089
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$41.45 |
| Max. Negotiated Rate |
$176.18 |
| Rate for Payer: Adventist Health Commercial |
$41.45
|
| Rate for Payer: Cash Price |
$93.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$145.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$82.91
|
| Rate for Payer: EPIC Health Plan Senior |
$82.91
|
| Rate for Payer: Galaxy Health WC |
$176.18
|
| Rate for Payer: Global Benefits Group Commercial |
$124.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$131.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$122.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.74
|
| Rate for Payer: Multiplan Commercial |
$165.82
|
| Rate for Payer: Networks By Design Commercial |
$134.73
|
| Rate for Payer: Prime Health Services Commercial |
$176.18
|
|
|
HC CATH FOLEY 18FR 30ML 3WAY
|
Facility
|
IP
|
$117.42
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698709
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.48 |
| Max. Negotiated Rate |
$99.81 |
| Rate for Payer: Networks By Design Commercial |
$76.32
|
| Rate for Payer: Adventist Health Commercial |
$23.48
|
| Rate for Payer: Cash Price |
$52.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$82.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.97
|
| Rate for Payer: EPIC Health Plan Senior |
$46.97
|
| Rate for Payer: Galaxy Health WC |
$99.81
|
| Rate for Payer: Global Benefits Group Commercial |
$70.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$74.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$69.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.18
|
| Rate for Payer: Multiplan Commercial |
$93.94
|
| Rate for Payer: Prime Health Services Commercial |
$99.81
|
|
|
HC CATH FOLEY 18FR 30ML 3WAY
|
Facility
|
OP
|
$117.42
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698709
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.48 |
| Max. Negotiated Rate |
$99.81 |
| Rate for Payer: Adventist Health Commercial |
$23.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$99.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$88.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.35
|
| Rate for Payer: Cash Price |
$52.84
|
| Rate for Payer: Cash Price |
$52.84
|
| Rate for Payer: Cigna of CA HMO |
$75.15
|
| Rate for Payer: Cigna of CA PPO |
$86.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$99.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$99.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$99.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$82.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.97
|
| Rate for Payer: EPIC Health Plan Senior |
$46.97
|
| Rate for Payer: Galaxy Health WC |
$99.81
|
| Rate for Payer: Global Benefits Group Commercial |
$70.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$74.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$69.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82.19
|
| Rate for Payer: Multiplan Commercial |
$93.94
|
| Rate for Payer: Networks By Design Commercial |
$76.32
|
| Rate for Payer: Prime Health Services Commercial |
$99.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.71
|
| Rate for Payer: United Healthcare All Other HMO |
$58.71
|
| Rate for Payer: United Healthcare HMO Rider |
$58.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$58.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$99.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$99.81
|
| Rate for Payer: Vantage Medical Group Senior |
$99.81
|
|
|
HC CATH FOLEY 18FR COUDE TIP 2WAY
|
Facility
|
IP
|
$27.06
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698754
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$23.00 |
| Rate for Payer: Adventist Health Commercial |
$5.41
|
| Rate for Payer: Cash Price |
$12.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.82
|
| Rate for Payer: EPIC Health Plan Senior |
$10.82
|
| Rate for Payer: Galaxy Health WC |
$23.00
|
| Rate for Payer: Global Benefits Group Commercial |
$16.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.49
|
| Rate for Payer: Multiplan Commercial |
$21.65
|
| Rate for Payer: Networks By Design Commercial |
$17.59
|
| Rate for Payer: Prime Health Services Commercial |
$23.00
|
|
|
HC CATH FOLEY 18FR COUDE TIP 2WAY
|
Facility
|
OP
|
$27.06
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901698754
