|
HC CATH VAPRO PLUS 14FR 16IN
|
Facility
|
OP
|
$17.30
|
|
| Hospital Charge Code |
901698330
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$14.71 |
| Rate for Payer: Adventist Health Commercial |
$3.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.62
|
| Rate for Payer: Cash Price |
$7.78
|
| Rate for Payer: Cigna of CA HMO |
$11.07
|
| Rate for Payer: Cigna of CA PPO |
$12.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.92
|
| Rate for Payer: EPIC Health Plan Senior |
$6.92
|
| Rate for Payer: Galaxy Health WC |
$14.71
|
| Rate for Payer: Global Benefits Group Commercial |
$10.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.11
|
| Rate for Payer: Multiplan Commercial |
$13.84
|
| Rate for Payer: Networks By Design Commercial |
$11.24
|
| Rate for Payer: Prime Health Services Commercial |
$14.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.65
|
| Rate for Payer: United Healthcare All Other HMO |
$8.65
|
| Rate for Payer: United Healthcare HMO Rider |
$8.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.71
|
| Rate for Payer: Vantage Medical Group Senior |
$14.71
|
|
|
HC CATH VAPRO PLUS 14FR 16IN
|
Facility
|
IP
|
$17.30
|
|
| Hospital Charge Code |
901698330
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$14.71 |
| Rate for Payer: Adventist Health Commercial |
$3.46
|
| Rate for Payer: Cash Price |
$7.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.92
|
| Rate for Payer: EPIC Health Plan Senior |
$6.92
|
| Rate for Payer: Galaxy Health WC |
$14.71
|
| Rate for Payer: Global Benefits Group Commercial |
$10.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.15
|
| Rate for Payer: Multiplan Commercial |
$13.84
|
| Rate for Payer: Networks By Design Commercial |
$11.24
|
| Rate for Payer: Prime Health Services Commercial |
$14.71
|
|
|
HC CATH VASC MINNIE SUPPORT
|
Facility
|
IP
|
$593.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.60 |
| Max. Negotiated Rate |
$504.05 |
| Rate for Payer: Adventist Health Commercial |
$118.60
|
| Rate for Payer: Cash Price |
$266.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$237.20
|
| Rate for Payer: EPIC Health Plan Senior |
$237.20
|
| Rate for Payer: Galaxy Health WC |
$504.05
|
| Rate for Payer: Global Benefits Group Commercial |
$355.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$395.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$225.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$367.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.32
|
| Rate for Payer: Multiplan Commercial |
$474.40
|
| Rate for Payer: Networks By Design Commercial |
$385.45
|
| Rate for Payer: Prime Health Services Commercial |
$504.05
|
|
|
HC CATH VASC MINNIE SUPPORT
|
Facility
|
OP
|
$593.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$118.60 |
| Max. Negotiated Rate |
$504.05 |
| Rate for Payer: Adventist Health Commercial |
$118.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$504.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$326.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$444.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$364.16
|
| Rate for Payer: Cash Price |
$266.85
|
| Rate for Payer: Cigna of CA HMO |
$379.52
|
| Rate for Payer: Cigna of CA PPO |
$438.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$504.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$504.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$504.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$237.20
|
| Rate for Payer: EPIC Health Plan Senior |
$237.20
|
| Rate for Payer: Galaxy Health WC |
$504.05
|
| Rate for Payer: Global Benefits Group Commercial |
$355.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$395.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$225.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$367.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$415.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$415.10
|
| Rate for Payer: Multiplan Commercial |
$474.40
|
| Rate for Payer: Networks By Design Commercial |
$385.45
|
| Rate for Payer: Prime Health Services Commercial |
$504.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$355.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$355.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$296.50
|
| Rate for Payer: United Healthcare All Other HMO |
$296.50
|
| Rate for Payer: United Healthcare HMO Rider |
$296.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$296.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$504.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$504.05
|
| Rate for Payer: Vantage Medical Group Senior |
$504.05
|
|
|
HC CATH VASC PRONTO LP
|
Facility
|
OP
|
$1,978.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
906812381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$395.60 |
| Max. Negotiated Rate |
$1,681.30 |
| Rate for Payer: Adventist Health Commercial |
$395.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,297.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,681.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,087.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,483.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,214.69
|
| Rate for Payer: Cash Price |
$890.10
|
| Rate for Payer: Cigna of CA HMO |
$1,265.92
|
| Rate for Payer: Cigna of CA PPO |
$1,463.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,681.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,681.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,681.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.20
|
| Rate for Payer: EPIC Health Plan Senior |
$791.20
|
| Rate for Payer: Galaxy Health WC |
$1,681.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,186.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,319.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$753.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,224.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$474.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,384.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,384.60
|
| Rate for Payer: Multiplan Commercial |
