|
HC CATH FOLEY 6FR UR METER TRAY
|
Facility
|
OP
|
$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: Aetna of CA HMO/PPO |
$188.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$157.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$215.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$184.30
|
| Rate for Payer: Cash Price |
$129.24
|
| Rate for Payer: Cigna of CA HMO |
$183.81
|
| Rate for Payer: Cigna of CA PPO |
$212.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$244.13
|
| 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 Medi-Cal |
$104.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.05
|
| 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
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$143.60
|
| Rate for Payer: United Healthcare All Other HMO |
$143.60
|
| Rate for Payer: United Healthcare HMO Rider |
$143.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$143.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$244.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.13
|
| Rate for Payer: Vantage Medical Group Senior |
$244.13
|
|
|
HC CATH FOLEY 8FR 3ML 2WAY PEDS
|
Facility
|
OP
|
$36.82
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Adventist Health Commercial |
$7.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.63
|
| Rate for Payer: Cash Price |
$16.57
|
| Rate for Payer: Cash Price |
$16.57
|
| Rate for Payer: Cigna of CA HMO |
$23.56
|
| Rate for Payer: Cigna of CA PPO |
$27.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.73
|
| Rate for Payer: EPIC Health Plan Senior |
$14.73
|
| Rate for Payer: Galaxy Health WC |
$31.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.77
|
| Rate for Payer: Multiplan Commercial |
$29.46
|
| Rate for Payer: Networks By Design Commercial |
$23.93
|
| Rate for Payer: Prime Health Services Commercial |
$31.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.41
|
| Rate for Payer: United Healthcare All Other HMO |
$18.41
|
| Rate for Payer: United Healthcare HMO Rider |
$18.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.30
|
| Rate for Payer: Vantage Medical Group Senior |
$31.30
|
|
|
HC CATH FOLEY 8FR 3ML 2WAY PEDS
|
Facility
|
IP
|
$36.82
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$31.30 |
| Rate for Payer: Adventist Health Commercial |
$7.36
|
| Rate for Payer: Cash Price |
$16.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.73
|
| Rate for Payer: EPIC Health Plan Senior |
$14.73
|
| Rate for Payer: Galaxy Health WC |
$31.30
|
| Rate for Payer: Global Benefits Group Commercial |
$22.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.84
|
| Rate for Payer: Multiplan Commercial |
$29.46
|
| Rate for Payer: Networks By Design Commercial |
$23.93
|
| Rate for Payer: Prime Health Services Commercial |
$31.30
|
|
|
HC CATH FOLEY 8FR UR METER TRAY
|
Facility
|
OP
|
$287.21
|
|
| Hospital Charge Code |
901698922
|
|
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: Aetna of CA HMO/PPO |
$188.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$244.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$157.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$215.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$184.30
|
| Rate for Payer: Cash Price |
$129.24
|
| Rate for Payer: Cigna of CA HMO |
$183.81
|
| Rate for Payer: Cigna of CA PPO |
$212.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$244.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$244.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$244.13
|
| 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 Medi-Cal |
$104.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$169.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$68.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$201.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$201.05
|
| 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
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$172.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$172.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$143.60
|
| Rate for Payer: United Healthcare All Other HMO |
$143.60
|
| Rate for Payer: United Healthcare HMO Rider |
$143.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$143.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$244.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$244.13
|
| Rate for Payer: Vantage Medical Group Senior |
$244.13
|
|
|
HC CATH FOLEY 8FR UR METER TRAY
|
Facility
|
IP
|
$287.21
|
|
| Hospital Charge Code |
901698922
|
|
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
|
|
|
HC CATH FOLEY COUDE 14FR 15CC
|
Facility
|
OP
|
$32.06