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$34.97 |
| Rate for Payer: Adventist Health Commercial |
$5.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.36
|
| Rate for Payer: Cash Price |
$12.18
|
| Rate for Payer: Cash Price |
$12.18
|
| Rate for Payer: Cigna of CA HMO |
$17.32
|
| Rate for Payer: Cigna of CA PPO |
$20.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.82
|
| Rate for Payer: EPIC Health Plan Senior |
$10.82
|
| Rate for Payer: Galaxy Health WC |
$23.00
|
| Rate for Payer: Global Benefits Group Commercial |
$16.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.94
|
| Rate for Payer: Multiplan Commercial |
$21.65
|
| Rate for Payer: Networks By Design Commercial |
$17.59
|
| Rate for Payer: Prime Health Services Commercial |
$23.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.53
|
| Rate for Payer: United Healthcare All Other HMO |
$13.53
|
| Rate for Payer: United Healthcare HMO Rider |
$13.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.00
|
| Rate for Payer: Vantage Medical Group Senior |
$23.00
|
|
|
HC CATH FOLEY 22FR 5CC 2WAY
|
Facility
|
OP
|
$95.38
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601366
|
|
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 |
$34.97
|
| 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 |
$61.21
|
| Rate for Payer: Cash Price |
$42.92
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.77
|
| 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 Foundation Hospitals Commercial/Self Funded |
$60.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.27
|
| 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 FOLEY 22FR 5CC 2WAY
|
Facility
|
IP
|
$95.38
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601366
|
|
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: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.77
|
| 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 Foundation Hospitals Commercial/Self Funded |
$60.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.27
|
| 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 FOLEY 24FR 5CC 2 WAY
|
Facility
|
OP
|
$18.20
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$34.97 |
| Rate for Payer: Adventist Health Commercial |
$3.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.68
|
| Rate for Payer: Cash Price |
$8.19
|
| Rate for Payer: Cash Price |
$8.19
|
| Rate for Payer: Cigna of CA HMO |
$11.65
|
| Rate for Payer: Cigna of CA PPO |
$13.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.28
|
| Rate for Payer: EPIC Health Plan Senior |
$7.28
|
| Rate for Payer: Galaxy Health WC |
$15.47
|
| Rate for Payer: Global Benefits Group Commercial |
$10.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.74
|
| Rate for Payer: Multiplan Commercial |
$14.56
|
| Rate for Payer: Networks By Design Commercial |
$11.83
|
| Rate for Payer: Prime Health Services Commercial |
$15.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.10
|
| Rate for Payer: United Healthcare All Other HMO |
$9.10
|
| Rate for Payer: United Healthcare HMO Rider |
$9.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.47
|
| Rate for Payer: Vantage Medical Group Senior |
$15.47
|
|
|
HC CATH FOLEY 24FR 5CC 2 WAY
|
Facility
|
IP
|
$18.20
|
|
|
Service Code
|
CPT A4338
|
| Hospital Charge Code |
901601367
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$15.47 |
| Rate for Payer: Adventist Health Commercial |
$3.64
|
| Rate for Payer: Cash Price |
$8.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.28
|
| Rate for Payer: EPIC Health Plan Senior |
$7.28
|
| Rate for Payer: Galaxy Health WC |
$15.47
|
| Rate for Payer: Global Benefits Group Commercial |
$10.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.37
|
| Rate for Payer: Multiplan Commercial |
$14.56
|
| Rate for Payer: Networks By Design Commercial |
$11.83
|
| Rate for Payer: Prime Health Services Commercial |
$15.47
|
|
|
HC CATH FOLEY 3WAY 16FR 30ML
|
Facility
|
IP
|
$61.66
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698649
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$52.41 |
| Rate for Payer: Adventist Health Commercial |
$12.33
|
| Rate for Payer: Cash Price |
$27.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$43.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.66
|
| Rate for Payer: EPIC Health Plan Senior |
$24.66
|
| Rate for Payer: Galaxy Health WC |
$52.41
|