$1,582.40
|
| Rate for Payer: Networks By Design Commercial |
$1,285.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,681.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,186.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,186.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$989.00
|
| Rate for Payer: United Healthcare All Other HMO |
$989.00
|
| Rate for Payer: United Healthcare HMO Rider |
$989.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$989.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,681.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,681.30
|
| Rate for Payer: Vantage Medical Group Senior |
$1,681.30
|
|
|
HC CATH VASC PRONTO LP
|
Facility
|
IP
|
$1,978.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
906812381
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$395.60 |
| Max. Negotiated Rate |
$1,681.30 |
| Rate for Payer: Adventist Health Commercial |
$395.60
|
| Rate for Payer: Cash Price |
$890.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$791.20
|
| Rate for Payer: EPIC Health Plan Senior |
$791.20
|
| Rate for Payer: Galaxy Health WC |
$1,681.30
|
| Rate for Payer: Global Benefits Group Commercial |
$1,186.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,319.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$753.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,224.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$474.72
|
| Rate for Payer: Multiplan Commercial |
$1,582.40
|
| Rate for Payer: Networks By Design Commercial |
$1,285.70
|
| Rate for Payer: Prime Health Services Commercial |
$1,681.30
|
|
|
HC CATH VASC SKYWAY
|
Facility
|
OP
|
$805.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$684.25 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$528.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$442.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$603.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$494.35
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: Cigna of CA HMO |
$515.20
|
| Rate for Payer: Cigna of CA PPO |
$595.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$684.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$684.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$684.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$563.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$563.50
|
| Rate for Payer: Multiplan Commercial |
$644.00
|
| Rate for Payer: Networks By Design Commercial |
$523.25
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$483.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$483.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$402.50
|
| Rate for Payer: United Healthcare All Other HMO |
$402.50
|
| Rate for Payer: United Healthcare HMO Rider |
$402.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$402.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$684.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$684.25
|
| Rate for Payer: Vantage Medical Group Senior |
$684.25
|
|
|
HC CATH VASC SKYWAY
|
Facility
|
IP
|
$805.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812333
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$161.00 |
| Max. Negotiated Rate |
$684.25 |
| Rate for Payer: Adventist Health Commercial |
$161.00
|
| Rate for Payer: Cash Price |
$362.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$322.00
|
| Rate for Payer: EPIC Health Plan Senior |
$322.00
|
| Rate for Payer: Galaxy Health WC |
$684.25
|
| Rate for Payer: Global Benefits Group Commercial |
$483.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$536.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$306.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$498.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.20
|
| Rate for Payer: Multiplan Commercial |
$644.00
|
| Rate for Payer: Networks By Design Commercial |
$523.25
|
| Rate for Payer: Prime Health Services Commercial |
$684.25
|
|
|
HC CATH VASC SWITH IT
|
Facility
|
OP
|
$621.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812506
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.20 |
| Max. Negotiated Rate |
$527.85 |
| Rate for Payer: Adventist Health Commercial |
$124.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$407.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$527.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$341.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$465.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$381.36
|
| Rate for Payer: Cash Price |
$279.45
|
| Rate for Payer: Cigna of CA HMO |
$397.44
|
| Rate for Payer: Cigna of CA PPO |
$459.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$527.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$527.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$527.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$248.40
|
| Rate for Payer: EPIC Health Plan Senior |
$248.40
|
| Rate for Payer: Galaxy Health WC |
$527.85
|
| Rate for Payer: Global Benefits Group Commercial |
$372.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$414.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$236.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$384.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$149.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$434.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$434.70
|
| Rate for Payer: Multiplan Commercial |
$496.80
|
| Rate for Payer: Networks By Design Commercial |
$403.65
|
| Rate for Payer: Prime Health Services Commercial |
$527.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$372.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$372.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$310.50
|
| Rate for Payer: United Healthcare All Other HMO |
$310.50
|
| Rate for Payer: United Healthcare HMO Rider |
$310.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$310.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$527.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$527.85
|
| Rate for Payer: Vantage Medical Group Senior |
$527.85
|
|
|
HC CATH VASC SWITH IT
|
Facility
|
IP
|