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$388.84 |
| Rate for Payer: Adventist Health Commercial |
$6.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.57
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: Cigna of CA HMO |
$20.52
|
| Rate for Payer: Cigna of CA PPO |
$23.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Senior |
$12.82
|
| Rate for Payer: Galaxy Health WC |
$27.25
|
| Rate for Payer: Global Benefits Group Commercial |
$19.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.44
|
| Rate for Payer: Multiplan Commercial |
$25.65
|
| Rate for Payer: Networks By Design Commercial |
$20.84
|
| Rate for Payer: Prime Health Services Commercial |
$27.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.03
|
| Rate for Payer: United Healthcare All Other HMO |
$16.03
|
| Rate for Payer: United Healthcare HMO Rider |
$16.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.25
|
| Rate for Payer: Vantage Medical Group Senior |
$27.25
|
|
|
HC CATH FOLEY COUDE 14FR 15CC
|
Facility
|
IP
|
$32.06
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604051
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$27.25 |
| Rate for Payer: Adventist Health Commercial |
$6.41
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Senior |
$12.82
|
| Rate for Payer: Galaxy Health WC |
$27.25
|
| Rate for Payer: Global Benefits Group Commercial |
$19.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.69
|
| Rate for Payer: Multiplan Commercial |
$25.65
|
| Rate for Payer: Networks By Design Commercial |
$20.84
|
| Rate for Payer: Prime Health Services Commercial |
$27.25
|
|
|
HC CATH FOLEY COUDE 16FR 10ML
|
Facility
|
OP
|
$39.69
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.94 |
| Max. Negotiated Rate |
$90.52 |
| Rate for Payer: Adventist Health Commercial |
$7.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$90.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.47
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Cigna of CA HMO |
$25.40
|
| Rate for Payer: Cigna of CA PPO |
$29.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.88
|
| Rate for Payer: EPIC Health Plan Senior |
$15.88
|
| Rate for Payer: Galaxy Health WC |
$33.74
|
| Rate for Payer: Global Benefits Group Commercial |
$23.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.78
|
| Rate for Payer: Multiplan Commercial |
$31.75
|
| Rate for Payer: Networks By Design Commercial |
$25.80
|
| Rate for Payer: Prime Health Services Commercial |
$33.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.84
|
| Rate for Payer: United Healthcare All Other HMO |
$19.84
|
| Rate for Payer: United Healthcare HMO Rider |
$19.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.74
|
| Rate for Payer: Vantage Medical Group Senior |
$33.74
|
|
|
HC CATH FOLEY COUDE 16FR 10ML
|
Facility
|
IP
|
$39.69
|
|
|
Service Code
|
CPT A4340
|
| Hospital Charge Code |
901698849
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.94 |
| Max. Negotiated Rate |
$33.74 |
| Rate for Payer: Adventist Health Commercial |
$7.94
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.88
|
| Rate for Payer: EPIC Health Plan Senior |
$15.88
|
| Rate for Payer: Galaxy Health WC |
$33.74
|
| Rate for Payer: Global Benefits Group Commercial |
$23.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.53
|
| Rate for Payer: Multiplan Commercial |
$31.75
|
| Rate for Payer: Networks By Design Commercial |
$25.80
|
| Rate for Payer: Prime Health Services Commercial |
$33.74
|
|
|
HC CATH FOLEY COUDE 16FR 5-15CC
|
Facility
|
IP
|
$32.06
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604698
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$27.25 |
| Rate for Payer: Adventist Health Commercial |
$6.41
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Senior |
$12.82
|
| Rate for Payer: Galaxy Health WC |
$27.25
|
| Rate for Payer: Global Benefits Group Commercial |
$19.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.69
|
| Rate for Payer: Multiplan Commercial |
$25.65
|
| Rate for Payer: Networks By Design Commercial |
$20.84
|
| Rate for Payer: Prime Health Services Commercial |
$27.25
|
|
|
HC CATH FOLEY COUDE 16FR 5-15CC
|
Facility
|
OP
|
$32.06
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604698
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$388.84 |
| Rate for Payer: Adventist Health Commercial |
$6.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.57
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: Cigna of CA HMO |
$20.52
|
| Rate for Payer: Cigna of CA PPO |
$23.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Senior |
$12.82
|
| Rate for Payer: Galaxy Health WC |
$27.25
|
