|
HC CATH FOLEY SLCN 18FR 10ML LF
|
Facility
|
OP
|
$25.75
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Adventist Health Commercial |
$5.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.52
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: Cigna of CA HMO |
$16.48
|
| Rate for Payer: Cigna of CA PPO |
$19.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$21.89
|
| Rate for Payer: Global Benefits Group Commercial |
$15.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.02
|
| Rate for Payer: Multiplan Commercial |
$20.60
|
| Rate for Payer: Networks By Design Commercial |
$16.74
|
| Rate for Payer: Prime Health Services Commercial |
$21.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO |
$12.88
|
| Rate for Payer: United Healthcare HMO Rider |
$12.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.89
|
| Rate for Payer: Vantage Medical Group Senior |
$21.89
|
|
|
HC CATH FOLEY SLCN 18FR 10ML LF
|
Facility
|
IP
|
$25.75
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$21.89 |
| Rate for Payer: Adventist Health Commercial |
$5.15
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$21.89
|
| Rate for Payer: Global Benefits Group Commercial |
$15.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.18
|
| Rate for Payer: Multiplan Commercial |
$20.60
|
| Rate for Payer: Networks By Design Commercial |
$16.74
|
| Rate for Payer: Prime Health Services Commercial |
$21.89
|
|
|
HC CATH FOLEY SLCN 18FR 2WY30CC
|
Facility
|
OP
|
$53.05
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Adventist Health Commercial |
$10.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$45.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.04
|
| Rate for Payer: Cash Price |
$23.87
|
| Rate for Payer: Cash Price |
$23.87
|
| Rate for Payer: Cigna of CA HMO |
$33.95
|
| Rate for Payer: Cigna of CA PPO |
$39.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$45.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$45.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.22
|
| Rate for Payer: EPIC Health Plan Senior |
$21.22
|
| Rate for Payer: Galaxy Health WC |
$45.09
|
| Rate for Payer: Global Benefits Group Commercial |
$31.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$19.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$37.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37.13
|
| Rate for Payer: Multiplan Commercial |
$42.44
|
| Rate for Payer: Networks By Design Commercial |
$34.48
|
| Rate for Payer: Prime Health Services Commercial |
$45.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.52
|
| Rate for Payer: United Healthcare All Other HMO |
$26.52
|
| Rate for Payer: United Healthcare HMO Rider |
$26.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$45.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.09
|
| Rate for Payer: Vantage Medical Group Senior |
$45.09
|
|
|
HC CATH FOLEY SLCN 18FR 2WY30CC
|
Facility
|
IP
|
$53.05
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605354
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.61 |
| Max. Negotiated Rate |
$45.09 |
| Rate for Payer: Adventist Health Commercial |
$10.61
|
| Rate for Payer: Cash Price |
$23.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$37.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.22
|
| Rate for Payer: EPIC Health Plan Senior |
$21.22
|
| Rate for Payer: Galaxy Health WC |
$45.09
|
| Rate for Payer: Global Benefits Group Commercial |
$31.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.73
|
| Rate for Payer: Multiplan Commercial |
$42.44
|
| Rate for Payer: Networks By Design Commercial |
$34.48
|
| Rate for Payer: Prime Health Services Commercial |
$45.09
|
|
|
HC CATH FOLEY SLCN 20FR 10ML LF
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607389
|
|
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 20FR 10ML LF
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607389
|
|
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 20FR 30ML LF
|
Facility
|
IP
|
$30.34
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$25.79 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Senior |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Multiplan Commercial |
$24.27
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
|
|
HC CATH FOLEY SLCN 20FR 30ML LF
|
Facility
|
OP
|
$30.34
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607391
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Adventist Health Commercial |
$6.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.47
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Cigna of CA HMO |
$19.42
|
| Rate for Payer: Cigna of CA PPO |
$22.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Senior |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.24
|
| Rate for Payer: Multiplan Commercial |
$24.27
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.17
|
| Rate for Payer: United Healthcare All Other HMO |
$15.17
|
| Rate for Payer: United Healthcare HMO Rider |
$15.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.79
|
| Rate for Payer: Vantage Medical Group Senior |
$25.79
|
|
|
HC CATH FOLEY SLCN 22FR 10ML LF
|
Facility
|
OP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607388
|
|
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 22FR 10ML LF
|
Facility
|
IP
|
$25.67
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607388
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$21.82 |
| Rate for Payer: EPIC Health Plan Senior |