$621.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812506
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.20 |
| Max. Negotiated Rate |
$527.85 |
| Rate for Payer: Adventist Health Commercial |
$124.20
|
| Rate for Payer: Cash Price |
$279.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$248.40
|
| Rate for Payer: EPIC Health Plan Senior |
$248.40
|
| Rate for Payer: Galaxy Health WC |
$527.85
|
| Rate for Payer: Global Benefits Group Commercial |
$372.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$414.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$236.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$384.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$149.04
|
| Rate for Payer: Multiplan Commercial |
$496.80
|
| Rate for Payer: Networks By Design Commercial |
$403.65
|
| Rate for Payer: Prime Health Services Commercial |
$527.85
|
|
|
HC CATH VASC TWIN-PASS
|
Facility
|
OP
|
$1,495.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$299.00 |
| Max. Negotiated Rate |
$1,270.75 |
| Rate for Payer: Adventist Health Commercial |
$299.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$980.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,270.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$822.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,121.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$918.08
|
| Rate for Payer: Cash Price |
$672.75
|
| Rate for Payer: Cigna of CA HMO |
$956.80
|
| Rate for Payer: Cigna of CA PPO |
$1,106.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,270.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,270.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,270.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$598.00
|
| Rate for Payer: EPIC Health Plan Senior |
$598.00
|
| Rate for Payer: Galaxy Health WC |
$1,270.75
|
| Rate for Payer: Global Benefits Group Commercial |
$897.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$997.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$569.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$925.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$358.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,046.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,046.50
|
| Rate for Payer: Multiplan Commercial |
$1,196.00
|
| Rate for Payer: Networks By Design Commercial |
$971.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,270.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$897.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$897.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$747.50
|
| Rate for Payer: United Healthcare All Other HMO |
$747.50
|
| Rate for Payer: United Healthcare HMO Rider |
$747.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$747.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,270.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,270.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1,270.75
|
|
|
HC CATH VASC TWIN-PASS
|
Facility
|
IP
|
$1,495.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812332
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$299.00 |
| Max. Negotiated Rate |
$1,270.75 |
| Rate for Payer: Adventist Health Commercial |
$299.00
|
| Rate for Payer: Cash Price |
$672.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$598.00
|
| Rate for Payer: EPIC Health Plan Senior |
$598.00
|
| Rate for Payer: Galaxy Health WC |
$1,270.75
|
| Rate for Payer: Global Benefits Group Commercial |
$897.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$997.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$569.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$925.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$358.80
|
| Rate for Payer: Multiplan Commercial |
$1,196.00
|
| Rate for Payer: Networks By Design Commercial |
$971.75
|
| Rate for Payer: Prime Health Services Commercial |
$1,270.75
|
|
|
HC CATH VENTRICULAR BACTISEAL
|
Facility
|
IP
|
$2,300.00
|
|
| Hospital Charge Code |
901604923
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
|
|
HC CATH VENTRICULAR BACTISEAL
|
Facility
|
OP
|
$2,300.00
|
|
| Hospital Charge Code |
901604923
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,508.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,412.43
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH VENTRICULAR EDM TRANSLUC
|
Facility
|
IP
|
$821.28
|
|
| Hospital Charge Code |
901604606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$164.26 |
| Max. Negotiated Rate |
$698.09 |
| Rate for Payer: Adventist Health Commercial |
$164.26
|
| Rate for Payer: Cash Price |
$369.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$328.51
|
| Rate for Payer: EPIC Health Plan Senior |
$328.51
|
| Rate for Payer: Galaxy Health WC |
$698.09
|
| Rate for Payer: Global Benefits Group Commercial |
$492.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$547.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$312.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$508.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.11
|
| Rate for Payer: Multiplan Commercial |
$657.02
|
| Rate for Payer: Networks By Design Commercial |
$533.83
|
| Rate for Payer: Prime Health Services Commercial |
$698.09
|
|
|
HC CATH VENTRICULAR EDM TRANSLUC
|
Facility
|
OP
|
$821.28
|
|
| Hospital Charge Code |
901604606
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$164.26 |
| Max. Negotiated Rate |
$698.09 |
| Rate for Payer: Adventist Health Commercial |
$164.26
|
| Rate for Payer: Aetna of CA HMO/PPO |
$538.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$698.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$451.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$615.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$504.35
|
| Rate for Payer: Cash Price |
$369.58
|
| Rate for Payer: Cigna of CA HMO |
$525.62
|
| Rate for Payer: Cigna of CA PPO |
$607.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$698.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$698.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$698.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$328.51