| Rate for Payer: Global Benefits Group Commercial |
$19.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.44
|
| Rate for Payer: Multiplan Commercial |
$25.65
|
| Rate for Payer: Networks By Design Commercial |
$20.84
|
| Rate for Payer: Prime Health Services Commercial |
$27.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.03
|
| Rate for Payer: United Healthcare All Other HMO |
$16.03
|
| Rate for Payer: United Healthcare HMO Rider |
$16.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.25
|
| Rate for Payer: Vantage Medical Group Senior |
$27.25
|
|
|
HC CATH FOLEY COUDE 18FR 5-15CC
|
Facility
|
IP
|
$32.06
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$27.25 |
| Rate for Payer: Adventist Health Commercial |
$6.41
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Senior |
$12.82
|
| Rate for Payer: Galaxy Health WC |
$27.25
|
| Rate for Payer: Global Benefits Group Commercial |
$19.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.69
|
| Rate for Payer: Multiplan Commercial |
$25.65
|
| Rate for Payer: Networks By Design Commercial |
$20.84
|
| Rate for Payer: Prime Health Services Commercial |
$27.25
|
|
|
HC CATH FOLEY COUDE 18FR 5-15CC
|
Facility
|
OP
|
$32.06
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901604699
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$388.84 |
| Rate for Payer: Adventist Health Commercial |
$6.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.57
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: Cash Price |
$14.43
|
| Rate for Payer: Cigna of CA HMO |
$20.52
|
| Rate for Payer: Cigna of CA PPO |
$23.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.82
|
| Rate for Payer: EPIC Health Plan Senior |
$12.82
|
| Rate for Payer: Galaxy Health WC |
$27.25
|
| Rate for Payer: Global Benefits Group Commercial |
$19.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.44
|
| Rate for Payer: Multiplan Commercial |
$25.65
|
| Rate for Payer: Networks By Design Commercial |
$20.84
|
| Rate for Payer: Prime Health Services Commercial |
$27.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.03
|
| Rate for Payer: United Healthcare All Other HMO |
$16.03
|
| Rate for Payer: United Healthcare HMO Rider |
$16.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.25
|
| Rate for Payer: Vantage Medical Group Senior |
$27.25
|
|
|
HC CATH FOLEY SLCN 12FR 10ML LF
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$21.68 |
| Rate for Payer: Adventist Health Commercial |
$5.10
|
| Rate for Payer: Cash Price |
$11.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.20
|
| Rate for Payer: EPIC Health Plan Senior |
$10.20
|
| Rate for Payer: Galaxy Health WC |
$21.68
|
| Rate for Payer: Global Benefits Group Commercial |
$15.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.12
|
| Rate for Payer: Multiplan Commercial |
$20.40
|
| Rate for Payer: Networks By Design Commercial |
$16.57
|
| Rate for Payer: Prime Health Services Commercial |
$21.68
|
|
|
HC CATH FOLEY SLCN 12FR 10ML LF
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Adventist Health Commercial |
$5.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.36
|
| Rate for Payer: Cash Price |
$11.48
|
| Rate for Payer: Cash Price |
$11.48
|
| Rate for Payer: Cigna of CA HMO |
$16.32
|
| Rate for Payer: Cigna of CA PPO |
$18.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.20
|
| Rate for Payer: EPIC Health Plan Senior |
$10.20
|
| Rate for Payer: Galaxy Health WC |
$21.68
|
| Rate for Payer: Global Benefits Group Commercial |
$15.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.85
|
| Rate for Payer: Multiplan Commercial |
$20.40
|
| Rate for Payer: Networks By Design Commercial |
$16.57
|
| Rate for Payer: Prime Health Services Commercial |
$21.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.75
|
| Rate for Payer: United Healthcare All Other HMO |
$12.75
|
| Rate for Payer: United Healthcare HMO Rider |
$12.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.68
|
| Rate for Payer: Vantage Medical Group Senior |
$21.68
|
|
|
HC CATH FOLEY SLCN 14FR 10ML LF
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607519
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Adventist Health Commercial |
$5.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.47
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cigna of CA HMO |
$16.43
|
| Rate for Payer: Cigna of CA PPO |
$19.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Senior |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.97
|
| Rate for Payer: Multiplan Commercial |
$20.54
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.84
|
| Rate for Payer: United Healthcare All Other HMO |