| Rate for Payer: Global Benefits Group Commercial |
$37.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$39.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.80
|
| Rate for Payer: Multiplan Commercial |
$49.33
|
| Rate for Payer: Networks By Design Commercial |
$40.08
|
| Rate for Payer: Prime Health Services Commercial |
$52.41
|
|
|
HC CATH FOLEY 3WAY 16FR 30ML
|
Facility
|
OP
|
$61.66
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698649
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$55.90 |
| Rate for Payer: Adventist Health Commercial |
$12.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$52.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$46.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39.57
|
| Rate for Payer: Cash Price |
$27.75
|
| Rate for Payer: Cash Price |
$27.75
|
| Rate for Payer: Cigna of CA HMO |
$39.46
|
| Rate for Payer: Cigna of CA PPO |
$45.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$52.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$52.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$43.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.66
|
| Rate for Payer: EPIC Health Plan Senior |
$24.66
|
| Rate for Payer: Galaxy Health WC |
$52.41
|
| Rate for Payer: Global Benefits Group Commercial |
$37.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$39.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$43.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43.16
|
| Rate for Payer: Multiplan Commercial |
$49.33
|
| Rate for Payer: Networks By Design Commercial |
$40.08
|
| Rate for Payer: Prime Health Services Commercial |
$52.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.83
|
| Rate for Payer: United Healthcare All Other HMO |
$30.83
|
| Rate for Payer: United Healthcare HMO Rider |
$30.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$52.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.41
|
| Rate for Payer: Vantage Medical Group Senior |
$52.41
|
|
|
HC CATH FOLEY 3WAY 18FR 30ML
|
Facility
|
OP
|
$65.60
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.12 |
| Max. Negotiated Rate |
$55.90 |
| Rate for Payer: Adventist Health Commercial |
$13.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.10
|
| Rate for Payer: Cash Price |
$29.52
|
| Rate for Payer: Cash Price |
$29.52
|
| Rate for Payer: Cigna of CA HMO |
$41.98
|
| Rate for Payer: Cigna of CA PPO |
$48.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.24
|
| Rate for Payer: EPIC Health Plan Senior |
$26.24
|
| Rate for Payer: Galaxy Health WC |
$55.76
|
| Rate for Payer: Global Benefits Group Commercial |
$39.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.92
|
| Rate for Payer: Multiplan Commercial |
$52.48
|
| Rate for Payer: Networks By Design Commercial |
$42.64
|
| Rate for Payer: Prime Health Services Commercial |
$55.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.80
|
| Rate for Payer: United Healthcare All Other HMO |
$32.80
|
| Rate for Payer: United Healthcare HMO Rider |
$32.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.76
|
| Rate for Payer: Vantage Medical Group Senior |
$55.76
|
|
|
HC CATH FOLEY 3WAY 18FR 30ML
|
Facility
|
IP
|
$65.60
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.12 |
| Max. Negotiated Rate |
$55.76 |
| Rate for Payer: Adventist Health Commercial |
$13.12
|
| Rate for Payer: Cash Price |
$29.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.24
|
| Rate for Payer: EPIC Health Plan Senior |
$26.24
|
| Rate for Payer: Galaxy Health WC |
$55.76
|
| Rate for Payer: Global Benefits Group Commercial |
$39.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.74
|
| Rate for Payer: Multiplan Commercial |
$52.48
|
| Rate for Payer: Networks By Design Commercial |
$42.64
|
| Rate for Payer: Prime Health Services Commercial |
$55.76
|
|
|
HC CATH FOLEY 3WAY 22FR 30ML
|
Facility
|
IP
|
$56.25
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$47.81 |
| Rate for Payer: Adventist Health Commercial |
$11.25
|
| Rate for Payer: Cash Price |
$25.31
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.50
|
| Rate for Payer: EPIC Health Plan Senior |
$22.50
|
| Rate for Payer: Galaxy Health WC |
$47.81
|
| Rate for Payer: Global Benefits Group Commercial |
$33.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.50
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$36.56
|