|
| Rate for Payer: EPIC Health Plan Senior |
$328.51
|
| Rate for Payer: Galaxy Health WC |
$698.09
|
| Rate for Payer: Global Benefits Group Commercial |
$492.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$547.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$312.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$508.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$574.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$574.90
|
| Rate for Payer: Multiplan Commercial |
$657.02
|
| Rate for Payer: Networks By Design Commercial |
$533.83
|
| Rate for Payer: Prime Health Services Commercial |
$698.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$492.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$492.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$410.64
|
| Rate for Payer: United Healthcare All Other HMO |
$410.64
|
| Rate for Payer: United Healthcare HMO Rider |
$410.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$410.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$698.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$698.09
|
| Rate for Payer: Vantage Medical Group Senior |
$698.09
|
|
|
HC CATH VENTRICULAR LG BACTISEAL
|
Facility
|
OP
|
$2,300.00
|
|
| Hospital Charge Code |
901605478
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,508.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,412.43
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,472.00
|
| Rate for Payer: Cigna of CA PPO |
$1,702.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,150.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,150.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,150.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,150.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH VENTRICULAR LG BACTISEAL
|
Facility
|
IP
|
$2,300.00
|
|
| Hospital Charge Code |
901605478
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,495.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
|
|
HC CATH VIRDEN
|
Facility
|
OP
|
$221.76
|
|
| Hospital Charge Code |
901600875
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.35 |
| Max. Negotiated Rate |
$188.50 |
| Rate for Payer: Adventist Health Commercial |
$44.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$145.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$188.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$121.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$166.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$136.18
|
| Rate for Payer: Cash Price |
$99.79
|
| Rate for Payer: Cigna of CA HMO |
$141.93
|
| Rate for Payer: Cigna of CA PPO |
$164.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$188.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$188.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.70
|
| Rate for Payer: EPIC Health Plan Senior |
$88.70
|
| Rate for Payer: Galaxy Health WC |
$188.50
|
| Rate for Payer: Global Benefits Group Commercial |
$133.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$147.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$155.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$155.23
|
| Rate for Payer: Multiplan Commercial |
$177.41
|
| Rate for Payer: Networks By Design Commercial |
$144.14
|
| Rate for Payer: Prime Health Services Commercial |
$188.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$133.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$133.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$110.88
|
| Rate for Payer: United Healthcare All Other HMO |
$110.88
|
| Rate for Payer: United Healthcare HMO Rider |
$110.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$110.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$188.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.50
|
| Rate for Payer: Vantage Medical Group Senior |
$188.50
|
|
|
HC CATH VIRDEN
|
Facility
|
IP
|
$221.76
|
|
| Hospital Charge Code |
901600875
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.35 |
| Max. Negotiated Rate |
$188.50 |
| Rate for Payer: Adventist Health Commercial |
$44.35
|
| Rate for Payer: Cash Price |
$99.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$88.70
|
| Rate for Payer: EPIC Health Plan Senior |
$88.70
|
| Rate for Payer: Galaxy Health WC |
$188.50
|
| Rate for Payer: Global Benefits Group Commercial |
$133.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$147.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$84.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$137.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.22
|
| Rate for Payer: Multiplan Commercial |
$177.41
|
| Rate for Payer: Networks By Design Commercial |
$144.14
|
| Rate for Payer: Prime Health Services Commercial |
$188.50
|
|
|
HC CATH VLCNO MICROCATH
|
Facility
|
IP
|
$2,300.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812479
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
|
|
HC CATH VLCNO MICROCATH
|
Facility
|
OP
|
$2,300.00
|
|
|
Service Code
|
CPT C1887
|
| Hospital Charge Code |
906812479
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$460.00 |
| Max. Negotiated Rate |
$1,955.00 |
| Rate for Payer: Adventist Health Commercial |
$460.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,265.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,725.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,332.16
|
| Rate for Payer: Blue Shield of California Commercial |
$1,697.40
|
| Rate for Payer: Blue Shield of California EPN |
$1,117.80
|
| Rate for Payer: Cash Price |
$1,035.00
|
| Rate for Payer: Cigna of CA HMO |
$1,610.00
|
| Rate for Payer: Cigna of CA PPO |
$1,610.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,955.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,955.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$920.00
|
| Rate for Payer: EPIC Health Plan Senior |
$920.00
|
| Rate for Payer: Galaxy Health WC |
$1,955.00
|
| Rate for Payer: Global Benefits Group Commercial |
