|
HC CATH HMDYLYS KIT 8FR 2LUMEN
|
Facility
|
OP
|
$440.86
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698866
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.17 |
| Max. Negotiated Rate |
$374.73 |
| Rate for Payer: Adventist Health Commercial |
$88.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$374.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$242.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$330.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$266.85
|
| Rate for Payer: Blue Shield of California Commercial |
$223.52
|
| Rate for Payer: Blue Shield of California Commercial |
$339.02
|
| Rate for Payer: Cash Price |
$198.39
|
| Rate for Payer: Cigna of CA HMO |
$308.60
|
| Rate for Payer: Cigna of CA PPO |
$308.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$374.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$374.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$374.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$308.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$176.34
|
| Rate for Payer: EPIC Health Plan Senior |
$176.34
|
| Rate for Payer: Galaxy Health WC |
$374.73
|
| Rate for Payer: Global Benefits Group Commercial |
$264.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$279.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$160.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$260.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$308.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$308.60
|
| Rate for Payer: Multiplan Commercial |
$352.69
|
| Rate for Payer: Networks By Design Commercial |
$220.43
|
| Rate for Payer: Prime Health Services Commercial |
$374.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$264.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$264.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$165.45
|
| Rate for Payer: United Healthcare All Other HMO |
$161.05
|
| Rate for Payer: United Healthcare HMO Rider |
$157.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$144.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$374.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$374.73
|
| Rate for Payer: Vantage Medical Group Senior |
$374.73
|
|
|
HC CATH HYDRO-KIT 16" 12FR COUDE
|
Facility
|
OP
|
$21.48
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$388.84 |
| Rate for Payer: Adventist Health Commercial |
$4.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.78
|
| Rate for Payer: Cash Price |
$9.67
|
| Rate for Payer: Cash Price |
$9.67
|
| Rate for Payer: Cigna of CA HMO |
$13.75
|
| Rate for Payer: Cigna of CA PPO |
$15.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.59
|
| Rate for Payer: EPIC Health Plan Senior |
$8.59
|
| Rate for Payer: Galaxy Health WC |
$18.26
|
| Rate for Payer: Global Benefits Group Commercial |
$12.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.04
|
| Rate for Payer: Multiplan Commercial |
$17.18
|
| Rate for Payer: Networks By Design Commercial |
$13.96
|
| Rate for Payer: Prime Health Services Commercial |
$18.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.74
|
| Rate for Payer: United Healthcare All Other HMO |
$10.74
|
| Rate for Payer: United Healthcare HMO Rider |
$10.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.26
|
| Rate for Payer: Vantage Medical Group Senior |
$18.26
|
|
|
HC CATH HYDRO-KIT 16" 12FR COUDE
|
Facility
|
IP
|
$21.48
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607693
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$18.26 |
| Rate for Payer: Adventist Health Commercial |
$4.30
|
| Rate for Payer: Cash Price |
$9.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.59
|
| Rate for Payer: EPIC Health Plan Senior |
$8.59
|
| Rate for Payer: Galaxy Health WC |
$18.26
|
| Rate for Payer: Global Benefits Group Commercial |
$12.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.16
|
| Rate for Payer: Multiplan Commercial |
$17.18
|
| Rate for Payer: Networks By Design Commercial |
$13.96
|
| Rate for Payer: Prime Health Services Commercial |
$18.26
|
|
|
HC CATH HYDRO-KIT 16" 14FR COUDE
|
Facility
|
IP
|
$34.52
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$29.34 |
| Rate for Payer: Adventist Health Commercial |
$6.90
|
| Rate for Payer: Cash Price |
$15.53
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.81
|
| Rate for Payer: EPIC Health Plan Senior |
$13.81
|
| Rate for Payer: Galaxy Health WC |
$29.34
|
| Rate for Payer: Global Benefits Group Commercial |
$20.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.28
|
| Rate for Payer: Multiplan Commercial |
$27.62
|
| Rate for Payer: Networks By Design Commercial |
$22.44
|
| Rate for Payer: Prime Health Services Commercial |
$29.34
|
|
|
HC CATH HYDRO-KIT 16" 14FR COUDE
|
Facility
|
OP
|
$34.52
|
|
|
Service Code
|
CPT C1758
|
| Hospital Charge Code |
901607695
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$388.84 |
| Rate for Payer: Networks By Design Commercial |
$22.44
|
| Rate for Payer: Multiplan Commercial |
$27.62
|
| Rate for Payer: Adventist Health Commercial |
$6.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$388.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.15
|
| Rate for Payer: Cash Price |
$15.53
|
| Rate for Payer: Cash Price |
$15.53
|
| Rate for Payer: Cigna of CA HMO |
$22.09
|
| Rate for Payer: Cigna of CA PPO |
$25.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.81
|
| Rate for Payer: EPIC Health Plan Senior |
$13.81
|
| Rate for Payer: Galaxy Health WC |
$29.34
|
| Rate for Payer: Global Benefits Group Commercial |