| Rate for Payer: Prime Health Services Commercial |
$47.81
|
|
|
HC CATH FOLEY 3WAY 22FR 30ML
|
Facility
|
OP
|
$56.25
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$55.90 |
| Rate for Payer: Adventist Health Commercial |
$11.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.10
|
| Rate for Payer: Cash Price |
$25.31
|
| Rate for Payer: Cash Price |
$25.31
|
| Rate for Payer: Cigna of CA HMO |
$36.00
|
| Rate for Payer: Cigna of CA PPO |
$41.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$47.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.50
|
| Rate for Payer: EPIC Health Plan Senior |
$22.50
|
| Rate for Payer: Galaxy Health WC |
$47.81
|
| Rate for Payer: Global Benefits Group Commercial |
$33.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.38
|
| Rate for Payer: Multiplan Commercial |
$45.00
|
| Rate for Payer: Networks By Design Commercial |
$36.56
|
| Rate for Payer: Prime Health Services Commercial |
$47.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.12
|
| Rate for Payer: United Healthcare All Other HMO |
$28.12
|
| Rate for Payer: United Healthcare HMO Rider |
$28.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.81
|
| Rate for Payer: Vantage Medical Group Senior |
$47.81
|
|
|
HC CATH FOLEY 3WAY 24FR 30ML
|
Facility
|
IP
|
$65.11
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607382
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.02 |
| Max. Negotiated Rate |
$55.34 |
| Rate for Payer: Adventist Health Commercial |
$13.02
|
| Rate for Payer: Cash Price |
$29.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.04
|
| Rate for Payer: EPIC Health Plan Senior |
$26.04
|
| Rate for Payer: Galaxy Health WC |
$55.34
|
| Rate for Payer: Global Benefits Group Commercial |
$39.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.63
|
| Rate for Payer: Multiplan Commercial |
$52.09
|
| Rate for Payer: Networks By Design Commercial |
$42.32
|
| Rate for Payer: Prime Health Services Commercial |
$55.34
|
|
|
HC CATH FOLEY 3WAY 24FR 30ML
|
Facility
|
OP
|
$65.11
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901607382
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.02 |
| Max. Negotiated Rate |
$55.90 |
| Rate for Payer: Adventist Health Commercial |
$13.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.78
|
| Rate for Payer: Cash Price |
$29.30
|
| Rate for Payer: Cash Price |
$29.30
|
| Rate for Payer: Cigna of CA HMO |
$41.67
|
| Rate for Payer: Cigna of CA PPO |
$48.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.04
|
| Rate for Payer: EPIC Health Plan Senior |
$26.04
|
| Rate for Payer: Galaxy Health WC |
$55.34
|
| Rate for Payer: Global Benefits Group Commercial |
$39.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.58
|
| Rate for Payer: Multiplan Commercial |
$52.09
|
| Rate for Payer: Networks By Design Commercial |
$42.32
|
| Rate for Payer: Prime Health Services Commercial |
$55.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.55
|
| Rate for Payer: United Healthcare All Other HMO |
$32.55
|
| Rate for Payer: United Healthcare HMO Rider |
$32.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.34
|
| Rate for Payer: Vantage Medical Group Senior |
$55.34
|
|
|
HC CATH FOLEY 6FR LF
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901606996
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.62
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC CATH FOLEY 6FR LF
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901606996
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC CATH FOLEY 6FR UR METER TRAY
|
Facility
|
IP
|
$287.21
|
|
| Hospital Charge Code |
901698921
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$57.44 |
| Max. Negotiated Rate |
$244.13 |
| Rate for Payer: Adventist Health Commercial |
$57.44
|
| Rate for Payer: Cash Price |
$129.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$201.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$114.88
|
| Rate for Payer: EPIC Health Plan Senior |
$114.88
|
| Rate for Payer: Galaxy Health WC |
$244.13
|
| Rate for Payer: Global Benefits Group Commercial |
$172.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$182.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.93
|
| Rate for Payer: Multiplan Commercial |
$229.77
|
| Rate for Payer: Networks By Design Commercial |
$186.69
|
| Rate for Payer: Prime Health Services Commercial |
$244.13
|
|