$10.27
|
| Rate for Payer: Galaxy Health WC |
$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: 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 22FR 2WY 30C
|
Facility
|
OP
|
$31.65
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Adventist Health Commercial |
$6.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.31
|
| Rate for Payer: Cash Price |
$14.24
|
| Rate for Payer: Cash Price |
$14.24
|
| Rate for Payer: Cigna of CA HMO |
$20.26
|
| Rate for Payer: Cigna of CA PPO |
$23.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.66
|
| Rate for Payer: EPIC Health Plan Senior |
$12.66
|
| Rate for Payer: Galaxy Health WC |
$26.90
|
| Rate for Payer: Global Benefits Group Commercial |
$18.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.16
|
| Rate for Payer: Multiplan Commercial |
$25.32
|
| Rate for Payer: Networks By Design Commercial |
$20.57
|
| Rate for Payer: Prime Health Services Commercial |
$26.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.82
|
| Rate for Payer: United Healthcare All Other HMO |
$15.82
|
| Rate for Payer: United Healthcare HMO Rider |
$15.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.90
|
| Rate for Payer: Vantage Medical Group Senior |
$26.90
|
|
|
HC CATH FOLEY SLCN 22FR 2WY 30C
|
Facility
|
IP
|
$31.65
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605356
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$26.90 |
| Rate for Payer: Adventist Health Commercial |
$6.33
|
| Rate for Payer: Cash Price |
$14.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.66
|
| Rate for Payer: EPIC Health Plan Senior |
$12.66
|
| Rate for Payer: Galaxy Health WC |
$26.90
|
| Rate for Payer: Global Benefits Group Commercial |
$18.99
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.60
|
| Rate for Payer: Multiplan Commercial |
$25.32
|
| Rate for Payer: Networks By Design Commercial |
$20.57
|
| Rate for Payer: Prime Health Services Commercial |
$26.90
|
|
|
HC CATH FOLEY SLCN 24FR 2WY 5CC
|
Facility
|
IP
|
$39.77
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$33.80 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.91
|
| Rate for Payer: EPIC Health Plan Senior |
$15.91
|
| Rate for Payer: Galaxy Health WC |
$33.80
|
| Rate for Payer: Global Benefits Group Commercial |
$23.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.54
|
| Rate for Payer: Multiplan Commercial |
$31.82
|
| Rate for Payer: Networks By Design Commercial |
$25.85
|
| Rate for Payer: Prime Health Services Commercial |
$33.80
|
|
|
HC CATH FOLEY SLCN 24FR 2WY 5CC
|
Facility
|
OP
|
$39.77
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605360
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.52
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Cigna of CA HMO |
$25.45
|
| Rate for Payer: Cigna of CA PPO |
$29.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.91
|
| Rate for Payer: EPIC Health Plan Senior |
$15.91
|
| Rate for Payer: Galaxy Health WC |
$33.80
|
| Rate for Payer: Global Benefits Group Commercial |
$23.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.84
|
| Rate for Payer: Multiplan Commercial |
$31.82
|
| Rate for Payer: Networks By Design Commercial |
$25.85
|
| Rate for Payer: Prime Health Services Commercial |
$33.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.89
|
| Rate for Payer: United Healthcare All Other HMO |
$19.89
|
| Rate for Payer: United Healthcare HMO Rider |
$19.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.80
|
| Rate for Payer: Vantage Medical Group Senior |
$33.80
|
|
|
HC CATH FOLEY SLCN 24FR 30ML LF
|
Facility
|
OP
|
$32.31
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Adventist Health Commercial |
$6.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.73
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Cigna of CA HMO |
$20.68
|
| Rate for Payer: Cigna of CA PPO |
$23.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.92
|
| Rate for Payer: EPIC Health Plan Senior |
$12.92
|
| Rate for Payer: Galaxy Health WC |
$27.46
|
| Rate for Payer: Global Benefits Group Commercial |
$19.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.62
|
| Rate for Payer: Multiplan Commercial |
$25.85
|
| Rate for Payer: Networks By Design Commercial |
$21.00
|
| Rate for Payer: Prime Health Services Commercial |
$27.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.16
|
| Rate for Payer: United Healthcare All Other HMO |
$16.16
|
| Rate for Payer: United Healthcare HMO Rider |
$16.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.46
|
| Rate for Payer: Vantage Medical Group Senior |
$27.46
|
|
|
HC CATH FOLEY SLCN 24FR 30ML LF
|
Facility
|
IP
|
$32.31
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901607390
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$27.46 |
| Rate for Payer: Adventist Health Commercial |
$6.46
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.92
|
| Rate for Payer: EPIC Health Plan Senior |
$12.92
|
| Rate for Payer: Galaxy Health WC |
$27.46
|
| Rate for Payer: Global Benefits Group Commercial |
$19.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.75
|
| Rate for Payer: Multiplan Commercial |
$25.85
|
| Rate for Payer: Networks By Design Commercial |
$21.00
|
| Rate for Payer: Prime Health Services Commercial |
$27.46
|
|
|
HC CATH FOLEY SLCN 26FR 2WY 5CC
|
Facility
|
OP
|
$57.65
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$49.00 |
| Rate for Payer: Adventist Health Commercial |