$20.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.16
|
| Rate for Payer: Prime Health Services Commercial |
$29.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.26
|
| Rate for Payer: United Healthcare All Other HMO |
$17.26
|
| Rate for Payer: United Healthcare HMO Rider |
$17.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.34
|
| Rate for Payer: Vantage Medical Group Senior |
$29.34
|
|
|
HC CATH IAB LIGHTWAVE
|
Facility
|
IP
|
$3,607.50
|
|
| Hospital Charge Code |
906812383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$721.50 |
| Max. Negotiated Rate |
$3,066.38 |
| Rate for Payer: Adventist Health Commercial |
$721.50
|
| Rate for Payer: Cash Price |
$1,623.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,525.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,443.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,443.00
|
| Rate for Payer: Galaxy Health WC |
$3,066.38
|
| Rate for Payer: Global Benefits Group Commercial |
$2,164.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,290.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,128.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$865.80
|
| Rate for Payer: Multiplan Commercial |
$2,886.00
|
| Rate for Payer: Networks By Design Commercial |
$2,344.88
|
| Rate for Payer: Prime Health Services Commercial |
$3,066.38
|
|
|
HC CATH IAB LIGHTWAVE
|
Facility
|
OP
|
$3,607.50
|
|
| Hospital Charge Code |
906812383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$721.50 |
| Max. Negotiated Rate |
$3,066.38 |
| Rate for Payer: Adventist Health Commercial |
$721.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,366.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,066.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,984.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,705.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,314.93
|
| Rate for Payer: Cash Price |
$1,623.38
|
| Rate for Payer: Cigna of CA HMO |
$2,308.80
|
| Rate for Payer: Cigna of CA PPO |
$2,669.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,066.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,066.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,066.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,525.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,443.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,443.00
|
| Rate for Payer: Galaxy Health WC |
$3,066.38
|
| Rate for Payer: Global Benefits Group Commercial |
$2,164.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,290.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,309.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,128.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$865.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,525.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,525.25
|
| Rate for Payer: Multiplan Commercial |
$2,886.00
|
| Rate for Payer: Networks By Design Commercial |
$2,344.88
|
| Rate for Payer: Prime Health Services Commercial |
$3,066.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,164.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,164.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,803.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,803.75
|
| Rate for Payer: United Healthcare HMO Rider |
$1,803.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,803.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,066.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,066.38
|
| Rate for Payer: Vantage Medical Group Senior |
$3,066.38
|
|
|
HC CATH, ICP MONITORING PRESSIO
|
Facility
|
OP
|
$3,802.50
|
|
| Hospital Charge Code |
901698600
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$760.50 |
| Max. Negotiated Rate |
$3,232.12 |
| Rate for Payer: Adventist Health Commercial |
$760.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,494.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,232.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,091.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,851.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,440.06
|
| Rate for Payer: Cash Price |
$1,711.12
|
| Rate for Payer: Cigna of CA HMO |
$2,433.60
|
| Rate for Payer: Cigna of CA PPO |
$2,813.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,232.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,232.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,232.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,661.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,521.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,521.00
|
| Rate for Payer: Galaxy Health WC |
$3,232.12
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,414.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,380.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,243.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$912.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,661.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,661.75
|
| Rate for Payer: Multiplan Commercial |
$3,042.00
|
| Rate for Payer: Networks By Design Commercial |
$2,471.62
|
| Rate for Payer: Prime Health Services Commercial |
$3,232.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,281.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,281.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,901.25
|
| Rate for Payer: United Healthcare All Other HMO |
$1,901.25
|
| Rate for Payer: United Healthcare HMO Rider |
$1,901.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,901.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,232.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,232.12