$12.84
|
| Rate for Payer: United Healthcare HMO Rider |
$12.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.82
|
| Rate for Payer: Vantage Medical Group Senior |
$21.82
|
|
|
HC CATH FOLEY SLCN 14FR 10ML LF
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607519
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$21.82 |
| Rate for Payer: Adventist Health Commercial |
$5.13
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Senior |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.16
|
| Rate for Payer: Multiplan Commercial |
$20.54
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
|
|
HC CATH FOLEY SLCN 16FR 10ML LF
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Adventist Health Commercial |
$5.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.47
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Cigna of CA HMO |
$16.43
|
| Rate for Payer: Cigna of CA PPO |
$19.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Senior |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.97
|
| Rate for Payer: Multiplan Commercial |
$20.54
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.84
|
| Rate for Payer: United Healthcare All Other HMO |
$12.84
|
| Rate for Payer: United Healthcare HMO Rider |
$12.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.82
|
| Rate for Payer: Vantage Medical Group Senior |
$21.82
|
|
|
HC CATH FOLEY SLCN 16FR 10ML LF
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607394
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$21.82 |
| Rate for Payer: Adventist Health Commercial |
$5.13
|
| Rate for Payer: Cash Price |
$11.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.27
|
| Rate for Payer: EPIC Health Plan Senior |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$21.82
|
| Rate for Payer: Global Benefits Group Commercial |
$15.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.16
|
| Rate for Payer: Multiplan Commercial |
$20.54
|
| Rate for Payer: Networks By Design Commercial |
$16.69
|
| Rate for Payer: Prime Health Services Commercial |
$21.82
|
|
|
HC CATH FOLEY SLCN 16FR 30ML LF
|
Facility
|
OP
|
$30.50
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Adventist Health Commercial |
$6.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.57
|
| Rate for Payer: Cash Price |
$13.72
|
| Rate for Payer: Cash Price |
$13.72
|
| Rate for Payer: Cigna of CA HMO |
$19.52
|
| Rate for Payer: Cigna of CA PPO |
$22.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12.20
|
| Rate for Payer: Galaxy Health WC |
$25.93
|
| Rate for Payer: Global Benefits Group Commercial |
$18.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.35
|
| Rate for Payer: Multiplan Commercial |
$24.40
|
| Rate for Payer: Networks By Design Commercial |
$19.82
|
| Rate for Payer: Prime Health Services Commercial |
$25.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.25
|
| Rate for Payer: United Healthcare All Other HMO |
$15.25
|
| Rate for Payer: United Healthcare HMO Rider |
$15.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: Vantage Medical Group Senior |
$25.93
|
|
|
HC CATH FOLEY SLCN 16FR 30ML LF
|
Facility
|
IP
|
$30.50
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607392
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$25.93 |
| Rate for Payer: Adventist Health Commercial |
$6.10
|
| Rate for Payer: Cash Price |
$13.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12.20
|
| Rate for Payer: Galaxy Health WC |
$25.93
|
| Rate for Payer: Global Benefits Group Commercial |
$18.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.32
|
| Rate for Payer: Multiplan Commercial |
$24.40
|
| Rate for Payer: Networks By Design Commercial |
$19.82
|
| Rate for Payer: Prime Health Services Commercial |
$25.93
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5CC
|
Facility
|
IP
|
$70.36
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901605366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.07 |
| Max. Negotiated Rate |
$59.81 |
| Rate for Payer: Galaxy Health WC |
$59.81
|
| Rate for Payer: Adventist Health Commercial |
$14.07
|
| Rate for Payer: Cash Price |
$31.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.14
|
| Rate for Payer: EPIC Health Plan Senior |
$28.14
|
| Rate for Payer: Global Benefits Group Commercial |
$42.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$44.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.89
|
| Rate for Payer: Multiplan Commercial |
$56.29
|
| Rate for Payer: Networks By Design Commercial |
$45.73
|
| Rate for Payer: Prime Health Services Commercial |
$59.81
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5CC
|
Facility
|
OP
|