$11.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$49.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.99
|
| Rate for Payer: Cash Price |
$25.94
|
| Rate for Payer: Cash Price |
$25.94
|
| Rate for Payer: Cigna of CA HMO |
$36.90
|
| Rate for Payer: Cigna of CA PPO |
$42.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$49.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$49.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$49.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$40.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.06
|
| Rate for Payer: EPIC Health Plan Senior |
$23.06
|
| Rate for Payer: Galaxy Health WC |
$49.00
|
| Rate for Payer: Global Benefits Group Commercial |
$34.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40.35
|
| Rate for Payer: Multiplan Commercial |
$46.12
|
| Rate for Payer: Networks By Design Commercial |
$37.47
|
| Rate for Payer: Prime Health Services Commercial |
$49.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.82
|
| Rate for Payer: United Healthcare All Other HMO |
$28.82
|
| Rate for Payer: United Healthcare HMO Rider |
$28.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$49.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$49.00
|
| Rate for Payer: Vantage Medical Group Senior |
$49.00
|
|
|
HC CATH FOLEY SLCN 26FR 2WY 5CC
|
Facility
|
IP
|
$57.65
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.53 |
| Max. Negotiated Rate |
$49.00 |
| Rate for Payer: Adventist Health Commercial |
$11.53
|
| Rate for Payer: Cash Price |
$25.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$40.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.06
|
| Rate for Payer: EPIC Health Plan Senior |
$23.06
|
| Rate for Payer: Galaxy Health WC |
$49.00
|
| Rate for Payer: Global Benefits Group Commercial |
$34.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.84
|
| Rate for Payer: Multiplan Commercial |
$46.12
|
| Rate for Payer: Networks By Design Commercial |
$37.47
|
| Rate for Payer: Prime Health Services Commercial |
$49.00
|
|
|
HC CATH FOLEY SLCN 28FR 2WY 30CC
|
Facility
|
OP
|
$30.42
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.08 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Adventist Health Commercial |
$6.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.52
|
| Rate for Payer: Cash Price |
$13.69
|
| Rate for Payer: Cash Price |
$13.69
|
| Rate for Payer: Cigna of CA HMO |
$19.47
|
| Rate for Payer: Cigna of CA PPO |
$22.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.17
|
| Rate for Payer: EPIC Health Plan Senior |
$12.17
|
| Rate for Payer: Galaxy Health WC |
$25.86
|
| Rate for Payer: Global Benefits Group Commercial |
$18.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.29
|
| Rate for Payer: Multiplan Commercial |
$24.34
|
| Rate for Payer: Networks By Design Commercial |
$19.77
|
| Rate for Payer: Prime Health Services Commercial |
$25.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.21
|
| Rate for Payer: United Healthcare All Other HMO |
$15.21
|
| Rate for Payer: United Healthcare HMO Rider |
$15.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.86
|
| Rate for Payer: Vantage Medical Group Senior |
$25.86
|
|
|
HC CATH FOLEY SLCN 28FR 2WY 30CC
|
Facility
|
IP
|
$30.42
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901605368
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.08 |
| Max. Negotiated Rate |
$25.86 |
| Rate for Payer: Adventist Health Commercial |
$6.08
|
| Rate for Payer: Cash Price |
$13.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.17
|
| Rate for Payer: EPIC Health Plan Senior |
$12.17
|
| Rate for Payer: Galaxy Health WC |
$25.86
|
| Rate for Payer: Global Benefits Group Commercial |
$18.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.30
|
| Rate for Payer: Multiplan Commercial |
$24.34
|
| Rate for Payer: Networks By Design Commercial |
$19.77
|
| Rate for Payer: Prime Health Services Commercial |
$25.86
|
|
|
HC CATH FOLEY SLCN 6FR 1.5CC
|
Facility
|
OP
|
$131.78
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901602794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.36 |
| Max. Negotiated Rate |
$112.01 |
| Rate for Payer: Adventist Health Commercial |
$26.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$112.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$72.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$98.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$84.56
|
| Rate for Payer: Cash Price |
$59.30
|
| Rate for Payer: Cash Price |
$59.30
|
| Rate for Payer: Cigna of CA HMO |
$84.34
|
| Rate for Payer: Cigna of CA PPO |
$97.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$112.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$112.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$112.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$92.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.71
|
| Rate for Payer: EPIC Health Plan Senior |
$52.71
|
| Rate for Payer: Galaxy Health WC |
$112.01
|
| Rate for Payer: Global Benefits Group Commercial |
$79.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$47.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$92.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$92.25
|
| Rate for Payer: Multiplan Commercial |
$105.42
|
| Rate for Payer: Networks By Design Commercial |
$85.66
|
| Rate for Payer: Prime Health Services Commercial |
$112.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$79.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$65.89