|
| Rate for Payer: Vantage Medical Group Senior |
$3,232.12
|
|
|
HC CATH, ICP MONITORING PRESSIO
|
Facility
|
IP
|
$3,802.50
|
|
| Hospital Charge Code |
901698600
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$760.50 |
| Max. Negotiated Rate |
$3,232.12 |
| Rate for Payer: Adventist Health Commercial |
$760.50
|
| Rate for Payer: Cash Price |
$1,711.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,661.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,521.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,521.00
|
| Rate for Payer: Galaxy Health WC |
$3,232.12
|
| Rate for Payer: Global Benefits Group Commercial |
$2,281.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,414.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,243.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$912.60
|
| Rate for Payer: Multiplan Commercial |
$3,042.00
|
| Rate for Payer: Networks By Design Commercial |
$2,471.62
|
| Rate for Payer: Prime Health Services Commercial |
$3,232.12
|
|
|
HC CATH INDIGO THROM
|
Facility
|
IP
|
$4,875.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000007
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$975.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Cigna of CA HMO |
$3,412.50
|
| Rate for Payer: Cigna of CA PPO |
$3,412.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,412.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,095.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,876.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,170.00
|
| Rate for Payer: Multiplan Commercial |
$3,900.00
|
| Rate for Payer: Networks By Design Commercial |
$2,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,829.59
|
| Rate for Payer: United Healthcare All Other HMO |
$1,780.84
|
| Rate for Payer: United Healthcare HMO Rider |
$1,742.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,596.56
|
|
|
HC CATH INDIGO THROM
|
Facility
|
OP
|
$4,875.00
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
909000007
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$975.00 |
| Max. Negotiated Rate |
$4,143.75 |
| Rate for Payer: Adventist Health Commercial |
$975.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,681.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,656.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,950.84
|
| Rate for Payer: Blue Shield of California Commercial |
$2,471.62
|
| Rate for Payer: Blue Shield of California Commercial |
$3,748.88
|
| Rate for Payer: Cash Price |
$2,193.75
|
| Rate for Payer: Cigna of CA HMO |
$3,412.50
|
| Rate for Payer: Cigna of CA PPO |
$3,412.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,143.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,143.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,412.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,950.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,950.00
|
| Rate for Payer: Galaxy Health WC |
$4,143.75
|
| Rate for Payer: Global Benefits Group Commercial |
$2,925.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,095.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,769.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,876.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,170.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,412.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,412.50
|
| Rate for Payer: Multiplan Commercial |
$3,900.00
|
| Rate for Payer: Networks By Design Commercial |
$2,437.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,143.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,925.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,925.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,829.59
|
| Rate for Payer: United Healthcare All Other HMO |
$1,780.84
|
| Rate for Payer: United Healthcare HMO Rider |
$1,742.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,596.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,143.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,143.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4,143.75
|
|
|
HC CATH INFUSION SL 7FR 16CM SL
|
Facility
|
OP
|
$85.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.05 |
| Max. Negotiated Rate |
$72.48 |
| Rate for Payer: Adventist Health Commercial |
$17.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$46.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$63.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51.61
|
| Rate for Payer: Blue Shield of California Commercial |
$43.23
|
| Rate for Payer: Blue Shield of California Commercial |
$65.57
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Cigna of CA HMO |
$59.69
|
| Rate for Payer: Cigna of CA PPO |
$59.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$72.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$72.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$59.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.11
|
| Rate for Payer: EPIC Health Plan Senior |
$34.11
|
| Rate for Payer: Galaxy Health WC |
$72.48
|
| Rate for Payer: Global Benefits Group Commercial |
$51.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$54.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$50.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$59.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$59.69
|
| Rate for Payer: Multiplan Commercial |
$68.22
|
| Rate for Payer: Networks By Design Commercial |
$42.63
|
| Rate for Payer: Prime Health Services Commercial |