$70.36
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901605366
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.07 |
| Max. Negotiated Rate |
$59.81 |
| Rate for Payer: Adventist Health Commercial |
$14.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$59.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$38.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.15
|
| Rate for Payer: Cash Price |
$31.66
|
| Rate for Payer: Cash Price |
$31.66
|
| Rate for Payer: Cigna of CA HMO |
$45.03
|
| Rate for Payer: Cigna of CA PPO |
$52.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$59.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$59.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$59.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$49.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.14
|
| Rate for Payer: EPIC Health Plan Senior |
$28.14
|
| Rate for Payer: Galaxy Health WC |
$59.81
|
| Rate for Payer: Global Benefits Group Commercial |
$42.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$44.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$41.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$49.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$49.25
|
| Rate for Payer: Multiplan Commercial |
$56.29
|
| Rate for Payer: Networks By Design Commercial |
$45.73
|
| Rate for Payer: Prime Health Services Commercial |
$59.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$35.18
|
| Rate for Payer: United Healthcare All Other HMO |
$35.18
|
| Rate for Payer: United Healthcare HMO Rider |
$35.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$35.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$59.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$59.81
|
| Rate for Payer: Vantage Medical Group Senior |
$59.81
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5ML
|
Facility
|
OP
|
$111.64
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698402
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.33 |
| Max. Negotiated Rate |
$94.89 |
| Rate for Payer: Adventist Health Commercial |
$22.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$55.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$94.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$61.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$83.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$71.64
|
| Rate for Payer: Cash Price |
$50.24
|
| Rate for Payer: Cash Price |
$50.24
|
| Rate for Payer: Cigna of CA HMO |
$71.45
|
| Rate for Payer: Cigna of CA PPO |
$82.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$94.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$94.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$94.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.66
|
| Rate for Payer: EPIC Health Plan Senior |
$44.66
|
| Rate for Payer: Galaxy Health WC |
$94.89
|
| Rate for Payer: Global Benefits Group Commercial |
$66.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$70.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$40.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$65.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$78.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$78.15
|
| Rate for Payer: Multiplan Commercial |
$89.31
|
| Rate for Payer: Networks By Design Commercial |
$72.57
|
| Rate for Payer: Prime Health Services Commercial |
$94.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.82
|
| Rate for Payer: United Healthcare All Other HMO |
$55.82
|
| Rate for Payer: United Healthcare HMO Rider |
$55.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$94.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$94.89
|
| Rate for Payer: Vantage Medical Group Senior |
$94.89
|
|
|
HC CATH FOLEY SLCN 16FR 3WY 5ML
|
Facility
|
IP
|
$111.64
|
|
|
Service Code
|
CPT A4346
|
| Hospital Charge Code |
901698402
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.33 |
| Max. Negotiated Rate |
$94.89 |
| Rate for Payer: Adventist Health Commercial |
$22.33
|
| Rate for Payer: Cash Price |
$50.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$78.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.66
|
| Rate for Payer: EPIC Health Plan Senior |
$44.66
|
| Rate for Payer: Galaxy Health WC |
$94.89
|
| Rate for Payer: Global Benefits Group Commercial |
$66.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$70.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$65.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.79
|
| Rate for Payer: Multiplan Commercial |
$89.31
|
| Rate for Payer: Networks By Design Commercial |
$72.57
|
| Rate for Payer: Prime Health Services Commercial |
$94.89
|
|