$1,380.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,534.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$876.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,423.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$552.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,610.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,610.00
|
| Rate for Payer: Multiplan Commercial |
$1,840.00
|
| Rate for Payer: Networks By Design Commercial |
$1,150.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,955.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,380.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,380.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$863.19
|
| Rate for Payer: United Healthcare All Other HMO |
$840.19
|
| Rate for Payer: United Healthcare HMO Rider |
$822.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$753.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,955.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,955.00
|
|
|
HC CATH VLCNO REVOLUTION IVUS
|
Facility
|
OP
|
$2,633.00
|
|
| Hospital Charge Code |
906812376
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$526.60 |
| Max. Negotiated Rate |
$2,238.05 |
| Rate for Payer: Adventist Health Commercial |
$526.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,238.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,448.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,974.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,525.03
|
| Rate for Payer: Blue Shield of California Commercial |
$1,943.15
|
| Rate for Payer: Blue Shield of California EPN |
$1,279.64
|
| Rate for Payer: Cash Price |
$1,184.85
|
| Rate for Payer: Cigna of CA HMO |
$1,843.10
|
| Rate for Payer: Cigna of CA PPO |
$1,843.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,238.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,238.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,238.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,053.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,053.20
|
| Rate for Payer: Galaxy Health WC |
$2,238.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,579.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,756.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,003.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,629.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$631.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,843.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1,843.10
|
| Rate for Payer: Multiplan Commercial |
$2,106.40
|
| Rate for Payer: Networks By Design Commercial |
$1,316.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,238.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,579.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,579.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$988.16
|
| Rate for Payer: United Healthcare All Other HMO |
$961.83
|
| Rate for Payer: United Healthcare HMO Rider |
$941.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$862.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,238.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,238.05
|
| Rate for Payer: Vantage Medical Group Senior |
$2,238.05
|
|
|
HC CATH VLCNO REVOLUTION IVUS
|
Facility
|
IP
|
$2,633.00
|
|
| Hospital Charge Code |
906812376
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$526.60 |
| Max. Negotiated Rate |
$13,501.00 |
| Rate for Payer: Adventist Health Commercial |
$526.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,501.00
|
| Rate for Payer: Cash Price |
$1,184.85
|
| Rate for Payer: Cash Price |
$1,184.85
|
| Rate for Payer: Cigna of CA HMO |
$1,843.10
|
| Rate for Payer: Cigna of CA PPO |
$1,843.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,053.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1,053.20
|
| Rate for Payer: Galaxy Health WC |
$2,238.05
|
| Rate for Payer: Global Benefits Group Commercial |
$1,579.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,756.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,003.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,629.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$631.92
|
| Rate for Payer: Multiplan Commercial |
$2,106.40
|
| Rate for Payer: Networks By Design Commercial |
$1,316.50
|
| Rate for Payer: Prime Health Services Commercial |
$2,238.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$988.16
|
| Rate for Payer: United Healthcare All Other HMO |
$961.83
|
| Rate for Payer: United Healthcare HMO Rider |
$941.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$862.31
|
|
|
HC CATH VLCNO VISIONS PV IV US
|
Facility
|
OP
|
$3,900.00
|
|
|
Service Code
|
CPT C1753
|
| Hospital Charge Code |
906812508
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,145.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,925.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,258.88
|
| Rate for Payer: Blue Shield of California Commercial |
$2,878.20
|
| Rate for Payer: Blue Shield of California EPN |
$1,895.40
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO |
$2,730.00
|
| Rate for Payer: Cigna of CA PPO |
$2,730.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,315.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,560.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,560.00
|
| Rate for Payer: Galaxy Health WC |
$3,315.00
|
| Rate for Payer: Global Benefits Group Commercial |
$2,340.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,601.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,485.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,414.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,730.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,730.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$1,950.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,340.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,340.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,463.67
|
| Rate for Payer: United Healthcare All Other HMO |
$1,424.67
|
| Rate for Payer: United Healthcare HMO Rider |
$1,393.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,277.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,315.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3,315.00
|
|