$72.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31.15
|
| Rate for Payer: United Healthcare HMO Rider |
$30.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$72.48
|
| Rate for Payer: Vantage Medical Group Senior |
$72.48
|
|
|
HC CATH INFUSION SL 7FR 16CM SL
|
Facility
|
IP
|
$85.27
|
|
|
Service Code
|
CPT C1751
|
| Hospital Charge Code |
901605390
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17.05 |
| Max. Negotiated Rate |
$14,109.00 |
| Rate for Payer: Adventist Health Commercial |
$17.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14,109.00
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Cigna of CA HMO |
$59.69
|
| Rate for Payer: Cigna of CA PPO |
$59.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$59.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.11
|
| Rate for Payer: EPIC Health Plan Senior |
$34.11
|
| Rate for Payer: Galaxy Health WC |
$72.48
|
| Rate for Payer: Global Benefits Group Commercial |
$51.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$54.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$50.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.46
|
| Rate for Payer: Multiplan Commercial |
$68.22
|
| Rate for Payer: Networks By Design Commercial |
$42.63
|
| Rate for Payer: Prime Health Services Commercial |
$72.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.00
|
| Rate for Payer: United Healthcare All Other HMO |
$31.15
|
| Rate for Payer: United Healthcare HMO Rider |
$30.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.93
|
|
|
HC CATH INLINE SUCTION 5FR 3.0MM
|
Facility
|
IP
|
$101.69
|
|
| Hospital Charge Code |
901604236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.34 |
| Max. Negotiated Rate |
$86.44 |
| Rate for Payer: Adventist Health Commercial |
$20.34
|
| Rate for Payer: Cash Price |
$45.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$71.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.68
|
| Rate for Payer: EPIC Health Plan Senior |
$40.68
|
| Rate for Payer: Galaxy Health WC |
$86.44
|
| Rate for Payer: Global Benefits Group Commercial |
$61.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$64.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$60.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.41
|
| Rate for Payer: Multiplan Commercial |
$81.35
|
| Rate for Payer: Networks By Design Commercial |
$66.10
|
| Rate for Payer: Prime Health Services Commercial |
$86.44
|
|
|
HC CATH INLINE SUCTION 5FR 3.0MM
|
Facility
|
OP
|
$101.69
|
|
| Hospital Charge Code |
901604236
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.34 |
| Max. Negotiated Rate |
$86.44 |
| Rate for Payer: Adventist Health Commercial |
$20.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$66.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$55.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.25
|
| Rate for Payer: Cash Price |
$45.76
|
| Rate for Payer: Cigna of CA HMO |
$65.08
|
| Rate for Payer: Cigna of CA PPO |
$75.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$71.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.68
|
| Rate for Payer: EPIC Health Plan Senior |
$40.68
|
| Rate for Payer: Galaxy Health WC |
$86.44
|
| Rate for Payer: Global Benefits Group Commercial |
$61.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$64.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$60.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71.18
|
| Rate for Payer: Multiplan Commercial |
$81.35
|
| Rate for Payer: Networks By Design Commercial |
$66.10
|
| Rate for Payer: Prime Health Services Commercial |
$86.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$50.84
|
| Rate for Payer: United Healthcare All Other HMO |
$50.84
|
| Rate for Payer: United Healthcare HMO Rider |
$50.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.44
|
| Rate for Payer: Vantage Medical Group Senior |
$86.44
|
|
|
HC CATH INTERMITTENT 14FR FEMALE
|
Facility
|
IP
|
$3.20
|
|
| Hospital Charge Code |
901602782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$2.72 |
| Rate for Payer: Adventist Health Commercial |
$0.64
|
| Rate for Payer: Cash Price |
$1.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.28
|
| Rate for Payer: EPIC Health Plan Senior |
$1.28
|
| Rate for Payer: Galaxy Health WC |
$2.72
|
| Rate for Payer: Global Benefits Group Commercial |
$1.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Multiplan Commercial |
$2.56
|
| Rate for Payer: Networks By Design Commercial |
$2.08
|
| Rate for Payer: Prime Health Services Commercial |
$2.72
|
|
|
HC CATH INTERMITTENT 14FR FEMALE
|
Facility
|
OP
|
$3.20
|
|
| Hospital Charge Code |
901602782
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$2.72 |
| Rate for Payer: Adventist Health Commercial |
$0.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.05
|
| Rate for Payer: Cash Price |
$1.44
|
| Rate for Payer: Cigna of CA HMO |
$2.05
|
| Rate for Payer: Cigna of CA PPO |
$2.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.28
|
| Rate for Payer: EPIC Health Plan Senior |
$1.28
|
| Rate for Payer: Galaxy Health WC |
$2.72
|
| Rate for Payer: Global Benefits Group Commercial |
$1.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.24
|
| Rate for Payer: Multiplan Commercial |
$2.56
|
| Rate for Payer: Networks By Design Commercial |
$2.08
|
| Rate for Payer: Prime Health Services Commercial |
$2.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.60
|
| Rate for Payer: United Healthcare All Other HMO |
$1.60
|
| Rate for Payer: United Healthcare HMO Rider |