|
| Rate for Payer: United Healthcare All Other HMO |
$65.89
|
| Rate for Payer: United Healthcare HMO Rider |
$65.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$65.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$112.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$112.01
|
| Rate for Payer: Vantage Medical Group Senior |
$112.01
|
|
|
HC CATH FOLEY SLCN 6FR 1.5CC
|
Facility
|
IP
|
$131.78
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901602794
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$26.36 |
| Max. Negotiated Rate |
$112.01 |
| Rate for Payer: Adventist Health Commercial |
$26.36
|
| Rate for Payer: Cash Price |
$59.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$92.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.71
|
| Rate for Payer: EPIC Health Plan Senior |
$52.71
|
| Rate for Payer: Galaxy Health WC |
$112.01
|
| Rate for Payer: Global Benefits Group Commercial |
$79.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$83.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.63
|
| Rate for Payer: Multiplan Commercial |
$105.42
|
| Rate for Payer: Networks By Design Commercial |
$85.66
|
| Rate for Payer: Prime Health Services Commercial |
$112.01
|
|
|
HC CATH FOLEY SLCN 6FR 2WAY 1.5CC
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698667
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$45.68 |
| Rate for Payer: Adventist Health Commercial |
$6.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$45.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.36
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cigna of CA HMO |
$21.31
|
| Rate for Payer: Cigna of CA PPO |
$24.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.32
|
| Rate for Payer: EPIC Health Plan Senior |
$13.32
|
| Rate for Payer: Galaxy Health WC |
$28.30
|
| Rate for Payer: Global Benefits Group Commercial |
$19.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.30
|
| Rate for Payer: Multiplan Commercial |
$26.63
|
| Rate for Payer: Networks By Design Commercial |
$21.64
|
| Rate for Payer: Prime Health Services Commercial |
$28.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.97
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.64
|
| Rate for Payer: United Healthcare All Other HMO |
$16.64
|
| Rate for Payer: United Healthcare HMO Rider |
$16.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.30
|
| Rate for Payer: Vantage Medical Group Senior |
$28.30
|
|
|
HC CATH FOLEY SLCN 6FR 2WAY 1.5CC
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT A4344
|
| Hospital Charge Code |
901698667
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.66 |
| Max. Negotiated Rate |
$28.30 |
| Rate for Payer: Adventist Health Commercial |
$6.66
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.32
|
| Rate for Payer: EPIC Health Plan Senior |
$13.32
|
| Rate for Payer: Galaxy Health WC |
$28.30
|
| Rate for Payer: Global Benefits Group Commercial |
$19.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.99
|
| Rate for Payer: Multiplan Commercial |
$26.63
|
| Rate for Payer: Networks By Design Commercial |
$21.64
|
| Rate for Payer: Prime Health Services Commercial |
$28.30
|
|
|
HC CATH FUHRMAN 10.2FR DRAIN SET
|
Facility
|
OP
|
$596.90
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698639
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$119.38 |
| Max. Negotiated Rate |
$507.37 |
| Rate for Payer: Adventist Health Commercial |
$119.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$507.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$328.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$447.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$361.30
|
| Rate for Payer: Blue Shield of California Commercial |
$302.63
|
| Rate for Payer: Blue Shield of California Commercial |
$459.02
|
| Rate for Payer: Cash Price |
$268.60
|
| Rate for Payer: Cigna of CA HMO |
$417.83
|
| Rate for Payer: Cigna of CA PPO |
$417.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$507.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$507.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$507.37
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$417.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$238.76
|
| Rate for Payer: EPIC Health Plan Senior |
$238.76
|
| Rate for Payer: Galaxy Health WC |
$507.37
|
| Rate for Payer: Global Benefits Group Commercial |
$358.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$379.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$216.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$352.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.26
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$417.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$417.83
|
| Rate for Payer: Multiplan Commercial |
$477.52
|
| Rate for Payer: Networks By Design Commercial |
$298.45
|
| Rate for Payer: Prime Health Services Commercial |
$507.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$358.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$224.02
|
| Rate for Payer: United Healthcare All Other HMO |
$218.05
|
| Rate for Payer: United Healthcare HMO Rider |
$213.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$195.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$507.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$507.37
|
| Rate for Payer: Vantage Medical Group Senior |
$507.37
|
|