$1.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.72
|
| Rate for Payer: Vantage Medical Group Senior |
$2.72
|
|
|
HC CATH INTRAAORTIC 7.5FR 40CC
|
Facility
|
IP
|
$3,771.50
|
|
| Hospital Charge Code |
901698487
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$754.30 |
| Max. Negotiated Rate |
$3,205.78 |
| Rate for Payer: Adventist Health Commercial |
$754.30
|
| Rate for Payer: Cash Price |
$1,697.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,640.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,508.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,508.60
|
| Rate for Payer: Galaxy Health WC |
$3,205.78
|
| Rate for Payer: Global Benefits Group Commercial |
$2,262.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,394.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,225.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$905.16
|
| Rate for Payer: Multiplan Commercial |
$3,017.20
|
| Rate for Payer: Networks By Design Commercial |
$2,451.47
|
| Rate for Payer: Prime Health Services Commercial |
$3,205.78
|
|
|
HC CATH INTRAAORTIC 7.5FR 40CC
|
Facility
|
OP
|
$3,771.50
|
|
| Hospital Charge Code |
901698487
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$754.30 |
| Max. Negotiated Rate |
$3,205.78 |
| Rate for Payer: Adventist Health Commercial |
$754.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,473.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,205.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,074.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,828.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,420.17
|
| Rate for Payer: Cash Price |
$1,697.18
|
| Rate for Payer: Cigna of CA HMO |
$2,413.76
|
| Rate for Payer: Cigna of CA PPO |
$2,790.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,205.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,205.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,205.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,640.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,508.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,508.60
|
| Rate for Payer: Galaxy Health WC |
$3,205.78
|
| Rate for Payer: Global Benefits Group Commercial |
$2,262.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,394.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,369.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,225.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$905.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,640.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,640.05
|
| Rate for Payer: Multiplan Commercial |
$3,017.20
|
| Rate for Payer: Networks By Design Commercial |
$2,451.47
|
| Rate for Payer: Prime Health Services Commercial |
$3,205.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,262.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,262.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,885.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,885.75
|
| Rate for Payer: United Healthcare HMO Rider |
$1,885.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,885.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,205.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,205.78
|
| Rate for Payer: Vantage Medical Group Senior |
$3,205.78
|
|
|
HC CATH INTRAAORTIC 7FR 30CC
|
Facility
|
OP
|
$3,900.00
|
|
| Hospital Charge Code |
901698488
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,558.01
|
| 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 |
$2,502.63
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Cigna of CA HMO |
$2,496.00
|
| Rate for Payer: Cigna of CA PPO |
$2,886.00
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,415.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| 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 |
$2,535.00
|
| 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 |
$1,950.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,950.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,950.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,950.00
|
| 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
|
|
|
HC CATH INTRAAORTIC 7FR 30CC
|
Facility
|
IP
|
$3,900.00
|
|
| Hospital Charge Code |
901698488
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$780.00 |
| Max. Negotiated Rate |
$3,315.00 |
| Rate for Payer: Adventist Health Commercial |
$780.00
|
| Rate for Payer: Cash Price |
$1,755.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,730.00
|
| 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 Foundation Hospitals Commercial/Self Funded |
$2,476.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,301.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$936.00
|
| Rate for Payer: Multiplan Commercial |
$3,120.00
|
| Rate for Payer: Networks By Design Commercial |
$2,535.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,315.00
|
|
|
HC CATH INTRAAORTIC 8FR 50CC
|
Facility
|
OP
|
$3,771.50
|
|
| Hospital Charge Code |
901698486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$754.30 |
| Max. Negotiated Rate |
$3,205.78 |
| Rate for Payer: Adventist Health Commercial |
$754.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,473.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,205.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,074.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,828.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,420.17
|
| Rate for Payer: Cash Price |
$1,697.18
|
| Rate for Payer: Cigna of CA HMO |
$2,413.76
|
| Rate for Payer: Cigna of CA PPO |
$2,790.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,205.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,205.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3,205.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,640.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,508.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,508.60
|
| Rate for Payer: Galaxy Health WC |
$3,205.78
|
| Rate for Payer: Global Benefits Group Commercial |
$2,262.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,394.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,369.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,225.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$905.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,640.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,640.05
|
| Rate for Payer: Multiplan Commercial |
$3,017.20
|
| Rate for Payer: Networks By Design Commercial |
$2,451.47
|
| Rate for Payer: Prime Health Services Commercial |
$3,205.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,262.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,262.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,885.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1,885.75
|
| Rate for Payer: United Healthcare HMO Rider |
$1,885.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,885.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,205.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,205.78
|
| Rate for Payer: Vantage Medical Group Senior |
$3,205.78
|
|
|
HC CATH INTRAAORTIC 8FR 50CC
|
Facility
|
IP
|
$3,771.50
|
|
| Hospital Charge Code |
901698486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$754.30 |
| Max. Negotiated Rate |
$3,205.78 |
| Rate for Payer: Networks By Design Commercial |
$2,451.47
|
| Rate for Payer: Multiplan Commercial |
$3,017.20
|
| Rate for Payer: Adventist Health Commercial |
$754.30
|
| Rate for Payer: Cash Price |
$1,697.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,640.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,508.60
|
| Rate for Payer: EPIC Health Plan Senior |
$1,508.60
|
| Rate for Payer: Galaxy Health WC |
$3,205.78
|
| Rate for Payer: Global Benefits Group Commercial |
$2,262.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,394.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,225.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$905.16
|
| Rate for Payer: Prime Health Services Commercial |
$3,205.78
|
|
|
HC CATH INTRAAORTIC 9FR 50ML
|
Facility
|
OP
|
$3,317.46
|
|
| Hospital Charge Code |
901608083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.49 |
| Max. Negotiated Rate |
$2,819.84 |
| Rate for Payer: Vantage Medical Group Senior |
$2,819.84
|
| Rate for Payer: Adventist Health Commercial |
$663.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,175.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,819.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,824.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,488.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,128.81
|
| Rate for Payer: Cash Price |
$1,492.86
|
| Rate for Payer: Cigna of CA HMO |
$2,123.17
|
| Rate for Payer: Cigna of CA PPO |
$2,454.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,819.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,819.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,819.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,322.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.98
|
| Rate for Payer: EPIC Health Plan Senior |
$1,326.98
|
| Rate for Payer: Galaxy Health WC |
$2,819.84
|
| Rate for Payer: Global Benefits Group Commercial |
$1,990.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,106.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,204.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,957.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$796.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,322.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,322.22
|
| Rate for Payer: Multiplan Commercial |
$2,653.97
|
| Rate for Payer: Networks By Design Commercial |
$2,156.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,819.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,990.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,990.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,658.73
|
| Rate for Payer: United Healthcare All Other HMO |
$1,658.73
|
| Rate for Payer: United Healthcare HMO Rider |
$1,658.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,658.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,819.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,819.84
|
|
|
HC CATH INTRAAORTIC 9FR 50ML
|
Facility
|
IP
|
$3,317.46
|
|
| Hospital Charge Code |
901608083
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$663.49 |
| Max. Negotiated Rate |
$2,819.84 |
| Rate for Payer: Adventist Health Commercial |
$663.49
|
| Rate for Payer: Cash Price |
$1,492.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,322.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,326.98
|
| Rate for Payer: EPIC Health Plan Senior |
$1,326.98
|
| Rate for Payer: Galaxy Health WC |
$2,819.84
|
| Rate for Payer: Global Benefits Group Commercial |
$1,990.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,106.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,957.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$796.19
|
| Rate for Payer: Multiplan Commercial |
$2,653.97
|
| Rate for Payer: Networks By Design Commercial |
$2,156.35
|
| Rate for Payer: Prime Health Services Commercial |
$2,819.84
|
|
